2011 U.S. Measles Rates Highest In 15 Years

I’m willing to bet he would have been happier with the shot.

Misconceptions and fear have been fueling the anti-vaccination movement in recent years, particularly with regard to the measles, mumps, and rubella (MMR) vaccine. This is in part because a study published in The Lancet that linked the MMR vaccine to autism (Wakefield et al). In addition to rampant misinformation spread via the Internet, the Wakefield study continues to fuel public concern, despite thorough and unanimous scientific debunking by more than 20 studies (Poland), retraction by all but one of the authors – Wakefield himself — and retraction by The Lancet.

Unfortunately, despite overwhelming scientific evidence that the risks associated with the MMR vaccine are small and uncommon, particularly relative to the serious and more common risks associated with contracting the measles, some parents continue to refuse to immunize their children.

A report by the U.S. Centers for Disease Control and Prevention (CDC) not only underscores the significant risks associated with being unvaccinated for the measles, it also helps demonstrate the fallacious nature of many of the arguments against vaccination and highlights the importance of vaccination in protecting the community.

According to the CDC report, there were more measles cases reported in the U.S. in 2011 than in any of the prior 15 years. A total of 222 cases were reported, the majority of them in people less than 20 years of age. 65% of cases were in unvaccinated individuals, and another 21% of cases were in individuals whose vaccination status was unknown or not on record. Of those who were unvaccinated, a fraction (27 total cases) were under 12 months of age, and were therefore too young for the vaccine.

In light of this disturbing report, some common myths about measles…and the facts:

Myth: Measles is exceedingly rare in the U.S., as vaccination rates are generally high. Unless my children will be traveling to Europe or other parts of the world with higher measles rates, they don’t require measles protection.

Fact: While measles isn’t as common in the U.S. as it is elsewhere in the world (there were no U.S. cases in 2000, for instance), it’s imported from other countries (either by foreign travelers or by U.S. travelers returning from a measles-prone area) and can spread in the U.S., mainly due to unvaccinated individuals. Measles is contagious for about four days before any rash appears, meaning that travelers from foreign countries can bring the disease to the U.S. without being aware that they are doing so. The CDC notes that most cases of measles in the U.S. were brought in from Europe. Further, measles is so contagious that casual exposure to an infected individual (even one who doesn’t yet show signs of the disease) is very nearly 100% effective in transmitting the infection. Measles is spread through the air, meaning that it’s possible to get the disease without any physical contact with an infected individual.

Myth: Measles is a common, routine childhood illness, and there’s no reason to vaccinate for it.

Fact: Measles was common in the U.S. before the introduction of the vaccine in 1963. The disease is so contagious that essentially 100% of the population contracted it prior to the development of the vaccine. Simply because a disease was once common, however, does not mean it is “routine” or harmless. Measles complications are relatively common, and include severe dehydration and pneumonia. 32% of individuals who contracted measles in the U.S. in 2011 had to be hospitalized for complications. Thankfully, there were no deaths among these individuals. However, swelling of the brain and death are possible complications of the disease, occurring in about 3/1000 cases. Even among the individuals who do not require hospitalization, measles is a truly miserable experience. It comes with a high fever, which is accompanied by muscle aches, headache, and sensitivity to light. Unlike chicken pox, to which measles is sometimes erroneously compared because they both cause skin rashes, measles is respiratory and causes a dry cough and extremely sore throat, which contributes to dehydration. The rash can be very extensive (in many cases, it enters the mouth), and itches.

Myth: The MMR vaccine is more dangerous than the measles.

Fact: The MMR vaccine is associated with some mild side effects, including an innocuous and temporary rash in about 5% of vaccinated individuals. Moderate side effects, such as seizure, are very rare, occurring in about 1/3000 doses. Note that the moderate side effects (which are not life-threatening) are three times rarer than the risk of death from the measles. Serious side effects of the MMR vaccine, including death, are so rare that they can’t be statistically quantified. In other words, people die so rarely after getting an MMR that no one can be sure the death was due to the shot.

Myth: Since almost everyone in the U.S. is vaccinated against measles, my child will be protected.

Fact: The vast majority of U.S. citizens are vaccinated against measles. This means that measles won’t be able to take hold and spread across the country in the form of an epidemic, as it could have done before 1963. However, the disease can still spread from one individual to the next, particularly in areas of lower MMR compliance. The 222 cases of measles in the U.S. were primarily due to small outbreaks (there were 17 such outbreaks), where the average outbreak size was 6 individuals. Put another way, for every one case of measles brought into the country by a foreign traveler or returning U.S. citizen, five people who had never left the country got sick.

