Now imagine our brilliant researchers develop a vaccine that protects you and your children from this horrible scourge with a 97% assurance. Would you not want to protect yourself and loved ones?
I have just described Measles.
When my infant son was due for his first immunization, I was given a pamphlet that said there was 1 in 300,000 chance of an adverse reaction. I remember discussing with his godmother that I didn't like those odds. However, he was a healthy baby and his father and I both survived various immunizations, so I took him for his jabs and held him while he cried.
This was years before the debacle of Andrew Wakefield and his 1998 article published in The Lancet claiming links to autism from an immunization vaccine.
In this original research paper (Lancet 1998;351[9103]:637-41), Wakefield and 12 coauthors claimed to have investigated "a consecutive series" of 12 children referred to the Royal Free Hospital and School of Medicine and parents of eight of those 12 children associated their loss of acquired skills, including language, with the Measles, Mumps Rubella (MMR) vaccine. The authors concluded that "possible environmental triggers" (i.e. the vaccine) were associated with the onset of both gastrointestinal disease and developmental regression.
TWELVE YEARS LATER, Britain's General Medical Council (GMC) ruled in January, 2010, the 12 children that Wakefield studied were carefully selected and some of Wakefield's research was funded by lawyers acting for parents who were involved in lawsuits against vaccine manufacturers.
A few weeks after the GMC ruling (2 Feb 2010), The Lancet apologetically said that "several elements are incorrect, contrary to the findings of an earlier investigation."
Three months after The Lancet retraction, Wakefield was removed from the UK Medical Register for unethical behavior, misconduct, and fraud, with a statement identifying deliberate falsification in the research published in The Lancet, and was thereby barred from practicing medicine in the UK.
In the following year, articles by Brian Deer in The British Medical Journal described Wakefield's work as "an elaborate fraud" and claimed that Wakefield had planned to launch a venture that would profit from new medical tests and litigation-driven testing as a result of the MMR vaccination scare.
So where is Wakefield today?
Unable to practice medicine in the UK, the disgraced doctor has re-invented himself in Trump's anti-vax America. Based out of Austin Texas, he aims to advance his agenda and he is making progress. Emboldened by Trump's personal endorsement, he speaks at anti-vaccine rallies at the Texas state capitol building, and he holds screenings of his film, "Vaxxed: From Cover-Up to Catastrophe", throughout the state. Texas is also home to Texans for Vaccine Change, a Political Action Committee (PAC) that throws its support behind politicians who share their donors' views towards vaccinations. Non-medical vaccine exemptions have increased in Texas since 2003, when the state enacted some of the loosest vaccine exemption laws in the US. Parents can opt out of public school vaccine requirements if it goes against their conscientious beliefs as a result of the 2003 law. Today, the Waldorf School in Wakefield's hometown of Austin TX has an immunization exemption rate of more than 40 percent.
Texas is not a lone star in Wakefield's wake. It is only one of 19 states in the US that does not have a law requiring people to get vaccinations.
Prior to a visit from Wakefield in 2008, a Somali-American community in Minnesota had the highest rates of vaccinations against measles in the entire state. Last year, the community had an outbreak of Measles which was the highest the state had seen in years. When questioned by The Washington Post regarding the Minnesota outbreak, Wakefield said he was simply providing information about vaccines and autism. "The Somalis had decided themselves they were particularly concerned. I was responding to that," he said. "I don't feel responsible at all."
California
California's response to the "Disney Outbreak" illustrates how some regions are approaching this public health concern differently. In January, 2015, 84 people were diagnosed with Measles and most had visited Disneyland or Disney California Adventure in mid-December or were in contact with someone who had visited the theme park. As a result California outlawed "personal belief" exemptions from vaccination requirements for schoolchildren, and subsequently vaccination rates went up. Those familiar with the US know this is a significant departure from California's liberal reputation as a protector of individuals' rights.
"Measles is not dangerous", said Robert "Dr. Bob" Sears, MD, a California pediatrician, in his social media post. "Ask any grandma or grandpa (well, older ones anyway), and they'll say, 'Measles? So what? We all had it. It's like chicken pox.'" He is obviously referring to those who survived Measles in childhood. Those who did not survive would have a different answer.
Europe
In Europe, 2017 was a bad year for Measles. According to the European Centre for Disease Prevention and Control, most immunization rates in affected areas have fallen below the critical 95 percent threshold due to skepticism about the vaccine. After Romania, the second highest outbreak in 2017 was in Italy, which had 5,006 cases and three deaths; 88 percent of those people had not been vaccinated and 7 percent did not receive the recommended dose. Last year's Measles outbreaks have led Italy, Germany, and France to pass laws that require parents to vaccinate their children or consult a doctor about doing so. Italy and Germany now impose fines of $600 - $3000 for failing to comply.
REGARDLESS OF WHERE YOU ARE IN THE WORLD:
- Measles is highly contagious and is spread through coughing and sneezing. Those confirmed to have the disease are infectious from five days before the onset of the rash to five days after the rash starts. The rash usually first appears on the face, then moves down to the chest and arms. Ninety to ninety-five percent of those breathing the same air will be exposed. By comparison, flu transmission affects thirty to fifty percent of those breathing the same air.
- Measles was declared eliminated from the United States in 2000. Likely the shift working in the Emergency Department this weekend in any of the developed countries have not seen a confirmed case. It's easily missed in the best of hospitals since its early symptoms include a dry cough, runny nose, temperature of more than 38.5C (101.3 F) and feeling very unwell.
- Measles vaccine has led to a huge drop in global deaths from the disease. In the 1980s, Measles killed 2.6 million a year. In 2016, for the first time in recorded history, deaths fell below 100,000.
- Credit to the Church of Latter Day Saints for its strong pro-vaccine position. In addition to advising its members to get immunizations, the Church has donated millions of dollars to vaccinate children in over 40 countries since 2003.
- People are considered immune if they have had two doses of the MMR vaccine, have had Measles previously, or were born before 1969.
- People should stay in isolation while they're infectious - this means staying home from school or work and not having contact with unimmunized people.
- If you have children in school, ask about exemption rates. If they are not at or below the national average, consider changing schools. If you live in Austin Texas, good luck!
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CL=Confidence Limit.
The shaded area represents the number of deaths prevented as a result of the vaccine. The cumulative total for the period 2000-2016 is 20.4 million.
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