Measles outbreak going viral – drop in inoculations blamed

by Grace Eleyae

Scripted by Grace Eleyae, produced by Next Media Animation

A record number of measles cases is hitting the U.S. this year compared to any time since 2000 when measles was virtually eliminated. The cause: a drop in inoculations, according to the Centers for Disease Control and Prevention.

Measles 2014 increase
Measles cases have reached a record number in 2014 compared with previous years. Photo courtesy: http://www.cdc.gov/media/releases/2014/images/p0529-measles.pdf

There have been 603 reported cases of the measles virus from January 1 through October, according to the CDC. This is the highest number of reported cases since measles elimination was declared in the U.S. in 2000.

Vaccinations are a staple weaved into the fabric of global public health. They have been credited with ridding the world of smallpox, eradicating polio nationwide, and temporarily eliminating the measles virus in the United States.

Arguably, “vaccines are one of the greatest public health achievements of all time,” said Tina Tan, infectious diseases attending physician at Lurie Children’s Hospital in Chicago.

But even though they’ve been credited with these advances, vaccines have come under fire in the last 20 years. Rumors linking childhood immunizations to food allergies, diabetes, asthma and autism have frightened increasing numbers of parents into refusing to vaccinate their children, despite CDC recommendations.

Public health professionals credit the Measles-Mumps-Rubella vaccine with the elimination of the measles virus in the U.S. in 2000. That meant that there had been no continuous measles virus transmission in the U.S. for 12 months. However, in 1998, the MMR vaccine came under intense criticism when a now discredited study published in the British journal, “The Lancet,” linked an ingredient found in the MMR vaccine to autism.

Even though the study was widely discredited by peer-reviewers even before it was retracted by the journal in 2010, many parents still refuse to have the vaccine administered to their children.

“There has definitely been an increase in parents who refuse any or all CDC and AAP [the American Academy of Pediatrics] recommended childhood vaccines,” Tan said. “There is still a lot of misconceptions and mistrust surrounding vaccines and a lot of inaccurate or wrong information that is freely available on the internet.”

Measles Cases 2014
Photo courtesy: http://www.cdc.gov/measles/cases-outbreaks.html

With fewer people across the country immunizing their children with the MMR vaccine, 20 different outbreaks accounted for 89 percent of the 603 measles cases this year and the cases have room to grow.

“Routine use of the childhood vaccines has decreased most diseases by greater than 95 percent compared to the pre-vaccine era,” Tan said. “The use of vaccines was what resulted in the global eradication of smallpox and in the goal for the eradication of polio.”

So should everyone get vaccinated? The short answer is no. According to the CDC’s website, some people shouldn’t be immunized — particularly those who are allergic to an ingredient found in any of the vaccinations. Eula Biss, mother and author of the book “On Immunity,” agrees.  A vaccinated child in a community full of unvaccinated children is at a greater risk of catching a vaccine-preventable illness than an unvaccinated child in a community full of vaccinated children is, asserts Biss, a Chicago author.

Community or "Herd" immunity implies an inoculation of the majority in order to prevent an outbreak of disease.
Community or “herd” immunity implies an inoculation of the majority in order to prevent an outbreak of disease. Photo courtesy: http://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

In a sense, we inoculate the majority who can safely receive vaccinations to help protect the immunity of those around us, including the small minority that cannot be vaccinated. That immunity also protects those who refuse to be vaccinated. But protection spreads thinner when the numbers who refuse increase. “It shouldn’t be seen as asking too much for people to accept the risk of vaccination in exchange for the value that it offers in terms of protecting other people,” Biss said.

Still, there is risk associated with vaccinations. For example, rotavirus disease is a gastrointestinal illness that is most common in infants and young children. RotaShield, the vaccination created to prevent the disease, was recalled after one to two infants for every 10,000 doses experienced a severe allergic reaction. Biss shared an event that illustrates her perspective on that risk. She said she had what doctors termed a low-risk pregnancy leading up to the birth of her son. Even so, she experienced a severe, life-threatening incident immediately after her son was born in which her uterus inverted, causing her to lose a considerable amount of blood in just a matter of minutes. This only happens to one in 3,000 women, doctors told her.

“That one in 3,000 number got translated to me as very, very rare,” Biss said. “And then when I began researching vaccines, I learned that if a vaccine that we were giving children had a [serious] side effect rate of 1 in 3,000, it would not be allowed on the market. In terms of childbirth, we consider that rate very rare. With vaccines, it would be an unacceptably high rate.”

This ethical internal conflict is one that plagues mothers around the nation. Amira Kando, a Glendale Heights mother of six, hasn’t followed the government vaccine recommendations for her last three children. Her youngest remains completely unvaccinated. As she researched and learned more about vaccines, she said she concluded that the risk involved might be too great.

She said: “My responsibility to my child as a parent is to keep them as healthy as possible and not put on any additional risk by putting any chemicals in their bodies that are known to cause harm.”

That moral dilemma was something Biss also faced when deciding whether or not to immunize her son.

“With the awareness that it carried risk, I thought ‘How would I feel about this if he is the one who has an adverse reaction?’” she questioned. “And when I reflected on it deeply, I thought, ‘It would be horrible, and tragic, but I don’t think I’ll regret having done something that I think is essential to the good health of our society as a whole.’”

A brief history of vaccinations
Immunizations have saved millions of lives in the 200 years since the modern concept of vaccinations was introduced. Before vaccines, the smallpox virus devastated communities across the world. As early as 400 B.C., physicians knew that the people who survived smallpox were able to resist the virus for the rest of their lives, notes Dr. Stephen Riedel, professor of pathology at Baylor University in Waco, Texas, in an article on the history of the disease.

Riedel’s recounts how, in 1796, British surgeon Edward Jenner applied that knowledge to introduce a simple form of a smallpox vaccination using the pus from cows infected with cowpox. According to the Jenner Institute’s website, Jenner would take matter from oozing pocks on infected cows and rub it against the open skin of a non-immune individual. In many cases, the people he inoculated were able to live their lives without ever contracting smallpox, regardless of exposure to the virus. This process of inoculation, while not as sanitary as the way it’s practiced now, set the stage for the immunizations we know today. Smallpox was declared eradicated around the world in 1980 by the World Health Organization, and experts believe vaccinations played a large role in eliminating the disease.

Jenner’s smallpox vaccine was the first inoculation that worked. Vaccines to prevent tetanus, diphtheria, polio, yellow fever, hepatitis A and B and other diseases were developed in Jenner’s wake.

In the early 20th century, polio was the most feared disease in the U.S. It crippled an average of more than 35,000 people nationwide each year, according to the CDC. A researcher named Dr. Jonas Salk developed the polio vaccine in 1952, the year the nation endured its greatest polio outbreak with 58,000 confirmed cases. Salk tested the vaccine on more than 600,000 children in 1954. By 1994, after additional edits were made to make the vaccine more efficient, the disease was declared eradicated from the U.S. However, polio it is still prevalent in other countries. An on-going effort by the World Health Organization to eradicate polio worldwide was announced in 1988, and that effort continues today.