RiverStone Health Immunization Clinic

As many diseases are vaccine preventable, the RiverStone Health Immunization Clinic provides protection from disease through immunizations. Please remember to bring all immunization records with you to each visit.


The yearly flu shot is the best available prevention and the best protection against influenza, an upper respiratory illness spread mainly through coughing, sneezing and close contact with an infected person. A person with influenza can spread it to others for up to 24 hours before having symptoms.

The Centers for Disease Control and Prevention (CDC) recommends that everyone, six months and older get vaccinated every year.  There are very few exceptions to that recommendation.  Each year, the vaccine changes to protect against the strains that are expected to circulate.  Some vaccines will protect against three different strains while others protect against four different strains.  Seniors can get a high-dose vaccine, which may increase their protection.

Other prevention methods are:

  • Avoiding close contact with sick people.
  • Limiting contact with others if you are sick to avoid infecting them.
  • If you have flu-like symptoms, the CDC recommends staying home for at least 24 hours after your fever is gone except to get medical care or for other necessities. Your fever should be gone for 24 hours without the use of a fever-reducing medicine.
  • Covering your nose and mouth with a tissue when you cough or sneeze and throwing the tissue in the trash after using it.
  • Washing your hands often with soap and water. If soap and water are not available, use an alcohol based hand rub.
  • Avoiding touching your eyes, nose and mouth, to avoid spreading germs.
  • Cleaning and disinfecting surfaces and objects that may be contaminated with germs.


If you do get the flu, you may need to see your healthcare provider. Influenza is a virus so antibiotics cannot help unless the flu has led to another illness caused by bacteria, such as pneumonia.  Antivirals may be prescribed in some circumstances, and they are most effective if given early in the course of illness.

Frequently Asked Questions about Measles

In light of the measles outbreak in Washington State, here are some answers to some common questions about measles:

What’s the situation with measles in Washington State?

The measles outbreak in Washington State has spread, causing some Montanans to worry. As of February 19, there were 62 confirmed cases in two Washington counties and four confirmed case in Oregon linked to the outbreak.  For more current updates visit the Washington State Department of Health:

How worrisome is the situation for Montanans?

A letter to Yellowstone County parents with unvaccinated children

Most Montanans have been vaccinated against measles. Two doses of the vaccine are considered to be 97-percent effective in protecting against measles.  Anyone born before 1957 is presumed to be protected because measles cases were so widespread before the vaccine program was developed in the early 1960s. See this CDC link for more information. 

Measles is highly contagious and anyone who has never been vaccinated and was born after 1957 is at higher risk if they come into contact with someone who has the virus that causes measles.

How serious is measles?

While some people think of measles as just a little rash and fever, but measles can cause serious health complications, especially in children younger than 5 years of age.

  • About 1 in 4 people in the U.S. who get measles will be hospitalized
  • 1 out of every 1,000 people with measles will develop brain swelling, which could lead to brain damage
  • 1 or 2 out of 1,000 people with measles will die, even with the best care

How can I protect myself?

The best protection against measles is a safe and highly effective vaccine for measles-mumps-rubella (MMR). The MMR vaccine provides long-lasting protection against all strains of measles. A child needs two doses of MMR vaccine for the best protection. One dose of measles vaccine is about 93 percent effective at preventing measles if exposed to the virus. Two doses are about 97 percent effective.

What are common measles symptoms?

Symptoms commonly appear eight to 12 days after exposure to an infected person and the rash appears a few days later. If you have been exposed to measles and develop fever, runny nose, cough, red eyes, or rash, stay home and call your healthcare provider immediately.

How easily can measles spread?

Measles is very contagious. It spreads through the air when an infected person coughs or sneezes. It is so contagious that if one person has it, 9 out of 10 people around him are likely to become infected if they are not protected. You can get measles just by being in a room where a person with measles has been, even up to two hours after that person has left. You can spread measles to others before you know you have the disease. It is contagious from four days before the measles rash develops through four days afterward.

