Measles – Views from the Top and the Front Line

Share:

by Tia Will

Robbie Pearl is the CEO of The Permanente Medical Group. As such he is responsible for the provision of medical care to the 3.6 million people insured by Kaiser Permanente in Northern California. He writes a monthly column for Forbes. In the February 5th issue, his commentary started as follows :

“My father’s sister Mary died from measles when she was 6 years old. Her death haunted my grandparents for the rest of their lives.

She was one of thousands who died each year from measles before there was a vaccine to prevent this life-threatening disease.”

He then proceeds to lay out a very concise review of the history of measles, the discovery of an effective vaccine, the origins of the anti vaccination movement and makes a plea for vaccination as the most effective tool we have to stop illness and deaths related to this serious and highly infectious disease. I highly recommend his piece to anyone interested in this topic.

http://www.forbes.com/sites/robertpearl/2015/02/05/measles-vaccination-must-be-mandatory/

From January 1 st – February 6th there were 121 reported cases of measles in 17 states with 88 of these cases in California. Standard epidemiological case tracking and DNA testing have confirmed that most of these cases are linked either directly or as “second wave” to exposure at Disneyland and that this particular strain of the measles was imported from the Philippines.

My purpose in reintroducing this topic is to discuss the scope of this issue as it affects us here in Yolo County and what steps are currently being taken to minimize the risk. I will first present some information regarding measles and immunization in our county.

As of Thursday there were no reported cases of measles in Yolo County. Does this mean that we are safe, or have dodged a bullet, or are immune as a community in Davis ? Not necessarily. Measles, being an airborne pathogen is passed in waves. It can be carried by an individual who typically has a pro-drome of 3-4 days prior to outbreak of rash consisting of a low grade temperature elevation with runny nose and sneezing or coughing and can thus pass the disease on to many others before recognizing that what they have is a highly contagious and in some cases life threatening illness. The virus which causes measles is capable of lingering suspended in the air and in microscopic fluid droplets on surfaces for at least two hours after being expelled. Thus it is possible to transmit the virus without ever having had direct contact or even being in the same room at the same time with the recipient. It is our historical high rate of vaccination that has protected us until recently. However, with strengthening of the anti-vaccination movement there has been a decrease in the number of parents choosing to vaccinate their children. This decrease has not occurred uniformly throughout the area, but rather in pockets.

According to statistics gathered by the Yolo County Health Department for the 2013-2014 school year, the distribution of immunizations as reported by the local schools was as follows :

92% of entering kindergarteners were immunized

4% had personal belief exemptions

93 % of public school students were immunized

98 % of Woodland students were immunized

85 % of West Sac students were immunized

75 % of private school students were immunized

51% of Davis Waldorf students were immunized

Despite our access to efficient health care delivery systems here in Davis, we have one of the highest rates of non vaccination, and thus one of the highest rates of risk to those in our community who are not eligible for vaccination. In a recent conversation with a parent in our community who has two children not eligible for vaccination I learned that he is afraid to take his children out to public events such as the Davis Farmer’s Market for fear of exposure. His fear is not unfounded.

While there are risks involved in all medical interventions including vaccination, it is critical to look at the risks of the intervention in comparison with the risks of the disease. Robbie Pearl described the relative risks this way :

“The measles vaccine is proven safe and effective. The risk of experiencing a major problem from the vaccine is roughly less than 1 in 40,000. In contrast, studies show 1 in roughly every 333 people who contract measles will die from it.

While the perception that there is no need to vaccinate may have had some basis when it appeared that measles had been virtually eradicated in the United States, that is no longer true. Measles is again with us as this current outbreak has demonstrated . From the point of view of a primary care doctor, there is no longer any justification to not immunize any individual who does not have a medical contraindication and who choses to participate in the activities of the community thus putting the community at risk.

I chose to build my career with Kaiser over the past 27 years largely because of the shared philosophy in the group of the importance of primary prevention as invariably superior to treatment once a disease condition has developed. It is with this philosophy in mind that Kaiser has instituted the following steps to protect the health of our members and our community :

  1. Universal pediatric screening of all patients for currency of their immunization status
  2. Strong recommendation to parents to make up for any disparity from current pediatric recommendation.
  3. Physician outreach to parents of children who are not fully immunized in the form of telephone calls and secure ( HIPPA compliant) emails.
  4. Screening questions designed to identify patients calling who may be demonstrating symptoms of measles in much the same way as we used screening questions to identify patients who might have been exposed to Ebola prior to their arrival at our facilities.
  5. Strict isolation protocols for any patient arriving at our facilities with symptoms suggestive of the measles.
  6. Strict decontamination protocols for any room in which a measles patient may have been.

