Measles Vaccination Information for the Immigrant Community in Iowa

What to know..

Jun 13, 2025

Last month, I had a chance to sit down and do an interview with Christina Fernandez Morrow, with Hola America and RIVA (Refugees and Immigrant Voices in Action), and Dr. Jimmy Reyes, who is a healthcare provider in Des Moines. RIVA is an amazing organization doing great work in our communities. Please check out their website and consider how you might be able to help them continue their work.

Christina and Dr. Reyes present basic information regarding the measles vaccine, how to get them, and the importance for enough of us to get the vaccination so we can reach herd immunity.

During the interview, I misremembered the number of measles deaths in Texas because my brain is leaky. I apologize for that.

Since the interview took place, we now have three confirmed cases of measles in Iowa, which makes this interview even more important. Please consider sharing it widely.

The video of the interview is below, followed by a transcript.

Me: Hello, everybody. I'm here today with Christina Fernandez-Morrow, with Hola America, and also with RIVA. Refugees and Immigrant Voices in Action, and Dr. Jimmy Reyes, who is a healthcare provider in Des Moines. So welcome, everybody.

Dr. Reyes: Thank you, Robert. Good to have you.

Christina: Nice to be here.

Me: Christina, could you tell us a little bit about RIVA?

Christina: Yes, so Refugee and Immigrant Voices in Action is what it stands for, RIVA, and they've been providing reliable and accurate up-to-date information about healthcare and preventative care since 2020.

So during the pandemic, there was a lot of confusion over what folks should be doing. People weren't sure when and where to get vaccines, how they can protect themselves and their families, and especially when you got into communities that weren't as familiar with English, it was really hard for them to find information that was accurate and up-to-date. And so they created a multilingual helpline, and it has actually continued since then.

It's grown, it's served hundreds of people, and they are pairing that with their community health navigators to help them reach really the most susceptible, hard-to-reach populations who need this information about the measles and when and where to be vaccinated. So this campaign really is uniting health and community across Iowa to eliminate confusion and misinformation about the spread of measles, and to let Iowans know about the access to vaccinations, and hopefully they'll also get screenings and start kind of a regular medical care in their lives so they can stay healthy overall.

Me: Well, great. Well, thank you. And one of the major focus of what we want to do is talk about measles and teach people something about measles and the importance of getting vaccinations, and that's why Dr. Jimmy Reyes is here. Dr. Reyes, could you tell us a little bit about yourself, your practice, and then what we need to know about measles?

Dr. Reyes: Sounds good, Robert. And again, good morning, everyone, and thank you so much for giving us this platform to have some discussions about health and wellness and prevention. And also, I want to clarify that, yes, I'm a doctor, but I'm also a nurse practitioner. So I do need to say that to ensure that there is a differentiation.

I work with my physician colleagues and their experts, and I had the opportunity to be trained at the University of Iowa College of Nursing for 10 years, and I moved to the United States when I was 16 years old. I'm from Chile originally, and my parents wanted a different life for us, a better future, so that's why we moved to the United States. And I always knew I wanted to be a nurse because my grandmother was a public health nurse back in Chile, and she would take me with her to see patients out in the community.

So that gave me a passion to become empowered and help patients in communities that are underserved to help them and connect them with resources. Now I feel that I'm from Iowa. I would say that I'm from Iowa now.

I've been here for 25 years, and it's been a home. My parents have moved here. We have lots of friends and families.

I have very strong roots in Iowa, and I believe in the work that we're doing. Working with RIVA and other organizations have really given us a platform to not only talk about prevention and wellness, but also to empower and raise the voices of different community members, especially those that don't have a voice in the state. As we know today, we have several diseases, chronic conditions, many discussions about vaccine safety and what it is and what it isn't.

Whether, again, if you're a parent, a grandparent, a teacher, or a community leader, I think this conversation is for all of us, right? Our communities, again, continue to face health threats. We've had the COVID pandemic five years ago now that I cannot believe it's been five years already, but we know that new diseases will emerge. We know that old ones will also return, unfortunately, like measles.