Myth: If I choose not to vaccinate my children, I’m not hurting anyone but my own family.

Fact: This is not so. To protect a group of people from a disease as effectively as possible, it’s important to keep the vaccination rate as high as possible. The fewer unvaccinated individuals in a population, the less likely that someone with measles will come into contact with an unvaccinated individual, which reduces the likelihood of an outbreak. Vaccines are highly effective — vastly more so than most other medical treatments — but they’re not 100%. This is especially true in children who have had only one of their MMR shots (the CDC recommends a booster at age 4-6). Maximizing the number of immunized individuals helps to protect those for whom vaccination may not be effective. There are also those, including babies under one year of age, who are not eligible for vaccination. Maximizing the vaccination rate among the eligible minimizes the risk to vulnerable members of the population.

 

If you vaccinate, do you worry about those who don’t? If you don’t vaccinate, what about it makes you uncomfortable?

 

References:

Poland. MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science. Mayo Clin Proc. 2011 Sep;86(9):869-71.

Wakefield et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [retracted in: Lancet. 2010;375(9713):445]. Lancet. 1998;351(1903):637-641.

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27 Comments (+add yours?)

  1. Jem
    Apr 19, 2012 @ 10:50:36

    The downside to being part of a big ‘crunchy’ community online is that the majority are anti vax. I spend a lot of time rolling my eyes and resisting the urge to make jokes about tinfoil hats :p

    Reply

    • SquintMom
      Apr 19, 2012 @ 10:53:03

      Yes, I am distressed by the fact that people seem to want to adopt an entire ideology whole-cloth (if I co-sleep and breastfeed, I must also avoid vaccinations) rather than thinking about the issues critically on an individual basis.

      Reply

      • InBabyAttachMode
        Apr 19, 2012 @ 11:05:28

        Yes I totally agree! People should understand that vaccines are one of the major accomplishments of modern medicine! Even though I co-sleep and breastfeed (and didn’t have my son circumsized but that’s mostly cause we’re European and his dad is not circumsized either), I never even for a second doubted the need to vaccinate. The only thing we changed was to not have the first hepB shot in the hospital, but we postponed it to the first doctor’s visit, because I felt that it was a bit too soon to vaccinate a baby who was only just born. And besides, both my husband and I were vaccinated for hepB.

      • theadequatemother
        Apr 19, 2012 @ 16:08:24

        Ha! I cloth diaper, breastfeed and do baby-led weaning and have been known to wear my child sometimes…and while I write about it, I try to avoid flaunting it in real life because I don’t want people thinking that I’m also a vaccine rejectionist, unassisted childbirther who won’t teach my homeschooled children about evolution.

      • SquintMom
        Apr 19, 2012 @ 16:46:18

        Lol! I cloth diaper too, and am still breastfeeding at 14 mos. Oh, and I sometimes put her in an Ergo. But just like you, I fight the perception that I have consumed the Koolaid.

      • Megyn @MinimalistMommi
        Apr 20, 2012 @ 08:50:16

        It’s a hard perception to break, especially if you are hanging around similar-style parents. Since I homebirthed K, I often go to the homebirth circles. Let’s just say I’m in the minority with circumcised, vaccinated boys who have used antibiotics and modern medicine.

  2. shibon
    Apr 19, 2012 @ 18:17:49

    hmmm …. how many deaths were there from those who had the measles? the kid (in the photo) may have been happier with a shot but he would not have been healthier. he’s built up his immune system AND he doesn’t have a bunch of toxins in his body from the vaccine (nor does the planet have to worry about toxins and waste from the vaccines). this is about the industrialization of health. we are human – why do we think we have to be super human? will we vaccinate soon against the common cold? it’s also about the money-making drug industry. the irony is that all these parents who blindly vaccinate probably don’t even have 1/2 the vaccinations their kids are now required to get. yet they made it to adulthood and so did their families and friends. why aren’t they responsible enough to run out and pump themselves full of toxins? for many, the vaccine issue has NOTHING to do with autism so get over it.

    Reply

    • SquintMom
      Apr 20, 2012 @ 09:18:08

      Measles is fatal in about 3/1000 cases in countries with access to modern medicine, but up to 25% of cases in countries without such access. The shot builds up the immune system just as much as the measles; the proof of it is lifetime protection without the requirement for a booster after the second childhood shot.