So far, we have been lucky. There are no reported cases of the measles in either Davis or Yolo County. As a front line primary care provider, it is my goal to keep it that way. We all have a role to play in ensuring that our community remains free of this potentially devastating disease. My recommendation for each adult individual is the following :

  1. Know your own immunization status – if in doubt, consult with your doctor.
  2. Know the immunization status of your children. If you have not, please reconsider immunizing your children in light of the current outbreak.
  3. If you choose not to immunize your children, please consider keeping them out of public contact. The life that you save might be that of a stranger than you do not even know that you have affected, but it could equally well be the life of your own child.
  4. Talk about this issue with your family members and friends. Listen to concerns with respect and recommend that all to whom you talk give consideration to all of the issues involved, not just one specific fear.
  5. Be proactive. Don’t hesitate to engage in conversations about this issue. We all have much at stake in the protection of our lives, those dear to us, and the protection of the entire community from this life threatening illness which we have the ability to completely eradicate if all who are medically eligible were to receive vaccination.
Share:

About The Author

Disclaimer: the views expressed by guest writers are strictly those of the author and may not reflect the views of the Vanguard, its editor, or its editorial board.

Related posts

41 thoughts on “Measles – Views from the Top and the Front Line”

  1. SODA

    Thanks Tia!

    Just a question about the immunization rate data:  Were these all kindergarden rates?  Which is overall Davis? Has the Waldorf School been approached by the county health dept to engage in dialogue?

    What exactly is the process to decline immunization; just declining?  If a parent declines, who keeps those records? Does the county?

    Are you in favor of Dr Pan’s 2 proposals (think one might be law) but the second in committee now would require a visit to a physician and ‘signed note’ before immunization could be refused.

    I can somewhat understand the feelings of parents who decline as I have expressed in past DV’s posts, although I do not agree. What I am perplexed about is their thoughts on the greatly increased risk to vulnerable individuals including of course their own children but to infants and others who cannot take the vaccine because of medical conditions. Do you have any perspective on that or can anyone else provide it?  I asked before and do not think we saw any….

    1. Tia Will

      Hi SODA

      Good questions. I apparently deleted rather than posting my response, so I will try again.

      1. Only the first stat applied only to kindergartners. The rest are not age separated.
      2. I do not have numbers specifically for Davis schools as a group.
      3. I do not know if the county has made any direct outreach to any school. I am hoping to address this through my participation on the Health Council.
      4. As to the question about process for declining immunization, I can only speak from my Kaiser experience and not for any other health system. Our integrated electronic charting system provides a diagnosis for “declines immunization” and allows for additional comments so that we can specify which immunization is being declined. This is information is available through the individual chart and can be “data mined” for statistical, reporting and research purposes without patient identifiers attached so as not to breech HIPAA regulation.
      5. This data is not reportable to the counties ( to the best of my knowledge).
      6. I believe that the county obtains their data from the schools. If anyone is aware of alternative sources, please correct me on this.
      7. I am conflicted on the best way to address this issue. I am a firm believer in individual choice with regard to one’s own health care and I certainly do not favor forced immunization. I also am a firm believer in individual responsibility including not recklessly endangering other members of the public. What I favor is a choice. Either immunize, or choose self isolation. I do not see this as substantially different from the safe use of public streets. We give people a choice. Either adhere to the established licensing procedures  and the agreed upon driving rules, or don’t drive on the public roads. The choice is theirs. I can see the possibility of issuing immunization statements much like driver’s licenses that must be shown to enter certain public venues ( schools, amusement parks, theaters, sporting events….) This would preserve the individual right not to immunize, while also preserving the individual right not to be exposed to a potentially life threatening disease.
  2. Davis Progressive

    “There are no reported cases of the measles in either Davis or Yolo County.”

    only by luck.  as i read recently, the davis schools are almost all below the 90% critical level.

    1. wdf1

      DP:  only by luck.  as i read recently, the davis schools are almost all below the 90% critical level.

      source

      Only two Davis public schools had vaccination rates above 95 percent for entering kindergartners this year, according to data from the California Department of Public Health. Ninety-five percent is the rate needed in a given population to prevent outbreaks of pertussis and measles, according to Yolo County’s health officer, Dr. Constance Caldwell.

