Measles Outbreak: Reexamining Herd Immunity

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The measles outbreak that started at Disneyland, in Anaheim, California, has resulted in more than 90 cases of measles in January alone. Most doctors are seeing this epidemic as a wake-up call to those parents who have refused to vaccinate their children. Parents who consider themselves part of the anti-vaccine movement, sometimes called “anti-vaxxers,” believe that vaccines are more dangerous than the childhood diseases they are meant to prevent.

In some places, the law backs them up. California, for instance, permits unvaccinated children to attend school. We’re not just talking about the measles vaccine but about vaccinations against ALL the childhood diseases including chicken pox, whooping cough, mumps, and Rubella. In Marin County, in which San Francisco is located, 7.8% of parents have consciously chosen not to vaccinate their children.

Vaccines do come with some risks and in 2000, the measles was declared eradicated in the United States. Therefore, argue the anti-vaccine people, there really is no good reason to vaccinate children. For one thing, they argue, vaccines can be deadly in a small percent of cases, while measles, on the other hand, has been wiped out.

Alas, this recent outburst of measles pretty much proves them wrong. Measles may have been eliminated in the United States, but it is still alive and kicking elsewhere in the world.  The Centers for Disease Control and Prevention (CDC) believes an international traveler, possibly a foreign worker, brought over the childhood disease from a different country. It is easy to understand how a contagious disease can spread among large,  happy-go-lucky amusement park crowds.

Unlike Ebola, which was thankfully not very contagious and turned out to be easily contained, measles is one of the most contagious diseases there is. Coming in contact with a carrier leaves the unvaccinated child or adult with a 90% chance of contracting the disease. For someone who isn’t vaccinated, just being in a room that was formerly occupied by a measles carrier, can mean catching the disease.

The recent outbreak was traced back to visits to the amusement park between December 15 and December 20. A handful of Disney workers were subsequently diagnosed with measles according to Disneyland officials. The typical incubation period for measles in 21 days, which means that a person exposed to the measles can take up to 21 days to exhibit symptoms. The risk of contagion begins four days before the onset of active measles symptoms and remains in effect until four days after the measles rash has gone.

Those parents against administering vaccines cite side effects as the main reason not to vaccinate though serious reactions such as severe allergic reaction, coma, permanent brain damage, deafness, and death are extremely rare. Severe allergic reactions occur in 4 children out of one million. The other serious side effects are so rare that experts are not sure whether they are at all connected to immunization.

Measles, on the other hand, is usually mild and clears up on its own within a few weeks. No big deal until one considers the fact that measles can lead to death in 1 or 2 children out of every one thousand who contract the disease. Now that is a scary statistic to contemplate, especially when one considers the highly contagious nature of measles.

If all we needed to consider as factors in the vaccination equation was the risk of side effects from immunization versus the risk of side effects from measles, vaccination would win out every time. But that isn’t the whole story by a long shot. There is the issue of herd immunity to consider.

Community immunity or “herd immunity” is when most of the people in a community are protected against the disease, so that the few who are unprotected have a relatively small risk for contracting the disease. What this means is that those unable to receive the vaccination because of pregnancy or a weakened immune system are less vulnerable because the majority of people in their community are vaccinated. That means it is unlikely that the vulnerable will come in contact with carriers of the disease.

Once the measles was said to be eliminated in the United States, parents belonging to the anti-vaccine movement felt vindicated in refraining from immunizing their children. They felt that since the disease was said to be eliminated, there was a greater risk from the vaccine than from the disease, since the disease was no longer an issue, having been eliminated. What the anti-vaccine people seemed not to understand is that by not having their children vaccinated, they were destroying the herd immunity that had been created and which had protected society and their children over the past 15 years.

With fewer people vaccinated, there was every opportunity for an international traveler to spread the disease. Now some high schools are barring unvaccinated students from their halls while some pediatricians are no longer treating children whose parents decided against vaccinating them. With measles back in California and spreading daily, schools and doctors can’t afford to take the chance of infecting vulnerable students and patients.

