Testing moms for measles immunity

If an expectant mom lacks immunity to measles, Irene Stafford, MD, MPH, wants to know about it before the patient contracts the disease, and three nurse practitioner students from Cizik School of Nursing at UTHealth Houston are working with her to improve screening processes.

Measles, one of the most contagious diseases known to humankind, poses particular risks to moms-to-be and their babies. It puts women at increased risk for miscarriage, premature labor, and potentially life-threatening complications like pneumonia. Babies can be born with respiratory problems when moms contract the illness late in pregnancy.

Unfortunately, the measles, mumps, and rubella (MMR) vaccine that most of us received as children can’t be given to pregnant women because it contains a live but weakened virus. Instead, women who get measles while pregnant can receive immunoglobulin G (IgG), a naturally occurring antibody extracted from donated blood plasma that reduces the risk of severe disease. The treatment must be administered within a few days of contracting the disease, so knowing a patient’s immunity status in advance saves precious time.

“This is one of the most important women’s health projects I have worked on in my career,” Stafford said. “Measles is not gone. It’s coming back. We decided to counterpunch by finding out whether patients are vaccinated or not. If we know their serology status ahead of time, we can be reassured that they are safe from measles, or we can be prepared to give them IgG faster.”

Stafford is the associate program director of the Maternal-Fetal Medicine Fellowship at McGovern Medical School at UTHealth Houston. She specializes in high-risk pregnancies complicated by infectious disease and is currently principal investigator on a research project, “Modernizing Perinatal Syphilis Testing,” which is funded by the National Institute of Child Health and Human Development of the National Institutes of Health.

Her goal with the measles project is to establish a workflow for providers that prompts them to verify vaccination documents for pregnant patients, order serology tests to determine immunity status if needed, and encourage postpartum moms to get vaccinated.

During the Spring 2026 semester, Stafford is serving as project liaison for three nurse practitioner students. Each will focus on different aspects of the intervention for the final quality improvement project required for their Doctor of Nursing Practice (DNP) degree.

Courtney McDuffie, RN, BSN, and Erika Martinez, RN, BSN, both family nurse practitioner (FNP) students, are assigned to UT Physicians in the Texas Medical Center. Meanwhile, psychiatric/nurse practitioner (PMHNP) student Cassandra Davidson, RN, BSN, focuses on Harris Health Lyndon B. Johnson General Hospital (LBJ). FNP student Skye Madsen plans to join the team in the summer semester.

The students are working together on presentations, posters, pamphlets, and modified order sets designed to remind providers about the need for serology tests. They will conduct provider surveys and chart audits to gauge the intervention’s effectiveness in increasing measles serology screening rates.

“Providers have a lot to do when they open Epic [the electronic health record], but ordering serology tests is not something we can skip,” said Davidson. She hails from Nigeria, where she has seen the catastrophic effects of measles outbreaks.

Each student brings a different perspective and nursing background to the multidisciplinary team. Davidson’s 4 ½ years in nursing includes working in pediatrics, mother/baby units, and psychiatric nursing. At LBJ, she sees many low-income and immigrant patients, about 40% of whom are susceptible to measles. She is interested in vaccine hesitancy and hopes to survey postpartum mothers about their attitudes toward getting the MMR shot.

McDuffie is working on with providers who treat high-risk patients in UTHealth Houston’s maternal/fetal medicine clinic. She has spent most of her 10 years as an emergency department nurse and wants to become an FNP to teach and promote public health programs.

Martinez works upstairs from McDuffie in a clinic that sees a lower-risk population of pregnant women. She has four years of experience in emergency departments and adult medicine and is seeking her FNP to help fill the need for Spanish-speaking providers.

“I want to be one of those providers who has the same culture as my patients and can speak the language,” she said.

The students are grateful for the opportunity to advocate for pregnant patients, and they share a common admiration for Stafford.

“She embodies everything a doctor and a leader should be,” McDuffie said. “She’s one of those people who authentically cares about what you have to say and what you bring to the table.”

Stafford is equally impressed by the students and Cizik School of Nursing.

“The DNP students have mad skills,” Stafford said, recalling how one jumped up to attend to a patient who had lost an IV port and needed a blood draw. “They have learned Epic and know how to query data, but their learning style is far more focused on direct patient care and excellent communication skills rather than an overemphasis on academic knowledge.”

She strongly encourages other physicians to precept and mentor DNP students.

“We are not providing health care by ourselves. We are a team and are so interdependent on one another,” Stafford said. “By working with and mentoring nurse practitioner students, we are bringing in a freshness and new perspectives. We can really grow with each other.”

Sherri Deatherage Green