      At both Korematsu and Willett elementary schools, 97 percent of all entering kindergartners were up to date on their immunizations.

      But rates at two elementary schools — the district’s smallest, Fairfield Elementary, and the district’s largest, César Chávez Elementary — were below 90 percent.

      Fairfield’s 82 percent was based on two kindergartners with personal-belief exemptions while Chavez’s 89 percent was based on 11 kindergartners with such exemptions.

      Last year, only two Chavez kindergartners claimed personal-belief exemptions.

      All other Davis public schools fell between 90 and 94 percent: Montgomery Elementary School reported 90 percent of kindergartners were up to date with five personal-belief exemptions; North Davis Elementary reported 92 percent up to date with three personal-belief exemptions; Patwin Elementary reported 92 percent up to date with five personal-belief exemptions; Birch Lane Elementary reported 94 percent up to date with five personal-belief exemptions; and Pioneer Elementary reported 94 percent up to date with four personal-belief exemptions.

      Additional info on individual schools for kindergarten and 7th grade classes for California can be found here.

  3. Anon

    Tia Will: “The risk of experiencing a major problem from the vaccine is roughly less than 1 in 40,000. In contrast, studies show 1 in roughly every 333 people who contract measles will die from it.

    This is the key point.  Vaccination should be a logical risk assessment.  No vaccine is 100% safe.  However, it is far riskier exposing your child to the disease than to the vaccine.  I had a serious case of the measles as a kid, which caused a nosebleed that nearly choked me and sent me to the emergency room.  My son had a terrible case of the chicken pox, in which he was nearly hospitalized.

    Tia, what is the vaccination rate for children in Davis?  You list Woodland and West Sac but not Davis!

    I am in favor of proposed legislation which removes the personal exemption. This is a public health issue.

    1. Tia Will

      Anon

      I know. I regret not having the statistics for the Davis schools separately. I used the Yolo County statistics site and was unable to find this number separately. I was hoping to be able to post the county interactive map which shows the rate by school but did not want to delay the article until I receive that from the county epidemiologist who is currently out of town. That website was not fully functional at the time I was otherwise ready to submit.

        1. Tia Will

          Anon

          “What is Davis trying to hide”

          I would ascribe this much more to my research limitations and time constraints than I would to any nefarious intent on the part of the City of Davis.

  4. Tia Will

    I had another thought that I wish I had included in my initial article with regard to steps individuals can take. I have found that there is a lot of power in peer interactions. I would recommend that all parents, when setting up a play date, take the very simple precaution of asking whether or not the intended playmate has been vaccinated. If this were the pre-requisite to playing with enough children, the parents might get the message that this is an expectation for the safety of our children.

    Years ago, I approached with some trepidation asking the question regarding whether or not guns were kept in the homes of prospective playmates. It was actually very well received and some mothers actually thanked me for asking. My take home lesson is that one should never be embarrassed about proactively seeking to protect their children from preventable harm.

    1. Anon

      Okay, I need a little help here in my understanding of the issue.  If I were a mother who had vaccinated her children, why would I care if my child plays with an unvaccinated child?  My children are protected, no?  Or could they still get a mild case of the disease, even if vaccinated?

      1. KSmith

        And not only in these cases that Anon brings up, but can’t the MMR vaccine “wear off”? So, some older adults may not still have the immunity conferred by their previous vaccinations? This is what happened with me with the pertussis vaccination (I got whooping cough back in 2010), so I’m wondering if this is also true for the measles vaccine.

        If so, is it recommended for adults to get an additional booster?

        1. Tia Will

          K Smith

          Although I do not offer specific medical advice here, I have posted a response to your question as found on Up to Date :

          high-risk adults need full immunity to all three diseases ( measles, mumps and rubella ) which is provided by any of the following:

          Documentation of the administration of two doses of the MMR vaccine administered at least 28 days apart to protect against measles and mumps

          Documentation of one dose of MMR or live rubella vaccine to protect against rubella

          Laboratory evidence of immunity to all three diseases

          Laboratory confirmation of disease

          Being born before 1957, except for women who could become pregnant and certain healthcare workers. This is because the age cohort born prior to 1957 were fully immunized often in the schools as part of population outreach.

