2015 Lessons Learned about Measles (Pedcast)

Topic Introduction

Today I thought it would be useful and informative to review what we have learned in 2015 about a very old but still important disease, measles. I think that the resurgence of measles in 2015, reminds us about why it is important for us, as a society, to stay the course with respect to requiring and giving vaccines.  I hope after listening to today’s pedcast, you will agree.  As I like to say, “We don’t have to touch the hot stove, to find out that it still hurts” so to speak!  So sit back and crank up your mp3 player for an important edition of Portable Practical Pediatrics.

Musical Introduction

The Growing Problem of Vaccine Refusal

I am sure you have noticed that there is a relentless and growing number of vaccine refusers in the US which is leading to a higher number of unvaccinated children and adults. Their refusal is becoming a serious public health problem. There was a time in America, when a child getting their shots, was as much a part of their youth as loosing a tooth or running out of class to recess. Not anymore. Many parents have been frightened by much of the negative messaging that vaccine technology has received in the press and social media.  Isn’t it ironic that a technology that has literally saved millions of children’s lives and countless misery and heartache, has also frightened and confused parents since its inception. For children, “getting their shots” is a brief few moments of terror but for their parents, it has become a subject of considerable angst where they have to confront their own fear of harming their children. Having a baby puts new parents right in the crosshairs of the vaccine safety debate. They are forced to make a monumental decision. From a pediatrician’s viewpoint however, having your child vaccinated is one of the most important activities  a parent, can do for their children, involving enormous benefit and very little risk.  For many parents however, it has become an agonizing decision whether to trust or reject the modern medical establishment.

Ground Zero in the Vaccine War… Measles Vaccine

Ground zero of the vaccine wars is the MMR, a short name for the measles, mumps, and rubella vaccine. In 2000 the CDC announced that measles had been eradicated in the United States but that eradication was short lived. According to the same organization, measles “is a highly contagious, acute viral illness that can lead to complications such as pneumonia, encephalitis and death.”(1 ) For a child, being infected with measles is not a reason to stay home and watch cartoons, but rather an illness that is a major infectious disease with a high rate of serious complications. During early 2015, 189 cases of measles were reported in the US mostly due to individuals “who were unvaccinated or had unknown vaccination status.” This signifies the importance of continuing prevention. ( 1) For years, health care providers, public health officials, and school systems had been encouraging parents to vaccinate their children but measles is making a comeback, fueled by reservoirs of unvaccinated populations around the world, easy international travel, pockets of  vaccine refusal in the US, and possibly illegal immigration.(2.3)

What New Information Has Been Learned in about Measles in 2015?

So what new information has been gathered in 2015  regarding the spread of measles worldwide?  First a recent study reconfirmed that the measles vaccine is a highly effective way to stop the spread of measles, especially if most of the population is vaccinated. (7 ) Events also demonstrated, once again, that measles is still deadly and highly contagious.(8 ) War, poverty, and governments that are ineffective or unwilling to put resources into vaccine programs fuel the continued misery of measles.  It is estimated that 145,000 people died from measles worldwide in 2015. The 2015 Disneyland outbreak demonstrated  that the combination of a poorly vaccinated population of people and international travel spreads measles, even when the countries that are visited, have a high vaccination rate. ( 9) We also learned that ambivalence toward vaccines continues and is not just a third world problem. While some governments like that of Australia have sent a clear message that children should be vaccinate, making childhood vaccines mandatory to be eligible for government benefits, our own recent political debates, both liberal and conservative, have demonstrated America’s ambivalence toward vaccinations.(4 )  The tension between protecting public health and ensuring personal freedoms rages on as it has done for centuries. While 2015 saw legislatures around the country tightening regulations for vaccine refusal, we also saw our own federal government making  policies that facilitated  the travel of poorly vaccinated or unvaccinated migrants much easier. (2,3)

Where Do We Go Now?

So where do we go as a country in 2016?  I think we stick with what we know works–a strong government mandated vaccine program, well funded and enforced, along with a robust public health campaign designed  to counter the anti-vaccine messages that will undoubtedly continue. While this approach is not perfect, it has served developed countries well since its inception. Vaccine injury programs should be continued to compensate families where vaccine injury can be documented. In my view, letting thousands of children die from a vaccine preventable disease like measles and returning to “survival of the fittest” strategy when it comes to children is just not an acceptable public health strategy or morally acceptable  to me in the 21st century. That Doc Smo pearl you have heard before, “Prevention beats treatment, every time.”  This has never been so true.

Outro

Well, as always, thanks for joining me today. I hope you found that discussion informative and useful. My goal is to make every parent the best informed parent in the room and give you practical information that you can use when you make your parenting decisions. Speaking of that, if you want a bucketload of such information, make sure you pick up a copy of my book, Can Doesn’t Mean Should, Essential Knowledge for 21st Century Parents,  I think you will enjoy reading it. It continues to have a 5 star rating on Amazon. I welcome your comments about my book, this pedcast, or any of my other pedcasts. Drop off your comments at my blog, www.docsmo.com, on iTunes, or on Facebook, Twitter, or Google+. This is Dr. Paul Smolen, hoping that if your child is hot, and has skin dots and the snots, you will get them help, Johnny on the spot. Until next time.

Written collaboratively by Dr. Norman Spencer and Dr. Paul Smolen

 

Smo Notes:

  1. Incidence of measles in the US by year-CDC

http://www.cdc.gov/measles/cases-outbreaks.html

 

2. German outbrreak of Measles 10X bigger than US

https://www.washingtonpost.com/news/worldviews/wp/2015/02/07/germany-is-battling-a-measles-outbreak-that-is-10-times-worse-than-the-one-in-the-u-s/

 

3. Atlantic article discussing measles transmission

http://news.nationalgeographic.com/news/2015/02/150204-measles-vaccinations-debate-autism-medicine-california/

 

4. Australia decides to withhold government benefits if children not vaccinated

http://www.examiner.com.au/story/3006310/support-for-government-push-to-withdraw-welfare-payments-from-anti-vaccination-parents/?cs=7

 

5. Low vaccine rates among Syrian refugees

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231133/

 

6. Why measles in the US-Refusers and lack of access

http://www.usnews.com/news/blogs/data-mine/2015/01/26/whats-really-behind-the-measles-outbreak

 

7. Measles vaccine is highly effective-herd immunity seen at 80% or greater

http://jid.oxfordjournals.org/content/204/suppl_1/S158.full

 

8. Measles still common and deadly around the world-145,000 dead last year

http://www.npr.org/2015/01/30/382716075/measles-is-a-killer-it-took-145-000-lives-worldwide-last-year

 

9. Facts about the measles outbreak in Disney

http://www.forbes.com/sites/tarahaelle/2015/01/20/five-things-to-know-about-the-disneyland-measles-outbreak/#4fa60f21273c

 

10. Map of 113 Countries with higher MMR vaccine rates in 1 year olds that US

https://www.washingtonpost.com/news/worldviews/wp/2015/02/03/map-113-countries-have-higher-measles-immunization-rates-than-the-u-s-for-1-year-olds/

 

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