And of course, measles is just one of the many diseases of childhood for which we have developed a vaccine. Things could get seriously nasty if, Heaven forfend, other diseases crop up that might have been prevented had most parents followed a proper immunization schedule for their children. Things are actually ALREADY nasty with the pro-vaccine people attacking the anti-Vaxxers for putting society at risk for what is presumed to be selfish reasons.

These sentiments against the anti-Vaxxers spawned, for instance, a satire piece that appeared in The Onion, entitled, I Don’t Vaccinate My Child Because It’s My Right To Decide What Eliminated Diseases Come Roaring Back:

As a mother, I put my parenting decisions above all else. Nobody knows my son better than me, and the choices I make about how to care for him are no one’s business but my own. So, when other people tell me how they think I should be raising my child, I simply can’t tolerate it. Regardless of what anyone else thinks, I fully stand behind my choices as a mom, including my choice not to vaccinate my son, because it is my fundamental right as a parent to decide which eradicated diseases come roaring back.

The decision to cause a full-blown, multi-state pandemic of a virus that was effectively eliminated from the national population generations ago is my choice alone, and regardless of your personal convictions, that right should never be taken away from a child’s parent. Never.

Say what you will about me, but I’ve read the information out there and weighed every option, so I am confident in my choice to revive a debilitating illness that was long ago declared dead and let it spread like wildfire from school to school, town to town, and state to state, until it reaches every corner of the country. Leaving such a momentous decision to someone you haven’t even met and who doesn’t care about your child personally—now that’s absurd! Maybe I choose to bring back the mumps. Or maybe it’s diphtheria. Or maybe it’s some other potentially fatal disease that can easily pass among those too young or too medically unfit to be vaccinated themselves. But whichever highly communicable and formerly wiped-out disease that I opt to resurrect with a vengeance, it is a highly personal decision that only I and my family have the liberty to make.

Last but not least, one cannot bring up the controversy surrounding immunization without bringing up the now thoroughly discredited link between vaccinations and autism. A man named Andrew Wakefield along with 12 colleagues, had a study published in 1998 in the distinguished medical journal, The Lancet, which suggested that the MMR (measles, mumps, rubella) vaccine had directly caused autism. Though the study was small in size, parents in droves stopped vaccinating their children for fear vaccination would result in autism.

Even after the fraud was exposed, parents were afraid to vaccinate their children. As a result, many children suffered not only from the effects of measles, mumps, and rubella, but from the serious complications that in rare cases arise from these diseases. There were measles outbreaks in the UK in 2008 and 2009, along with outbreaks in the U.S. and Canada. A great deal of time and money was spent in an effort to debunk Wakefield’s fraudulent claims and to convince parents the vaccine is relatively safe.

An Associated Press piece from 2011 described the Wakefield hoax and its result:

Wakefield made international waves following the publication in 1998 in the Lancet, a prestigious medical journal, that he and his colleagues had linked measles-mumps-rubella vaccine with autism in most of a dozen children they had studied.

It was a small series of observations, wrapped in a hypothesis — not even a full medical study. But it exploded in the media, prompting a wave of parental concerns in England as well as the United States.

Immunization rates in Britain dropped from 92 percent to 73 percent, and were as low as 50 percent in some parts of London. The effect was not nearly as dramatic in the United States, but researchers have estimated that as many as 125,000 U.S. children born in the late 1990s did not get the MMR vaccine because of the Wakefield splash.

And now we see that a well-educated pocket of people in California,  who truly believe they are doing the right thing by not vaccinating their children, have contributed to the destruction of the herd immunity that had mostly protected American children for the past decade and a half. I would posit that every parent has the right to study the issue of vaccination but that parents do not have the right to endanger their own children based on inaccurate or fraudulent data and misconceptions. Please study the subject at length and do the right thing. Don’t let fear drive your decision, let reality drive your decision.

Kars4Kids has no choice but to come to the firm conclusion that vaccination is a gift and that we have a responsibility to our children and our community at large to immunize those capable of receiving immunization. Discuss the matter with a doctor you trust. Do your independent study, too. But ultimately, choose to do the right thing.

Vaccinate your child, for everyone’s sake.