          If in doubt about your own immunization status or your specific risk, I highly recommend addressing the question to your doctor

    2. sisterhood

      Re: guns, you & I have discussed this before. I also asked parents if guns were present. I was sometimes surprised at their answers! Not always the parents one would make assumptions about! Of course, then my kids played somewhere else.

      A lovely woman I worked with years ago lost her young daughter to an accidental gun death. Another friend of mine almost lost her brother when he was loading a hunting rifle into the trunk of his car & forgot it was loaded. It only takes one second of forgetfulness. I think your suggestion is much better than my suggestion to have a public registry of non vaccinated children. It still doesn’t help the situation of newborns in public places. I guess the only way around that is to keep infants home as much as possible until all vaccines done.

      While working at WIC I was fortunate to watch a film showing a newborn with whooping cough.  It broke my heart & I wish all parents who are uncertain about vaccines could see it.

  5. Tia Will

    Anon

    That is actually a very astute question. Like with most things in life, it’s complicated. First, you are right. Immunization is not 100% effective but does tend to confer some protection even if not perfect. However, there is another issue at play. What if your child is one of those who is not eligible for immunization ? Or ,what if there is a new child in your household who is too young to be immunized? One thing that young children frequently have in common is younger sibs.

    It is also important to remember the ease with which this virus is spread. So let’s say that your child, a three year old who is immunized now goes to the home of an un-immunized 3 year old playmate. They share toys. Your three year old now brings home a toy carrying the invisible droplets of saliva from the mouth of his un-immunized playmate. Before you have time to clean or put the toys away, the toy as been in the hands of your nine month old who now pops her hands in her mouth. Measles transmission !  Yes, it is that easily transmitted.

    So let’s take this a step further. Over the next few days, your nine month old has not been idle. She has been at Mommy and me exercise classes, she has been to Story Time, she has been on several playgrounds and maybe at the nursery school at church. Everywhere she goes, she has multiple interactions with children of various ages and adoring adults. After a couple of days, you notice that she has a slight runny nose and cough and assume, quite reasonably that she has a mild cold. No alarm yet, so she is still out and about. Until around day 4 when she starts developing a rash. A call to the pediatrician raises the alarm and now we have a second wave case. You probably never even knew that your three year olds playmate’s family went to Disneyland !

    1. Anon

      Excellent response, and I see your point.  The example of having a older brother or sister playing with some child incubating measles, and then it transmits to a toy or whatever back to your baby who has not yet been immunized is just the sort of thing that illustrates why vaccinations need to be mandatory, w no personal exemption.  I am not sure I am even in favor of a religious exemption, quite frankly.

      1. Tia Will

        Anon

        I do not favor either a personal or a religious exemption. Actually, I see them as one and the same since I value people’s personal philosophic beliefs as highly as I value what another may identify as their religion. Again, I do not believe that vaccination should be forced. I do believe that the choice should be either vaccination or voluntary isolation. This preserves the ability to choose, protects against the harm feared from the vaccination, and protects against the potential harm caused by lack of immunization. A win – win scenario.

  6. sisterhood

    Measles is a known deadly disease. Maybe the people who choose not to immunize should be required to register this info with CDPH or DHCS, or the CDC. That way, the most vulnerable among us can protect themselves. Are people with sexually transmitted diseases required to divulge their info to any health organization? What, if any, disease requires reporting to the CDC?

    1. Tia Will

      sisterhood

      What, if any, disease requires reporting to the CDC?”

      There are a number of diseases that are reportable on the county level with statistics compiled and/or direct notification made to the CDC as needed. The most recent example of a disease that would require immediate notification in real time is Ebola.

      However, there are a number of diseases that are reportable, but there is a longer time frame. Please do not ask me what it is because our system has been integrated for so long that I no longer remember how long we have to report. The responsibility for reporting lies with the diagnosing clinician. When I make a diagnosis, I treat, document that I have done so, and forward the chart to my nurse who makes the report electronically.

      Reportable diseases include, but are not limited to, Ebola, measles, mumps, the sexually transmissible diseases including HIV, hepatitis, syphilis, gonorrhea, chlamydia, tuberculosis. That is all I can think of the top of my head. A complete list of reportable diseases is available by Googling “reportable diseases” or going directly to the CDC Web site.

       

      1. DavisBurns

        The anti-vaccination folks believe that side effects are underreported to CDC.  I read that there were no sanctions if side effects weren’t reported.  They take that to mean it is entirely optional, therefore, when parents report symptoms to doctors, the doctors may or may not report those symptoms.  If the symptoms aren’t reported the vaccines appear to have few side effects.