And in this podcast, in this forum, we'll talk a little more about why vaccines are safe, how measles spreads, and what we can do and the power that each one of us have in order to protect our families, our neighbors, and also our communities. Again, I just want to highlight that this isn't about fear. It's about facts, science, and also community care, right? Community empowerment.

So thank you so much for having us.

Me: Yes, it's great. This is an important message to get out this time. There's lots of misinformation out there, and I'm surprised that measles is back. I had measles when I was a kid, and it wasn't fun, and we were frightened about it. We believed in vaccinations. I mean, we really did. There was a young woman across the street from me that had polio. We were all anxious to get our polio vaccines. We believe in our vaccines. We know that they saved lives, but somehow, measles is back. It was nearly eradicated. That's correct?

Dr. Reyes: That is correct, Robert. It's been eradicated for almost about 20 years or so. We did have a couple of outbreaks the past five, seven years, but I think it's been a culmination, again, of some vaccine hesitancy, some questions about safety, also some individuals that cannot get vaccinated because of their immunocompromised system, like cancer or something else, or perhaps a religion exemption.

But what has happened is that we need to keep that 95% threshold to have herd immunity, meaning that we need to protect, and that will protect everyone around you. But if we don't achieve that at least 95% of herd immunity, then we're weakened, right, as a community. And perhaps even if you are healthy and you've had the vaccine, you may still be exposed to the virus because, again, it's a specific virus that causes a lot of, again, issues with hospitalizations, and that's what we're trying to prevent.

Before the vaccine was created, it appeared, looking at the data, that nearly every child got measles before the age of 15. And, Robert, you are one of those individuals, unfortunately, before 1971, when the vaccine wasn't available, that most people were exposed and had that disease. And during that time, there were about 400 to 500 deaths annually in the United States, which, again, caused about 48,000 hospitalizations.

And, again, a lot of the challenges with that, with measles that we don't talk about because we haven't seen it for so long, is complications with encephalitis, right, inflammation of the brain, brain damage, etc. So it's a very deadly disease that we're trying to, you know, mitigate and also reduce the risk of anyone getting that. And so what has also happened is that there's a lot of misinformation, right? There's a rise of a lot of social media platforms, but unfortunately, there's also a lot of misinformation that is not supported by evidence.

So that's how we have seen outbreaks of, again, in certain locations, you know, starting in Texas this time around, especially in a specific community where, unfortunately, many children were not vaccinated. So the 95% threshold was very, very low. We know that, again, measles is a highly contagious viral condition that, again, starts with a fever.

Somebody can get a cough, a runny nose, red eyes. And after that, there's this red rash that we typically see on the face and also in the rest of the body. But measles, it's more than just a rash, right? It also can impact, again, pneumonia.

The person can develop that. They can also have ear infections. What's more complicated is that encephalitis, right, that inflammation of the brain and the brain swelling, and that then can cause death.

I mean, typically one out of three, out of 1,000 children can die from it. So, but again, the main message is that prevention is key, right? Getting the vaccine, having your children immunized and vaccinated with those two doses, and also those that are coming to the United States, if they only had one dose, they can still get the second one. But I would highly encourage that they go to their healthcare provider to talk about it and where they are and also to see if they're eligible to receive the second dose so they can have full immunity towards measles.

(below is my error)

Me: One of the things that you said was a little unnerving. You said that there was, I think you said there were about 500 deaths a year before there was a vaccination. And if my memory is correct, there's been 400 or so deaths in the past year in just Texas and maybe a few in Mexico.

It spread to Mexico, right? So is it possible this is a more, I guess you would say virulent, I don't know, strain of measles? Because with what vaccination rate we have now, we wouldn't expect approximately the same number of deaths as before there was the vaccination. Is that a possibility?

