I am pro-vaccination: both in theory and in practice. I myself have had just about every vaccine that a person can, as a result of a rather esoteric travel history. If I have children, I intend to vaccinate them with every recommended vaccine, on the recommended schedule. I believe this is an important thing for a parent to do, both in terms of protecting one’s own child, and also as part of (what I believe to be) one’s civic duty to protect other people’s children.
I know this is a highly contentious topic for many people. I don’t pretend to be an expert on vaccines, and I’m certainly not a virologist, but I do have training and experience in interpreting biological and epidemiological data about infectious disease.
So with those caveats, I’d like to discuss importance of measles vaccination and the real life life and death consequences of vaccine refusal.
First of all, what is measles? Simply put, it’s a virus and a disease caused by that virus, with a rash, fever and cough as the main symptoms. One identifying feature of the measles rash is that it starts on the face and then spreads to the rest of the body. Although children are most likely to get measles, adults can get sick and, like with chickenpox, often have a more serious illness.
Once you get measles, there’s no specific treatment and you can spread infection before you even show symptoms. In fact, measles is one of the most highly contagious human diseases. In 2008, 164,000 people died from measles, most of them babies under the age of 5. Kids who are malnourished are especially at risk for complications, like blindness, or death. Even in high-income countries, measles can be a serious disease – one in 1000 people will get encephalitis (a brain infection that can cause deafness or mental disability), and 1 in 3000 may die.
Okay, but why should you care? Besides the fact that thousands of people die each year – 18 every hour – measles is making a comeback worldwide, and especially in high-income countries. In 2003, it looked like measles had been wiped out in the Americas, because by June of that year not one single case of measles had been detected. Parents started to become complacent, and for many people concerns about the vaccine started to outweigh concerns about measles. But, just because measles isn’t transmitting somewhere, doesn’t mean it can’t show up. And this is just what it has done.
In the first six months of 2008, there were 131 cases of measles across 15 US states; while in early 2010, 82 cases occurred in British Columbia, Canada, alone. Both outbreaks have been linked international travel. In the United Kingdom, too, measles is now circulating regularly in the population, despite having been wiped out in the mid-1990s.
What can we do? Measles is a disease of people, and is highly contagious. So long as one person has measles, everyone everywhere has the potential to get measles. But there’s a very effective vaccine – two doses effectively guarantee that you will never get measles, and costs less than 1 dollar (US and, approximately, CAN) for each dose.
Okay, but is the vaccine safe? Whenever a vaccine is given in the US, the doctor is required by law to report any problems or symptoms that follow to the CDC. Based on this reporting, we know that up to 15% of people who get the vaccine will get a fever, typically only following the first dose; approximately 5% of people will get a rash. More serious complications have been reported, including encephalitis, but these occur less than once for every million vaccine doses given – less frequently than the general, non-vaccine related occurrence – which suggests that these were coincidences rather than effects of getting vaccinated.
Not convinced? That’s fine. It’s not my place to convince you that you should vaccinate yourself or your kid. But I do want to convince you that measles is a problem – one that can be solved. Maybe you don’t think that the risk to your child, or yourself, of getting measles is very high. Maybe you even think it’s less than 1 in a million – in that case, the vaccine might actually be a bigger risk.
But there are millions of children who are at real risk of getting, and dying from, measles. And two dollars from you could keep them alive.
Something to think about.