  7. Napoleon Pig IV

    “51% of Davis Waldorf students were immunized”

    From this fact, may we conclude that 49% of Davis Waldorf students have  parents who are incapable of critical thinking, incapable of distinguishing objective data from propaganda, or are simply delusional simpletons?

    Oink!

    1. Tia Will

      Napoleon Pig IV

      “‘have  parents who are incapable of critical thinking, incapable of distinguishing objective data from propaganda, or are simply delusional simpletons?”

      I hope that you are speaking with tongue in jowl ( oh, excuse me, cheek). I honestly cannot tell and so I am going to address your comment as though it were serious.

      I think that these kinds of comments represent a serious misjudgment and unnecessary stigmatization of people whose perspectives and values may differ from our own. Questions about the safety of the vaccine are legitimate and not everyone reads the same information and processes it in the same way. There are still  individuals who feel that even though the work of Wakefield in linking the MMR to autism has been thoroughly discredited, that he was correct and that he was the victim of a “witch hunt”. One can find a number of reasonable sounding articles and commentary from anti – vaccinators. It is my belief that they are incorrect, not that they are “simpletons”.

      You apparently have chosen to ignore the following portion of my recommendations.

      Listen to concerns with respect and recommend that all to whom you talk give consideration to all of the issues involved, not just one specific fear”

       

      1. Napoleon Pig IV

        “I hope that you are speaking with tongue in jowl ( oh, excuse me, cheek). I honestly cannot tell and so I am going to address your comment as though it were serious.”

        Tia, all of my astute insights are said tongue in jowl, in the great tradition of others who have used satire and irony to make serious points (“Gulliver’s Travels” anyone?), and also in keeping with my role as a turncoat pig sympathetic to, while simultaneously skeptical of, sheep and other lesser barnyard critters. Please note as well that my statement was actually a question, one which you endeavored to address with reasonable skill and partial persuasiveness.

        However, that part about respect needs a bit of qualification. Respecting individual critters is a worthy thing for both pigs and sheep, but respecting their delusions and fantasies is another kettle of fish entirely. Shrouding some delusions in patriotism, religion, or opinion polls makes them no less undeserving of respect.

        I have great sympathy for anyone whose loved ones suffer from unexplained medical problems, whether the problems are autism, cancer, metabolic disorders, or any of the many other conditions that continue to plague our collective barnyard. However, confusing causation with correlation is the basis for bad individual decisions and even worse public policy no matter how much granola is crunched or how many flags are waved.

        Oh, wait, I forgot. The increased use of vaccines over the last several decades has, in addition to reducing childhood mortality and the overall burden of infectious disease, also caused an increase in childhood obesity, the loss of cursive writing skills, and an emerging adolescent obsession with zombies, not to mention increased surveillance of private citizens by government minions. I guess we’d better join paws and hooves and just respect those viruses away. Oink!

        1. hpierce

          Like your Gulliver’s Travels reference.  Of course, you must be familiar with another great satirist who spoke about “All animals are equal” but “some animals  are more equal than others”.  See you @ the trough! Oink back at you.

  8. DavisBurns

    Tia, I appreciate your advice to remain respectful to others with different opinions.  I find this has seldom been the case with the vaccine debate.

    I have children on the autism spectrum.  One child went to a private high school for high functioning kids with communication deficits where most of the parents were older, well educated and tended to have at least one and sometimes two parents with engineering degrees.  Vaccines were never an issue while I was there but our kids were born at the beginning of the increasing rate of autism so the autism/vaccination connection was not posited until well after these kids were vaccinated.  I remain in touch with one of these parents.  While she is not opposed to vaccinations, nor am I, she was concerned about the vilification of those who do hold those beliefs.

    This led me to do some reading about the vaccine controversy.  I wanted to understand the concerns of the people who are not vaccinating their children.  I found they raised some questions I thought were valid and some that I at least understood.  For me, the bottom line is we have individuals, sometimes communities who don’t trust the medical establishment, the pharmaceutical industry and the government.  While we will never change any minds by calling them stupid, we might convince some by answering there primary concerns.