Dr. Reyes: It is a possibility. But again, I think it is being contained at the moment.

I think public health is doing the best that they can with the information that they have in order to contain the outbreak, right? We know that right now, as of today, and I checked the news this morning, it appears that about 25 to 26 states have had some type of outbreak on measles. And we know that unfortunately, three deaths have happened. And unfortunately, those three deaths were with children, among children that were unvaccinated in that particular community.

So again, it's, you know, getting back to that, talking about the 95% threshold, right? And what had happened is that in those communities, that 95% threshold of herd immunity wasn't, it wasn't created, it didn't have that type of herd immunity that we need in order to protect everyone, especially those who cannot get vaccinated, like the newborns, for example, right? They cannot get vaccinated yet because the first dose has to happen when you're about one year old or so. And also with people with immune conditions. And so yes, you know, the numbers are not the same how they used to be before 1971, when we had hundreds of deaths.

Right now, this year only, we've had three, hopefully not more. But again, it's something that we need to watch for. I think the big message is that, again, vaccines do work.

They do not cause, you know, there's lots of myths about other, that they cause other conditions. You know, I would say that yes, there is like a somebody gotta have pain on the side, you know, nobody likes to get vaccines. I mean, you see a needle, and you know, people are scared, there's fluid going inside.

But again, it's a very weakened dose of that virus or bacteria that is going in your body to help you develop that immunity in case you are exposed to that. And that's what creates that herd immunity. So making sure that, again, the key message is to make sure that your children, adolescents are always getting those vaccines to protect them from diseases that we haven't seen in a long time.

I think, Robert, you mentioned polio and others. We haven't seen that in a very long time. We do see that in, unfortunately, in low-income countries.

We do work in Nigeria, and I've seen cases, severe cases of patients that have developed, you know, complications from measles, polio, etc. But we live in a high-income country that really, you know, we have the ability to protect everyone.

Christina: And I'd like to add to that when people think that, well, it's not in Iowa or, you know, it's only in 25 to 26 states. Iowa is really prime at this point to get an outbreak for several reasons. One is that the herd immunity means that at least 95% of enrolled school children have the appropriate vaccines. They've gotten the two that's needed to protect themselves and protect others.

Well, that number in Iowa has been steadily decreasing since 2020. So in 2020, we had the numbers to say that we could rely on herd immunity. We no longer do.

As of 2024, the number dropped below that 95%. Now that we see that the weather is getting warmer, we are starting to travel more. People are traveling into the state.

There are several, you know, I mean, there's hundreds of events going on across Iowa that are going to bring people together, whether it's festivals, fairs, you know, people just generally, we've been locked up in our homes. We want to get out. We want to mingle with other people.

That's all of those have the potential, not to mention that neighboring states have already reported cases. So it is at our back door. And I think what RIVA learned during 2020, when they were serving the community, was that 85% of the essential workers who contacted their helpline caught COVID during that first wave.

85% of people who had no choice but to be in places and in situations where they were susceptible to contracting COVID. So knowing that measles, you know, one person can spread measles to about 18 people. One person could have spread COVID to three.

So when you put all of that together, we are really trying to get ahead of this so that it doesn't become a statewide crisis so that we don't see our health care system being as pushed to the limit as it was with COVID. And the best way to do that is to make sure that the community is informed, that they're booking their vaccination checkups, that they have a plan to ensure that their family is vaccinated, that they understand how to stay healthy. So if someone does contract measles, they have a greater chance of survival and to know what to look for, what to do.

So if you think that your child has measles, do you run to a crowded emergency room where they can spread it to others? You know, what we want to make sure that the entire community, that every Iowan understands the dangers of measles and how to protect themselves and the community at large.

Me: Great. Thank you. I need to acknowledge an error. I misremembered the death statistics and I apologize for that. And thank you for clarifying.