      To what toxins are you referring?

      You say we are human, and you’re right. Why do we have to be superhuman? Because the average lifespan of a human through the vast majority of human history was about 30-35 years. It’s industrialization, agriculture, and the modern medicine we now have access to that have changed that. We can’t have it both ways. If we want to be completely naturally human, we have to remember that natural human life is accompanied by natural human death…after about three decades on Earth.

      We can’t vaccinate against the common cold; it mutates too quickly. Also, it’s not associated with significant risks. The only diseases against which we vaccinate are those associated with significant risks.

      You say it’s about making money. This is a common argument against vaccination. However, it does not hold water.
      Pharmaceutical companies (as well as medical personnel) would enjoy vastly greater profits from uncontrolled epidemics of disease than they do from vaccination. A study by Michael Kremer (Harvard / The Brookings Institute / National Bureau of Economic Research) and George Snyder (George Washington University) modeled prospective revenue for pharmaceutical manufacturers, comparing the income from vaccines to that from disease treatments. Under two different modeling scenarios, they determined that the treatments yielded greater profits than the vaccines. (Kremer and Snyder. The Revenue Consequences of Vaccines Versus Drug Treatments. Harvard, 2002.

      Reply

      • Dorit Reiss
        Apr 20, 2012 @ 09:31:05

        I think one of the things the people that believe that the disease is better than the vaccine are forgetting is that death and maiming consequences are as natural as recovery. Throughout history people died in droves from diseases. Or remained disabled. It’s very human. The reason we have a lot less of that is thanks to modern medicine. Your immune system is not like a muscle in the sense that the only to build it is to constantly catch diseases. Vaccines can build your immunity just as well or better than the disease. Yes, they have risks; but compared to the risks of diseases like measles, or worse, Tetanus!!! Diphtheria! those risks are milder and less common.

      • SquintMom
        Apr 20, 2012 @ 09:34:31

        Absolutely. If we want natural life, we have to accept natural death, and people have forgotten just how quickly natural death comes.

    • theadequatemother
      Apr 20, 2012 @ 19:41:33

      Of course that kid would have been healthier! Give an immune system exposure to a virus. It makes antibodies. Give an immune system exposure to an attenutated virus or viral proteins…it makes antibodies.

      Don’t vaccinate the kid, he gets measels, all the discomfort from that and potentially horrific consequences. Give the kid the vaccine, his arm is mildly sore for a day or two.

      We vaccinate children because they are the ones that are most vulnerable to the horrible sequelae of vaccine-preventable disease.

      As a parent who “blindly vaccinates” (and it ain’t blind, let me tell you it is the healthy choice and the ONLY responsible choice) I sure as hell make sure my vaccinations are also up to date…and those of everyone that comes into contact with my infant and vulnerable son.

      Reply

      • SquintMom
        Apr 20, 2012 @ 22:06:31

        I suspect the original comment (that the kid would not have been healthier) was due to the common misconception that the immune system is like a muscle, in that a) it needs to be exercised to get stronger, and b) any immune activation strengthens the immune system across the board. The truth (as you point out) is that the immune system is equally “strengthened” with regard to measles whether the patient in question gets the vaccine or the disease. Further, neither scenario gives the immune system any sort of “power boost” with regard to any non-measles illness. Unfortunately, however, this misconception is quite rampant.

    • Sammye Foster
      Aug 19, 2012 @ 10:12:03

      Sure it built up his immunity. And his parents took a chance it didn’t kill or blind him. What a lucky kid. What will they “take a chance” with next to see if he can live through it?????????

      Reply

  3. Ashley @ C is for Cockerham
    Apr 19, 2012 @ 19:45:38

    We did natural childbirth classes, co-slept, practiced BLW, and are still breastfeeding and loving the Ergo, but I’m definitely not drinking the whole pitcher of Koolaid. Science says we should vaccinate, and as an informed parent, I do. It frustrates me that other parents don’t, but I try not to judge their decisions, since we know every mom is trying to make the best choice for her baby.

    Reply

    • Dorit Reiss
      Apr 20, 2012 @ 09:33:44

      Except, those parents are not making the decisions just for them, or even just for their child. They are making it for any infant that’s too young to vaccinate that may be exposed to their little disease-carrier at a wrong time, and they are reducing everyone’s herd immunity. I don’t think this is a matter of choice. In the U.S., the constitution makes it problematic to forbid vaccinations to those religiously opposed; but I think vaccinations should be mandatory for everyone else, just like carseats, especially since there is a no-fault compensation system in place for the small percentage who have negative reactions after the vaccine (whether or not that’s because of the vaccine).