How do measles outbreaks occur?
Routine measles vaccination of children has made measles a rare disease in the United States. There are occasional outbreaks of the disease in this country, but it is still common in many parts of the world. Worldwide, more than 89,000 people, mostly children, die from the disease.  Measles outbreaks typically start in the United States by unvaccinated travelers, both Americans and foreign visitors, who get measles while they are in other countries. The disease still occurs in parts of Europe, Africa, Asia, and the Pacific.

Am I protected against measles?

The Centers for Disease Control and Prevention considers you protected from measles if you have written records showing at least one of the following:

You received two doses of measles-containing vaccine, and you are:

  • A school-aged child (grades K-12)
  • An adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, healthcare personnel, and international travelers.

You received one dose of measles-containing vaccine, and you are:

  • A preschool-aged child
  • An adult who will not be in a high-risk setting for measles transmission.

You are also considered protected if a laboratory confirmed that you had measles at some point in your life or confirmed you are immune to measles.  If you were born before 1957, when measles was a very widespread childhood illness, you are also considered protected.

If you are unsure whether you’re immune to measles and cannot find your vaccination records or a record of measles immunity, you should get vaccinated with MMR vaccine. There is no harm in getting another dose of MMR vaccine if you may already be immune.

How common was measles in the United States before the vaccine?

Before the measles vaccination program started in 1963, about 3 to 4 million people got measles each year in the United States. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling) from measles.

Is measles still a concern for the United States?

Yes. Since measles is still common in many countries, travelers will continue to bring this disease into the U.S. Measles is highly contagious, so anyone who is not protected against measles is at risk of getting the disease. People who are unvaccinated for any reason, including those who refuse vaccination, risk getting infected with measles and spreading it to others. They may also spread measles to people who cannot get vaccinated because they are too young or have specific health conditions.

Research shows that people who refuse vaccines tend to group together in communities. When measles gets into communities with pockets of unvaccinated people, outbreaks are more likely to occur. These communities make it difficult to control the spread of the disease.

Where can I find out more?

For more information, visit or

Mumps Frequently Asked Questions

In light of the outbreak of mumps in the Bozeman area, here are some answers to commonly asked questions:

What is mumps and what are its symptoms?
Mumps is best known for the puffy cheeks and swollen jaw that the virus causes in the salivary glands. Swelling can last from two to ten days. The incubation period, or time from when you were infected to when you have symptoms, is 12 to 25 days. Other symptoms include fever, headache, muscle aches tiredness and loss of appetite. Some people with mumps may have mild or no symptoms and often do not know they have the disease. Mumps can be diagnosed by a combination of symptoms along with lab tests. See this CDC link for more information.

How does mumps spread?
Mumps spreads by droplets of saliva or mucus from the mouth, nose, or throat of an infected person. The virus can spread through coughing, sneezing or talking. Saliva can pass from one person to another when they share utensils, drinks, lip gloss or other personal items. It can also spread by touching objects or surfaces.

Is there a treatment for mumps?
There is no cure for mumps, only supportive treatment such as bed rest, fluids, and fever reducing medication.

What problems can mumps cause?
The vast majority of mumps cases do not lead to serious complications. But mumps can be serious, causing inflammation of the brain, spine or other organs and deafness.

How soon after infection do symptoms occur?
Symptoms usually occur 16 to 18 days after infection, but the time period can be as little as 12 days or as long as 25 days.

When are people with mumps contagious?
Mumps is most contagious before symptoms appear. People with mumps are usually contagious from two days before to five days after jaw and neck swelling starts.

How can a person with mumps avoid spreading it to others?
• Stay at home for five days after swelling symptoms appear. Avoid school, work, social gatherings, and other public settings.
• Don’t share eating or drinking utensils.
• Cover your mouth and nose with a tissue when you cough or sneeze. If you don’t have a tissue, cough or sneeze into your elbow, not your hands.
• Wash your hands frequently with soap and water or an alcohol-based hand cleaner.
• Limit contact with the people you live with, for example sleeping in a separate room, if you can.