So I guess for a whole lot of people, I mean, this information needs to go to everybody, but for a whole lot of people, immigration status is unknown. Even if you think you know it, there's been instances where whatever the exact status is, it's been ignored in some cases. And so I guess I'm just, we need to get everybody to get the vaccination, but these are uncertain times. Is there anything people should worry about?

Christina: Well, I guess to clarify, are you saying like, is there additional danger with having immigrants, like additional public health dangers having immigrants in the state? I just want to make sure I understand your question.

Me: No, I'm not. No, not at all. What I'm saying is I have friends that are here legally, but they're still concerned and they're concerned about their children. And do they have anything to worry about going to the doctor? That's my concern.

Christina: Thank you. Thank you for clarifying. No, not at all. And Dr. Reyes can speak more to this, but one of the main messages that our community health navigators want to get out there is that vaccinations in the state of Iowa are free and so you don't need insurance and you don't need to have documentation.

At this point, there are several partners that are working with RIVA to make sure that they have clinicians available and vaccines available for anyone who walks through the door. No question about insurance or status, citizenship, documentation. Jimmy, I'll let you speak to that.

Dr. Reyes: Thank you, Christina. That's a good segue in to answer some of your questions, Robert. So, for example, the questions that we're getting quite often are about adults who perhaps are coming to the states that don't know their immunization status, right? They don't recall if they've received the MMR vaccine.

So we are recommending now, and this is the latest and greatest from the CDC today, you know, the guidance may change, but as of right now, we know that adults born after 1957 who don't have two documented doses should get vaccinated, right? And that's the recommendation. They should go to their health care provider. Christina, you talked about several public health agencies.

I would agree with that. I think, you know, they do have the power and the ability to administer those vaccines. So those are the best places to go, either free of charge or a very low cost.

Also, anyone that is doing international travel, right? Many of us U.S. citizens going to other countries, making sure that we also have our list of vaccines. Another question that has also come up is about what about religious or cultural objections, right? And so I would say that based on my understanding, that most religions, including Catholic, Protestants, Jewish, and Muslim traditions, do support vaccines to protect life and preventing suffering. That being said, we know that we must meet people with compassion and understanding, right? Especially those who are immigrant or undocumented, or perhaps because of other religious objections, they do not choose to vaccinate their children because of fear of government programs, et cetera.

But again, I think we need to have a discussion that, again, compassion, understanding, and supporting those parents to have a discussion for them to make an informed decision, right? We don't want to force anything towards anyone, but I think education is key and the correct information is very important, right? We have so much misinformation right now, so much data that is, again, on our phones on a daily basis. So it's hard to know what to believe, what is real, what is not, and especially about myths about autism, right? I just want to address that quickly, if I may. So I looked into this in more detail, and it appears that in 1998, there was a study that falsely linked MMR to autism, but that study was retracted, and that author lost his medical license.

And ever since 1998, there has been tons of large studies that have found no link between vaccines and autism. But unfortunately, because of misinformation, that message was still propagated, and so that's misinformation that's happening now. And so I think it's important to understand that vaccines do not cause autism.

Autism is a real condition, but again, there are other factors that cause that, such as genetic factors, but we can talk about it at a later time. But I just want to be clear that that is a type of misinformation that unfortunately scares a lot of parents for them to decide not to vaccinate their children, which it's not true.

Christina: And what we have found with non-English social media sources is that a lot of that misinformation is rampant in other languages, and that some of the studies and information that has been translated is not translated correctly, and so that also helps to spread misinformation and fear.

And one of the things that we are really trying to combat is that perpetuance of fear from misinformation, from misguided advice that comes off of social media in communities of different languages.

Me: Wow. That's sad to hear that there might be more information in those communities than we have in the English-speaking world, because it seems like we're full of it, lots of misinformation. What else do we need to address today, Dr. Reyes?

