Why Is Measles Making An Unpleasant Comeback?
Measles, once eradicated in the US, is making a comeback. In fact, the state of Minnesota is currently experiencing the state’s worst measles outbreak in decades. There have been over 70 cases of measles in Minnesota and to put that in perspective this number exceeded the total number of cases reported in the entire United States last year.
With measles outbreaks rapidly spreading across Europe and in the United States, health experts are reminding people in developed countries that vaccines save lives. In Germany kindergartens must notify health authorities about parents who fail to prove they have been counselled on child vaccination. In England, around 24,000 children each year are at risk of measles, mumps and rubella because they have not been immunized. Meanwhile, in Italy, more than 130 families are allegedly threatening to seek asylum in Austria, days after the Italian president signed a decree requiring mandatory vaccinations for school admission.
It is ironic that while richer nations are struggling with measles outbreaks, Bhutan and the Maldives have completely eliminated measles, becoming the first countries in their region to stop the highly contagious disease. Both countries launched immunization programs around 40 years ago with a strategy of mass vaccination of high-risk populations.
In the first 3 months of 2007, over 2,000 measles cases were reported in the WHO European Region. Measles continues to spread within and among European countries, with the potential to cause large outbreaks wherever immunization coverage has dropped below the necessary threshold of 95%.
Of all cases with known vaccination status, around 90% were unvaccinated, and the rest were vaccinated with only one or two doses. This is not surprising; it is known that 2 doses of the measles vaccine is 97% effective at preventing measles, while one dose is about 93% effective. However, you can lose your immunity over time, or the vaccine may not be strong enough the first time around. Getting a vaccine doesn’t guarantee complete immunity, which is why it is advisable to get your blood checked for antibodies against the measles vaccine to ensure that it worked. Measles is a highly transmissible disease. So transmissible in fact, that 90 to 95 percent of people must be vaccinated in order to protect the entire population, or achieve what is called community immunity (also known as herd immunity).
Vaccines are one of the most successful scientific breakthroughs and cost-effective health investments in history. In fact, with the exception of safe drinking water, the vaccine is widely considered to be the greatest medical invention of modern civilization. So how did we get to this point where parents refuse to allow their children to receive vaccines? Vaccines are victims of their own success. They have been so effective in fighting childhood diseases that most parents today have never seen or heard of a case of measles, rubella, meningitis, polio or pertussis. These diseases have become so rare that many people are not even aware of them. We rarely see people infected with measles, so we think measles no longer exists.
Some people these days are more afraid of vaccines than of the diseases they prevent, while others do not feel that measles and other diseases represent major risks. This is far from the truth. In Europe, between April 2016 and June 2017, 30 deaths due to measles were reported, all in Romania. All of these deaths could have been prevented with community immunity.
This fear of vaccines started with a study published in a medical journal over 10 years ago. The study was “badly written and had no clear statement of its hypothesis or indeed of its conclusions,” according to Ben Goldacre, the debunker of scientific fraud. The unethical and unscientific publication was retracted and the main investigator lost his license to practice. Yet even with retractions and apologies this discredited study is still quoted by parents, who put their trust in it when deciding to delay or refuse vaccines. This fraudulent publication still lives in blogs and gets shared regularly.
In today’s social media driven world, Facebook, Twitter and other social media sites allow people to exchange information / misinformation on a much greater scale than ever before, while publishing platforms enable anyone to easily create a dynamic website with downright wrong information. To make things worse, President Trump believes that “doctors lied” about vaccination and has shown an interest in pursuing the Wakefield conspiracy theory.
As long as there are communities that have strong negative views about vaccines, there will be outbreaks of vaccine-preventable diseases. As long as people continue to share pseudo-science and fake news on social media, anti-vaccination supporters will gain more following. If more and more parents stop supporting vaccines and immunizations, disease like measles will continue to rise, we will see sustained chains of outbreaks, and we will all see the real impact of measles and other vaccine-preventable diseases.
Originally published at The Huffington Post.
Dr Melvin Sanicas is a vaccinologist and public health physician with over 10 years international experience in drug and vaccine development, regulatory affairs and drug safety. He was a Global Health Fellow and Program Officer at the Bill & Melinda Gates Foundation where he managed the Collaboration for TB Vaccine Discovery. He is a partner at the Brighton Collaboration, a Fellow of the Royal Society of Tropical Medicine and Hygiene, and a Fellow of the Royal Society for Public Health.