    One of the first things I noticed was how often the pro-vaccine people say ‘vaccines have been proven to be safe’.  If you have a child who seemed to be developing normally and regressive autism (which I used to simply dismiss because you’re born with it or not) coincides with a high fever, convulsions and a MMR vaccination, I don’t think anyone will ever dispel the belief that the two are connected.  That’s how humans operate.  That child and those parents lives are changed forever and they aren’t likely to be convinced.  So what can we do from a public health persecutive?  How about offering them a modicum of control if they are faced with another child and vaccinations?  Why can’t they have the option of a separate measles, mumps and rubella vaccination?  That is an option not available in this country but it is available in Japan.  It costs more but that seems like a small hurdle.  It takes more time but if the parents who would absolutely never risk an MMR vaccination but would agree to separate shots would that not be better for all concerned?

    When people with similar problems find each other, their negative experiences reenforce their beliefs.  Plus, there really is a lot of information that questions the government’s party line.  If you want to be convinced you will find a lot help you make up your mind.  Anyway, there are communities that support the belief that vaccines have not been proved to be safe.  I saw a many people who believe in supplements and diet as a way to protect their children. I have known parents who put their kids on all kinds of diets to improve dyslexia, learning disabilities, attention problems and behavior problems.  One characteristic of these parents is a their level of education.  They can’t be dismissed as stupid, ignorant or uneducated.  In fact, if you want a high level of vaccination look  for less educated parents.

    One of the first things I would do is to be upfront with the risks of the vaccine.  It is not risk free. If your child is the one in 40,000 who gets very sick (Tia’s number) or one in 200,000 or 300,000 or 400,000 (CDC’S numbers) then you are personally paying the price of herd immunity.  You, your extended family and your close community will not feel like it is risk free.  Put enough of those folks together, tell them it is risk free and they won’t believe anything you say.  If you are one of the unfortunate who ends up in National Vaccine Compensation Program (or vaccine court) because your child’s vaccine reaction included encephalitis and resulted in “autistic like symptoms” and you are compensated for your loss and a lifetime of care, then you and everyone who believes there is a connection will see this as proof there is a connection.  When you take that child to the doctor, those autistic like symptoms will lead to a diagnosis of autism.  While there is some sympathy for Andrew Wakefield, I think most people believe he was discredited because he lied and fudged his data. (I think the people who keep bringing him up are the pro-vaccine people–they should stop beating the dead horse because his research doesn’t seem to be central to parent’s decisions not to vaccinate.) These are intelligent people.  They don’t like him doing that anymore than they like the drug companies lying–and there is great distrust of Big Pharma.

    I grew up with childhood diseases.  I had measles, mumps, rubella and whooping cough.  Everyone in the neighborhood got all of them.  Parents even exposed kids so they would get it and get it over so I don’t have the same level of hysteria I read frequently.  Measles may cause death but I think they go too far when they call it deadly.  I oppose the bill to make vaccinations mandatory.  We need to do our best to be transparent about the risks of vaccinations and to give those who are reluctant all the information we can about the risks while giving them as many options as we can–like a very conservative vaccination schedule and separate shots.

    I will add that the United States is not alone in this problem. There have been measles outbreaks in  France, Germany, England, the Netherlands, Italy, Romania and Greece and Israel.  
    England reports 92.7 % for MMR in 2013-14 but in 2012 they reported 91% vaccination rate for MMR as the highest in 14 years.  In Brighton the rate is 87%.  There was an outbreak in Wales where 2,030 cases were reported 88 people were hospitalized and one person died.
    Japan has a much bigger problem than us but that is another posting. They are one of the biggest exporters of the measles virus.

     

    1. Tia Will

      DavisBurns

       I oppose the bill to make vaccinations mandatory. “

      How then do you propose that those of us who are strong believers in vaccination protect our children from measles? Are we then to have to isolate our children who are too young or otherwise not candidates for vaccination  because of the unproven theories of others in which we do not believe ?  I do not mean to be harsh, but I do believe that those who oppose mandatory vaccination do have some obligation to propose alternatives whereby the rest of us can remain safe.

    2. hpierce

      Thoughtful post, Davis Burns.  I too had all the childhood diseases.  The only vaccines I recall having were smallpox (nearly, but not quite eradicated, world-wide) and polio (was part of the “cube” generation, but may have also had an innoculation, was too young to remember… but I DO remember the sugar cubes!  And I am far from obese.