Dr. Reyes: I would say, you know, like how Christine and I shared in the beginning, all of us play a huge role in creating this herd immunity, right? So the things that we can do that we have control over is as parents, grandparents, is to check our immunization records, right? Making sure that our children, that all of us have the correct immunizations, vaccines. So that's one thing that we have control over, checking our documents, making sure that we have that protection. The second one is to, again, get your children caught up with any vaccines, right? I'm thinking of my nephew and my niece.

They are seven and nine years old. I talk to my sister all the time. She's asking me questions about when they should get their additional vaccines.

She's asking me questions about the HPV vaccine, because they're getting to that age where they might be exposed to that and we want to protect them. And those are great questions, right? It's good to question the status quo. It's good to question why we need certain vaccines and what they could cause if we don't get them.

Also talking to others, that's another power that we have. You know, encourage family conversations, friends, right? I know that those conversations can be very tenuous. They can be very, you know, there's a lot of passion that goes into that and lots of personal beliefs, and nobody wants to be attacked, right? We all have our own personal space and our beliefs, but again, talking in a way that is, again, engaging.

It's okay to disagree at the end of the day, but again, you know, coming in within a place that you are compassionate, that you are really wanting to help another person. And last but not least, connecting all of us with local resources. You know, Christina, she does a great job with RIVA, communicating the information.

RIVA is one of the organizations that really helps connect a lot of the resources for the social drivers of health, nutrition, physical activity, et cetera, to communities perhaps that don't have a voice. Also with My Health Iowa, the nonprofit that we are working in, we provide health screenings for blood pressure, blood sugar. So we go to communities, barber shops, health fairs, et cetera, and again, to empower others.

So it's good to be out there. It's good that now we have the ability to be outside. It's May already, and now the better weather is going, it's coming our way.

So sunnier times, warmer days, and again, new challenges, right? We're going to be outside, exposed to pollens. Right now, many of my patients are complaining of allergies, and so we're talking about allergies quite often. Also with sunscreen, right? Skin cancer, being outside, and exposure.

So again, every month brings new challenges, but I think that the key message is to make sure that, again, check your immunization records, get your children caught up with vaccines, talk to your family and friends about these topics, and also connect with local resources.

Me: Well, fantastic. Anything else you'd like to add, Christina?

Christina: I think I would just like to say that if you're not sure where to go, you can always go on RIVA website.

You can Google R-I-V-A Iowa, anywhere that RIVA community and outreach folks have been quoted on the topic. You can also find their 1-800 number there to call and get more information, and as Janice said, please, if you hear this podcast and you've heard some statistic that really surprises you, share that and share this podcast so that folks can get the accurate, up-to-date information that Dr. Reyes has researched. And he stays on top of this as being one of the main go-to people, not only for myself, but also for all of the folks on the ground who are doing the outreach, who are speaking at churches, who are speaking to parents, who are going into areas that are harder to reach, like rural communities, and talking to folks there about where they can get the vaccine and why it's so important.

I think the biggest thing that we can do is to make sure that this information gets out, and we can do that by sharing this podcast.

Me: And there'll be opportunities to comment, too, and so, yeah, if you have questions, just leave a comment. And anything else? You seem to sum it up pretty well, Dr. Reyes. Just want to check and make sure there isn't anything else to add.

Dr. Reyes:

Thank you again so much for the opportunity to have us here in your space, and happy to share information. And again, I want to highlight that there is always new information.

You know, as providers and social workers, we always get new information every day. Science is always changing, so making sure that we all keep up to date with the latest and greatest. The guidance that we're giving today may change tomorrow, but again, we're doing our best to ensure that we can empower everyone, because your health is your power, right? Making sure that you have the ability to make informed decisions.

We'll do our best to provide you with the best information. Please ask us any questions, and always contact your healthcare provider if you have concerns or other questions. So, thank you so much.

Me: Thank you, and thank you to our audience, and thanks for listening, for watching, and thank you, Christina, Dr. Reyes, for your important work. We very much appreciate it. Thank you.

Both: Thank you for having us.

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