Measles in California

California has had a lot of bad press in 2014 as vaccine-preventable diseases wreak havoc on citizens. As flu season is coming to a close, California has reported 278 deaths from the flu.

Now, measles, a highly contagious respiratory disease caused by a virus, has arrived in the state. As of late February, fifteen Californians have been diagnosed with measles. Almost half of the cases did not receive a measles childhood vaccine. To date, six counties have reported cases of measles. Last year, there were only two reported measles cases in California.

Health officials are worried that many people could be exposed to the measles virus by one of the sick people. Measles had been eliminated in the United States in 2000, but people can still contract it by visiting a country where it hasn’t been eliminated. In the case of the recent outbreak, three of the measles patients had recently been in the Philippines, two had recently traveled to India, and two had contact with travelers.

“A myth persists among many parents that the measles vaccine is dangerous,” stated California state epidemiologist Dr. Gil Chavez. “These illnesses continue to make a comeback because we have people who refuse to be vaccinated. There’s a tremendous burden to the counties and society.”

Thousands of people who ride the Bay Area Rapid Transit were warned they may have been exposed to measles after an unvaccinated UC Berkeley student contracted the disease on a trip to the Philippines and then rode public transportation.  Symptoms of measles include: rash, fever, runny nose and cough. If it isn’t treated, measles can cause: pneumonia, neurological damage, and birth defects in children if contracted by pregnant women.

It’s important to consult your physician when making vaccination choices. Measles and other diseases are serious threats to public health. When a parent chooses not to vaccinate their child, the choice can also have implications on the health of others.

The Ethics of Not Vaccinating

The anti-vaccine movement has been in the news a lot lately. Well-known anti-vaccination advocate Jenny McCarthy started on television’s The View this week, measles outbreaks struck Texas and Wales and children are headed back to school; prompting parents to question vaccine schedules.

During a Season 10 episode of Law & Order: Special Victims Unit, the hypothetical scenario was a mother who decided not to vaccinate her child for measles based on rumors that the vaccine causes autism. The child contracts measles at age four and passes it on to a one-year old child at the daycare center who is too young for the vaccine. The baby dies in the episode with the title “Selfish.”

A paper in the Journal of Law, Medicine and Ethics explores whether people can be held legally accountable for damage they cause by not vaccinating their children. Bioethicist Arthur L. Caplan is a co-author on the paper and states: “One can make a legitimate, state-sanctioned choice not to vaccinate, but that does not protect the person making the choice against the consequences of that choice for others.” The paper argues that a parent who decides not to vaccinate and endangers another child is clearly at fault and could be charged with criminally negligent homicide or sued for damages.

“Parents who choose not to vaccinate their kids for reasons of personal belief pose a serious danger to the public,” stated Jed Lipinski of the Albuquerque Journal. “Take the San Diego measles outbreak of 2008. After unknowingly contracting the disease on a trip to Switzerland, an unvaccinated 7-year old boy infected 11 other unvaccinated kids, according to the Centers for Disease Control and Prevention (CDC).”

“The majority of the cases occurred in kids whose parents had requested personal belief exemptions through the state of California,” Lipinski continues. “But three of the infected were either too young or medically unable to be vaccinated. And overall, 48 children too young to be vaccinated were quarantined, at an average cost to the family of $775 per child. The CDC noted that all 11 cases were ‘linked epidemiologically’ to the 7-year old boy and the outbreak response cost the public sector $10,376 per case.”

Caplan, Lipinski and others all agree that the government’s interest in protecting children from getting measles should trump parents’ interest in making medical decisions for their kids. Lipinski believes extra measures need to be taken to ensure non-vaccinators understand the risk they pose to other people’s children.

Vaccine Watch urges parents to seek answers to vaccine questions from their child’s pediatrician. As Caplan and Lipinski point out – choosing not to vaccinate your child can have much greater consequences than most parents realize.

Measles Outbreak in Wales

In November, cases of measles in Wales began increasing. Throughout April, the number of measles cases continued to rise and one man died. Last week the number of cases rose again, reaching 1,243 total across Wales.

Fifteen years ago, many parents chose not to vaccinate their children because Andrew Wakefield linked vaccines to autism in a 1998 report in the Lancet. His work has since been discredited and he was stripped of his medical license, however many children in this era were never vaccinated. Young people aged 10 to 18 have been the hardest hit by the measles outbreak in Wales because they missed this key vaccine as infants.