      Would be very scary if smallpox and/or polio could become prevalent again due to others not getting vaccinations.  Perhaps the anti-vax folks should be reminded of where the word “vaccination” comes from.  As I recall, a Dr named “Jenner” noticed that during smallpox epidemics that ‘dairy-maids’ who got “cowpox” had relatively minor side effects from THAT disease, and had little sign of contracting smallpox.  Salk and Sabin, if I recall, had different approaches as to using “dead” or “attenuated” virus to provide immunity.

      You and Tia have good points, but I particularly heard and honor your insights.

       

      1. wdf1

        hpierce:   The only vaccines I recall having were smallpox (nearly, but not quite eradicated, world-wide) and polio (was part of the “cube” generation, but may have also had an innoculation, was too young to remember

        Not MMR (measles/mumps/rubella)?  That was an early vaccine.

      2. DavisBurns

        My brother had polio, a mild case in 1952-3. I believe smallpox has been eradicated.  We got the shot that leaves the scar for smallpox but my kids didn’t get it.  Yes our parents were thankful to have vaccinations. One of the anti-vaccination folks concerns is how many the kids get these days.  I don’t have much to say in that regard.  My kids have gotten their shots and I have no grandchildren so I am out of the game. My two daughters and I don’t get flu shots.  I have been given a hard time about that on this forum.  As I get older i do have some concern about this decision and revisit it every year.  I discussed it again with my doctor and he agrees I should forego the shot….so no one has to tell me how irresponsible I am.  I am officially one of those for whom the flu shot is not recommended.

  9. Tia Will

    DavisBurns

    I appreciate your comments and your perspective. I am however baffled by one of your statements.

    Measles may cause death but I think they go too far when they call it deadly.”

    If something causes death, which measles certainly can, how can it be going to far to call it deadly. The definition of deadly is death causing.

    I was also wondering how you would feel about my suggestion for an immunization “license” much like a driver license which could serve as a pass into public venues. One could opt for the vaccine in order to obtain the pass, or opt out of the vaccine and choose not to go to large public events thus placing many others at risk. Your thoughts ?

     

    1. sisterhood

      I guess I’m biased but I don’t like more laws. Until enforcement of all existing laws are handled equally for all, I see them as just another tool to harass lower income folks or perhaps immigrants. I doubt I’d vote for any new law.

      I’d like to give a shout out to my former W.I.C. co-workers. W.I.C. does an exceptional job of reminding & educating every new mom and mom of a toddler about the importance of IZ.

  10. DavisBurns

    I can find a reference that says death for measles in .2% of case and about one death per year is reported since 1995.  I haven’t heard of any deaths from the current outbreak.  While it is highly contagious, it doesn’t seem to me to result death very often.  Maybe it’s just semantics.  Car travel can be deadly yet we don’t describe it as deadly car travel. ditto air travel.

    i am not sure what I think of restricted assess to public venues.  Would they be under virtual house arrest? Could they go to the supermarket or the park? How do you decide what is a large public event? The local movie theater? The library, school, the annual Nutcracker presentation, Disneyland? How would it be enforced?

    I certainly think parents of young children should know if their kids playmates are vaccinated.  It was a good suggestion on your part.  I read in the Enterprise the procedures the schools have in place if there is a measles outbreak–the unvaccinated kids are sent home and can’t return until 21 days after the last reported case.

    What did you think of additional public outreach and offering them more control over the vaccines schedule and single vaccine shots? When we have picked off the low hanging fruit is it worth while to pursue another one or two percent who might be persuaded? I think some will not vaccinate because of religious beliefs and some will never trust the government and the medical community but some might come around.
    I really think this is part of a culture of fear and distrust that is nexominf more pervasive in our culture.

    1. Anon

      I respect why you feel the way you do in being opposed to mandatory vaccinations, and I don’t take your concerns lightly.  Many years ago, there was hysteria raised by an irresponsible reporter, about the whooping cough vaccine.  At the time, I had to make a decision whether to immunize my child.  I asked the doctor about it, because I had the same concerns you do about vaccinations in general and the possibility of side effects.  That is not an unreasonable concern.  The doctor put it quite simply: the risk of having side effects from the vaccine is far out outweighed by the risk of having side effects from the disease.

      Having said that, and because too many anti-vaccinators are not immunizing their children under the personal exemption and we are seeing a resurgence of these childhood diseases, I consider this a public health issue that must be addressed by removing the personal exemption.  Would you agree to a personal exemption for the polio vaccine if there started to be a resurgence of that terrible disease?  That is precisely what is happening in Afghanistan because of a push by the Taliban to prevent polio vaccinations for children.  Polio is rearing its ugly head again.  Sometimes personal freedom has to take a back seat to the greater good – it is called freedom with responsibility.