Is there a vaccine to prevent mumps?
Yes, mumps can be prevented with the MMR vaccine (measles, mumps, and rubella.) The Centers for Disease Control and Prevention recommends children get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 to 6 years of age. People who receive two doses of mumps vaccine are much less likely to develop mumps than those who have one dose or none. Children may also get the MMRV vaccine, which protects against measles, mumps, rubella, and varicella for chickenpox. This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Can people who have been vaccinated still get mumps?
Yes, for every 100 people vaccinated, 80 to 90 of them will be protected. The vaccine greatly lowers the number of people who get sick when exposed to the virus. If a community maintains a high vaccination rate, the risk of exposure declines. People who get mumps following vaccination are at lower risk for complications and usually experience a milder case.

How do I reduce my chance of getting the mumps?
People who have two doses of MMR vaccine are presumed to have immunity to mumps. People are also presumed to have immunity if they were born before 1957, when mumps was widespread, have laboratory confirmation of the disease, or have positive titers, or blood tests, to determine immunity.

What should you do if you were exposed to mumps?
Two doses of MMR vaccine is required for enrollment in Montana schools. If your child has a religious or medical exemption for the MMR vaccine, the child may be excluded from school until it is safe for them to return.

What should I do if I have symptoms?
If you develop swelling along the face and neck along with a fever, you should stay home from work, school, sports and all public gatherings for five days after symptoms start. You should seek medical care to be properly diagnosed. To help prevent spreading the disease, you should call your doctor or healthcare provider before going to a hospital or doctor’s office.

What can be done to protect students who are not immunized against mumps?
If an outbreak of mumps occurs in a school, students who are not immunized may be excluded from school for 25 days after the last case of mumps in the school to protect those who are not immunized and limit the spread of the disease. If unimmunized students receive vaccinations, those students can return to school.

Where can I find out more about mumps and vaccinations?
Visit the Centers for Disease Control and Prevention (CDC) at:

Childhood Vaccines

Childhood immunizations are crucial to the health of your child, as well as the health of the community. Because they are so critical, Vaccines for Children, a federally-funded program, helps provide vaccinations to children who are not insured or underinsured.  With Vaccines for Children, there is no fee for the office visit, and no appointment is necessary. The Centers for Disease Control and Prevention recommends several childhood immunizations.

The state of Montana requires immunizations as a condition of daycare and school entry.

Adult Vaccines

Vaccines available for adults include: Hepatitis A and B, HPV (human papillomavirus), influenza, MMR (measles, mumps, rubella), meningitis, pneumonia, polio, Tdap (tetanus, diphtheria, pertussis), chickenpox, and shingles.

The Centers for Disease Control and Prevention (CDC) recommends that healthy adults age 50 and older, get two doses of the new shingles vaccine called Shingrix to prevent shingles and complications from the disease. The two doses, which should be separated by 2 to 6 months, are more than 90 percent effective at preventing shingles.  In May of 2018, the manufacturer of Shingrix began experiencing vaccine shortages and shipment delays due to high demand for the vaccine. Please call the RiverStone Health Immunization Clinic at 406.247.3382 to check on availability.  Find out more about shingles and the vaccine from the CDC.

For more information on adult vaccine schedules, Click here.

Travel Vaccines

If you travel overseas, you can protect yourself against many serious illnesses by making sure you have the proper immunizations. Give yourself four to six weeks prior to your trip to complete all necessary vaccinations. Travel vaccinations are available by appointment only. Contact us at 406.247.3382 to schedule an appointment. People age 60 and older need a prescription from their doctor to receive Yellow Fever Vaccine.

RiverStone Health Immunization Clinic
123 South 27th Street
Billings, Montana 59101
Phone: 406.247.3382
Fax: 406.651.6460

Hours: Monday 1pm-4:30pm; Wednesday 11am-5:30pm; Friday 1pm-4:30pm