Health officials are now concerned about the area of Gwent in Wales, where 84 measles cases have been reported since November. There are about 10,000 people aged 10 to 18 in Gwent that aren’t vaccinated for measles, mumps and rubella (MMR).

“It should be remembered that in 2011, we only saw 19 measles cases in the whole of Wales for the whole year,” Dr. Marion Lyons, the director of health protection for Public Health Wales states. “The 84 cases in Gwent are a huge concern to us and with 10,000 children still in need of vaccination, we are warning young people and parents not to be complacent just because they don’t live in the outbreak area.”

Since the outbreak began, more than 43,000 non-routine MMR vaccines have been given, reducing the number of unvaccinated children by 46%. However, 38,000 children in Wales remain unvaccinated, prompting concern among health officials about future outbreaks. Health officials have also estimated there are two million school children total in Britain who didn’t receive the vaccine when they were infants. A campaign was conducted earlier in the year to vaccinate one million of these children.

“It’s encouraging to see so many parents bringing their children for vaccination now who refused the vaccine in the past, and we must keep this up if we are going to see an end to the current outbreak and have the best chance of preventing more outbreaks in the future,” Dr. Lyons continues.

MMR is administered in two doses, the first dose provides 90% protection and with both doses, there is 99% protection. Measles is highly contagious with a rash and fever, as well as feeling poorly. Complications can include blindness, severe diarrhea, ear infections, pneumonia, or in extreme cases, death.

Dr. Sarah Wollaston is a former general practitioner and is a member of parliament representing Totnes, near Devon, where 30% of 5 year olds haven’t received both doses. With herd immunity, if 95% of children in a community are vaccinated the community is protected from outbreak. “The real ‘herd’ effect may be an unwarranted fear that vaccination is harmful or the belief that ‘natural’ methods like homeopathy can boost a child’s immunity and thereby offer a safe alternative to protect against that virus,” she explains.

“The MMR is a well-tested vaccine and offers protection against three of the most infectious childhood diseases,” Dr. Sam Barrell, a Brixham general practitioner states. “Measles is highly infectious and while most get over it quickly, for some it can have life-changing consequences.”

The tragic harm caused by Andrew Wakefield's fraudulent research continues to fuel vaccination fears and misinformation. It may take decades of education to undo this damage. 

Anti-Vaccination Messages Targeted To Children

Stephanie Messenger is an Australian anti-vaccine activist and self-published author.  She recently published a children’s book, the title is Melanie’s Marvelous Measles.

According to Messenger’s website, she wrote the book to:  “Educate children on the benefits of having measles and how you can heal from them naturally and successfully. Often today, we are being bombarded with messages from vested interests to fear all diseases in order for someone to sell some potion or vaccine, when, in fact, history shows that in industrialized countries, these diseases are quite benign and, according to natural health sources, beneficial to the body.”

Unfortunately, the message that Messenger missed was that measles is responsible for thousands of tragic deaths each year.  These deaths could be prevented through vaccination.  According to the World Health Organization (WHO), in 2011 there were 158,000 deaths from measles, or 18 deaths per hour. 

WHO also states that measles vaccination resulted in a 71% drop in measles deaths worldwide between 2000 and 2011.  However, 158,000 deaths a year for a disease we have a vaccination for is unacceptable.  Measles is a highly contagious virus and most of those who died were children under the age of five.  There is nothing marvelous about measles.

On the opposite end of the spectrum, the game company Tiltfactor has been using games to educate people about vaccinations.  Previously, Tiltfactor had developed a game called Pox to address misinformation about vaccines and recently introduced zombie-themed games. 

In addition to Pox, Tiltfactor now has a zombie invasion board game, an iPad app and a card game.  In each of the games, players figure out which people need to be vaccinated to slow the spread of the zombies.  To date the board game and card game have been the most popular, and the most effective at raising awareness about vaccinations.

Children's books and games have the potential to educate parents and kids about the value of vaccination. These opportunities should be capitalized on to answer questions and relieve unnecessary fears. Anti-vaccination messages delivered in children's books are a whole new face of the Anti-Vaccine movement that should not go unanswered.