What is going on with all the measles?

Baby chewing on a blogThis next post isn’t necessarily adolescent-specific, however since the Anti-Vaccine movement is in its adolescence, I’m making an exception. Right now, you can’t throw a snowball without running into a story about measles, vaccinations, and Disneyland. If you are on social media at all, you have seen sketches by comedians, interviews of scientists, pleas from parents of infants, opinions from politicians, and warnings from the happiest place on earth.  You have also seen a lot of misinformation. With each report, there are arguments: on one side, there is the medical and science community along with people who vaccinate their kids, on the other side are people who choose not to vaccinate.  These arguments get really heated (seriously, read the comments section on some of these…actually, don’t read them). So, what’s the real deal with measles and the current outbreak?

As of writing, there are 102 cases of measles in the US, encompassing 14 states (however this is still increasing).  In 2000, measles was declared eliminated in the United States. Between 2001 and 2011, the median number of measles cases reported per year nationwide was 62 (that’s 30 less than the number of cases in California over the past month). Unlike the current outbreak, most of those cases from the 2000s were brought into the United States by unvaccinated travelers.

Measles is one of the most infectious diseases known to man.  One of the problems is that it is contagious prior to the appearance of the characteristic rash, before someone may know they have the illness. If someone with measles coughs or sneezes, it can spread droplets of virus that can live on surfaces for up to two hours.  That means you can walk into the room that an infected individual sneezed in 1 hour ago and still be exposed to the disease.

Symptoms of measles include high fever, red eyes, and red spots that start on the head before spreading to the rest of the body. Complications of measles infection include diarrhea and subsequent dehydration, pneumonia, swelling of the brain (encephalitis), and death.

Before the measles vaccine was introduced in 1963, 500 people a year died of the disease nationwide (out of 549,000 people infected). The first dose of vaccine, called MMR as it protects against measles, mumps and rubella, is given at 12 to 15 months of age. The second dose is given at age 4 to 6. For years, only one dose was recommended, which protected about 95 percent of people. The second dose was recommended starting in 1991. Most people who get fully vaccinated have long-term immunity to the disease.

People who cannot get the vaccine include: infants under 1 year of age, immunocompromised (cancer, HIV, etc), and someone allergic to a component of the vaccine.  That’s it. These people depend on “herd immunity” where there’s little chance of an outbreak due to vaccinated individuals breaking the chain of infection.  In order to have adequate herd immunity, 90-95% of population needs to be vaccinated.  The more that are unvaccinated, the less the herd immunity, the more likely to have an outbreak (which is why there are certain pockets of the population that have had outbreaks, the vaccination rate in that community is low).

So why in the world are people NOT getting vaccinated?

In 1998, the medical journal Lancet published the article that started all the controversy.  In this study, the researchers claimed to find an association between the MMR vaccine and inflammation in the gut (which they postulated was related to autism).  This study was done on 12 handpicked patients (that’s right, TWELVE).  The main author, Dr. Wakefield, had a massive conflict of interest since he was paid a large sum of money by lawyers looking to sue the makers of the MMR vaccine; also, he may have had patent for his own competing vaccine (as in, “vaccine A is terrible for you, so here, try my Vaccine B”). None of his results were reproducible (millions of people studied). The Lancet has since retracted the article after investigations found falsified data. Wakefield lost his medical license. This study should never have seen the light of day.  However, you will continue to hear anecdotes of bad outcomes presumed to be due to MMR vaccination (most famously by a certain former Playboy Bunny who now claims that she was misunderstood). Just remember that anecdotes do not equal science.

The verdict:

Measles was nearly eradicated, can be deadly, and can be prevented.  Do not rely on what you read online. Please get your information from your child’s health care provider; trust the same person to protect your child as the person you would take them to if they got sick.

“The good thing about science is that it’s true whether or not you believe in it.” – Neil deGrasse Tyson