       

    2. Tia Will

      DavisBurns

      What did you think of additional public outreach and offering them more control over the vaccines schedule and single vaccine shots?”

      I would be in favor of these options. Actually, I would be in favor of almost any steps that would encourage more vaccination. I also believe that most doctors will work with patients to come up with an agreeable schedule. I have never, ever heard of a doctor saying, “no, you can’t vaccinate at all unless you do it on the dates I mandate”. I know that for people who are due for both a Tdap and the flu, if they ( in my opinion erroneously) fear getting them on the same day, I have my nurse give the one they will accept and then trust them to come back for the other. The problem is of course, sometimes they return, and sometimes they don’t.

      I agree with you that most people who do not vaccinate choose this course because of fear. Unfortunately, they are choosing to ignore the fears of others that their failure to act puts others at risk. The Disneyland outbreak has certainly demonstrated this.

      How do you decide what is a large public event? The local movie theater? The library, school, the annual Nutcracker presentation, Disneyland? How would it be enforced?”

      Yes to all. For enforcement, we have amply precedent for ways to set this up. We have drivers’s licenses. People get carded before they can order alcohol and to enter certain clubs. I even got carded not too long ago to prove I was a senior to get my senior discount !  I would envision a card which certified being up to date on one’s immunizations which would be presented at the door.

      1. hpierce

        Then, using your logic, Tia, where liquor is served, and depending on the type of “club”, we should have cards showing that the attendee is certified free of syphillus, gonarreah, clamydia, HIV, and other STD’s (apologize for the spelling).  In for a penny, in for a pound.  Pretty sure people die in ‘many orders of magnitude’ greater numbers from STD’s than from measles.

        I say this having had our kids vaccinated for all of the recommended ones, and choosing myself to get flu, shingles and pneumonia vaccines.

        1. Tia Will

          hpierce

          I understand your point about the STDs. However what is missing from your analogy is the difference in infectivity of the measles virus from the STDs none of which can spread through aerosolized droplets and thus pass to large numbers of people who may only be passing through the same space, not involved in intimate activity with the infected individual.

          There is another good and free preventative measure for STDs. Abstain.

          There is no way that you and your children can avoid the measles virus if someone else is shedding it. You can hardly choose to do the equivalent which would be “don’t breathe”.

        2. sisterhood

          Re: “don’t breathe”- why do I see folks wearng surgical masks? Do they actually help anything, or are those folks just a tad germaphobic? Are they being thoughtful & trying not to spread their own germs around? Or do they have allergies, perhaps?

  11. DavisBurns

    I was in Fairbanks Ak recently.  It is really popular destination for Japanese tourist in the winter.  Part of it has to do with seeing the aurora borealis but the Alaskans tell me they charter planes to come over and that is the bulk of their business in January and Febrary. Anyway, it was common to see them with masks on.  Which takes me back to Japan as a country that has had unusually high adverae reactions to MMR vaccines (a thousand fold more than expected) and consequently has a low vaccination rates and is a primary exporter of measles–they travel here and we travel there.

  12. DavisBurns

    One question I found interesting on the anti sites was the question of pneumonia vaccinations.  If one of the most common causes of death with measles (and the flu) is pneumonia, why don’t people get a pneumonia vaccine more often.

    Also, one study that linked vaccinations to autism was discredited.  Should we take that to mean there is no need for further research? When the pro folks say there is no link between vaccination, is disproving one study is that the end of the discussion? Something has caused the increase in the rate of autism…most likely something environmental.  Maybe it’s the increased use of pesticides and living near where they applied or maybe it’s an accumulation of proceased stuff we’ve been eating for a couple of generations plus a genetic predisposition. Whatever the cause, isn’t it correct to say “there have been no studies to date that link autism to vaccinations”. I know this is a public relations problem and we don’t want to increase the public’s fear but in doing that we harden the stance of the anti folks.  I am interested in continuing the discussion if others are interested,  my brief look at other countries tells me we aren’t alone with this problem.

Leave a Reply

X Close

Newsletter Sign-Up

X Close

Monthly Subscriber Sign-Up

Enter the maximum amount you want to pay each month
$ USD
Sign up for