Since the beginning of this year, certain states within the US have seen a drastic increase in the number of measles cases. The vast majority of these cases are in children under the age of 10, and aren’t due to any special increase in the virality of the measles virus. Vaccinations to prevent measles have been extremely effective in the developed world, making large scale outbreaks of the virus almost non-existent in the last 50 years. According to the CDC, the measles virus was declared eliminated from the United States in 2000, due to the effectiveness of the MMR (Measles, Mumps, Rubella) Vaccine. Before the MMR Vaccine was available in 1963, measles was a highly destructive disease due to its incredibly contagious nature, causing over 48,000 hospitalizations and 400-500 deaths annually. A person with the measles virus can infect others who do not have immunization simply by being in the same room with them. This highly contagious nature makes outbreaks hard to contain, and requires extreme vigilance on the part of family care providers and public health officials. While the virus is obviously now not eliminated in the US, it is thought that the probable cause of most US measles outbreaks is from travelers who bring measles into the country from abroad and then spread it to those of the US population who are not yet vaccinated or who chose not tobe. If the population maintains high vaccination rates, there is a much lower chance of individual cases becoming outbreaks of wider public health concern.
Unfortunately, in the last 20 years, one faulty and widely discredited study has created a large number of so called “anti-vaxxers” who believe the measles vaccine causes autism. This claim was based on one study by one Dr. Andrew Wakefield in 1998, grounded in false evidence and has never been replicated by the scientific community. In the medical world, this is the closest to being completely disproved that a theory can get. This study, however, has had disproportionate impact in creating a large community of followers connected by the internet and social media. The people who chose not to vaccinate their children are not only putting their children and themselves at risk but others within their community as well, and we have seen two large outbreaks in the US in the past five years, of which one is currently ongoing. Unfortunately the lies in the Wakefield study have taken on a life of their own and are parroted by people in positions of power who put us all at risk.
The first major outbreak in recent years was in California in 2014-15 although cases of measles are still being reported in the state at lower levels. The CDC has reported that the initial source of the outbreak was never identified but was probably due to a traveler with the virus visiting the Disney theme park in California, and the virus subsequently found many hosts there who did not have the vaccine or immunity. As a result of this outbreak at Disney, a wide reaching outbreak occurred with 147 cases identified in 7 US states.
The most recent outbreak is currently ongoing. It started in the pacific northwest in Washington and Oregon and centered in Clark County, Oregon. This area is home to a lot of people who believe that vaccines are either unsafe, and has forced public health officials in the area to publish a list of the places that people with measles have been, including shopping areas, sports arenas, and airports. This outbreak has spread to many other states nearby, and has been going on concurrently with a recent outbreak in Orthodox Jewish communities of New York City. In 2011 an outbreak affected a large number of people living in an Amish community, and these all point to the main cause of measles outbreaks to be low adherence to suggested vaccine regimens.
In most states in the US, exemptions to vaccination regimens are considered for religious or health/age reasons, but some states, including the ones which currently are experiencing outbreaks, allow for exemption from vaccines based on non-religious, non-health related reasons. Since the measles outbreak in California, the state moved to pass a law that no longer allowed for non-religious, non-health related exemptions, and over this past weekend while this article was being written, the State of Washington followed. For these people who may still believe the widely disproven Wakefield study or traffic in the various vaccine-related conspiracy theories on social media, they and their children are open not only to catching the disease themselves but to spreading it to others who may not be old enough to receive the vaccine yet or who cannot obtain it because of religious or health issues. This willful lack of consideration of medical certainty is promoted and given a larger platform thanks to the voices of celebrities, most notably Jenny McCarthy, Robert F. KennedyJr., and Donald Trump. In the early days of Trump’s presidency he actually stated he wanted to appoint Mr. Kennedy to a Chair position on a committee to review the safety of vaccines– and he has often tweeted about the lack of a consensus on the safety of vaccines (there isn’t a lack of scientific consensus). In addition to being false and misleading to the public, these claims are dangerous. A lowering of vaccine rates would endanger the public at large, especially our most vulnerable – those who are too young or sick to obtain vaccinations.
This trend seems to be a part of a growing wider disregard for scientific evidence in public policy and public debate. While it is unfortunately unrealistic to argue that the average person will base their beliefs and actions off of scientific consensus, we should not aspire to get our medical advice from celebrities. In a perfect world we would, as a nation, be able to inform our opinions by factual statements given by our elected officials because of the higher standard that should accompany holding public office. Repeatedly, scientific evidence has been pushed to the side to advance political ambition, playing off the lack of scientific literacy of the general public. In the United States especially, the scientific consensus on the existence of human-made climate change has been often pushed to the side or misrepresented; since 1997 Congress has specifically forbid the CDC from researching firearm violenceas a public health concern. Both of these willful omissions of truth have strong private-interest backing in the form of lobbying, and show a concerning trend of moving away from fact-based policy, and we are all certainly less safe for it.
Banner image: courtesy of Johnny Silvercloud via Flickr, © 2017, some rights reserved.