      Reply

      • SquintMom
        Apr 20, 2012 @ 10:09:57

        Although the flaw in the exception for those who are religiously opposed is that anyone can claim that exemption, regardless of whether they’re actually a member of a religion that opposes vaccination. It’s basically a “moral grounds” clause, meaning that there is no ability to legislate whatsoever.

  4. Dorit Reiss
    Apr 20, 2012 @ 09:59:45

    This is one of the best pieces I’ve read – it is clear without being judgmental, evidence-based, thoughtful. Thank you!

    Reply

  5. Mrs.W
    Apr 20, 2012 @ 10:27:53

    SquintMom – Love this post – just found your blog today it looks great! Next week (April 21-28) is world immunization week and I would encourage anybody with a blog who supports immunization to do at least one pro-vaccination post during that week. After all we should show that mom-bloggers “Give a Whoop” and support immunization – particularly given disturbing increases and outbreaks of vaccine preventable illnesses like measles and whooping cough.

    Reply

    • SquintMom
      Apr 20, 2012 @ 10:42:35

      Yes, I am definitely planning a pro-immunization post for next week! Glad to hear you’re enjoying the blog.

      Reply

  6. james brown
    Apr 24, 2012 @ 07:55:12

    this is a three part question for people on either side of this debate:
    1. apart from the 3 virusses what other ingriedience are in the dose?
    2. if it contains ingriedience such as squaline, thermerasol, formaldehyde, albumen, etc., would you be confortable putting this mixture in a glass and have your child drink it?
    3. with the easy access to ingriedence information on the internet, how many of you reasearch this before you decided?
    “think for yourselves, question the herd mentallity!” thanks for your time.

    Reply

    • SquintMom
      Apr 24, 2012 @ 10:51:33

      Good heavens, there’s a lot of misinformation out there on the Interwebs! For instance, albumen is nothing but a protein in egg yolk, and children’s vaccines aren’t preserved with thimerosal.

      Forums and opinion pieces are not reputable sources, and reading a bunch of anti-vax blog posts doesn’t count as “doing research.”

      Reply

  7. Dorit Reiss
    Apr 24, 2012 @ 15:07:32

    To remind you, what goes into vaccine is an issue that has been intensely and scientifically studied. There was precious little evidence that the small amount of mercury they used to have in vaccine, or other materials, caused any harm. Still, since there were concerns, those materials were removed. Those that need to be concerned about those issues are people with allergies to eggs, and they are warned (it’s in the materials given with the vaccine). I also want to remind you that a list of ingredients doesn’t actually tell you much without knowing more, since the amount matters a lot here: aspirin in large amounts can kill you; hey, water in large enough amounts can kill you. Small amounts of substances that are toxic in large amounts tell you nothing. With all due respect, most laypeople do not have the expertise to “research” this, and as pointed out by squintmom, the amount of nonsense on the internet is extensive.

    Reply

    • SquintMom
      Apr 25, 2012 @ 07:03:36

      Very, very well said. Too many people use the word “research” to refer to “random reading I did on the Interwebs.” The Internet is a huge, completely unregulated wiki…and there’s SO much misinformation. I applaud your willingness to make the comment that (most) laypeople don’t have the expertise required to research this topic. I always feel nervous making that statement, but I probably shouldn’t. After all, we confer degrees upon learned individuals in recognition that they know something we don’t. I wouldn’t do my own surgery; I’ll leave that to an MD. It would be the height of hubris (and would have ugly and likely fatal results) to attempt a surgery myself. Why, then, do so many laypeople assume that they can research topics of significant scientific sophistication? Reading stuff on the Internet is “research” the way putting a bandaid on a cut is surgery. It’s fine for small things, but you’d better get an expert if the cut is deep or the issue is significant!

      Reply

  8. Dorit Reiss
    Apr 25, 2012 @ 09:45:53

    Here is a great post from ScienceOfMom on vaccinations and trust – and why doing the research yourself is not the answer: http://www.mamamia.com.au/parenting/vaccination-parenting-and-science/

    Reply

  9. Trackback: Chemicals and Toxins — What Is Safe? | SquintMom.com

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