Measles: Once Eradicated, Back Again


Vaccination has remained controversial.

The scientific facts illustrate vaccines do not cause autism. In addition, it is inaccurate to think of autism as a single disorder. Autism is rather a spectrum of disorders characterized by different symptoms and their severity. So why do these controversies persist despite the United States Court of Federal Claims’ ruling on three cases that no evidence currently supports a correlation between vaccines and autism spectrum disorders? Individuals who choose to vaccinate, and not to vaccinate (read: anti-vaxxers) have both entered the debate with contention. This heated debate stems from anti-vaccine activists such as Andrew Wakefield; a physician barred from practicing medicine for allegations of scientific misconduct following a failure to replicate or confirm his findings of a correlation between the measles, mumps and rubella (MMR) vaccine and autism. In fact, the former practicing physician directed the anti-vaccine propaganda film Vaxxed: From Cover-Up to Catastrophe. Conspiracy theories interest me but after reviewing the research there comes a time to conclude these unsound controversies – especially when they risk harming others. This is one of those times.

Precautions taken to prevent debate from growing include removing thimerosal from vaccines administered to children. Anti-vaxxers have argued that thimerosal, a mercury-containing preservative, cause autism. Public health officials have dismissed these claims, stating there is a lack of evidence suggesting thimerosal is implicated in the development of autism, still thimerosal has been removed from vaccines in hope of persuading people to vaccinate their children. The heated debate continues along with an increase in reported frequency of measles, a disease once eradicated from America.

Measles is a highly infectious airborne disease spreading rapidly through simple interactions such as coughing or sneezing. Once contracted there is no cure, supportive care can however reduce mortality. America was declared free of circulating measles with approximately 900 recorded cases from 2001 to 2011. In 2014, the Centers for Disease Control (CDC) issued a statement suggesting endemic measles, rubella, and congenital rubella syndrome (CRS) has not returned to the United States apart from some reported cases of measles due to unvaccinated tourists infecting others around them.

In 2014, the anti-vaccination movement began to pick up again. By 2015, from January to April 159 cases of measles were reported by the CDC; 48% unvaccinated and 38% unsure whether they were vaccinated. Measles resulted in pneumonia and subsequently the death of one woman that year, the first fatality from measles in roughly a decade. In 2018, there were 273 reported cases of measles. Recently, from January to February an outbreak resulted in at least 58 confirmed incidents of measles in Clark County, Washington, where there is a higher rate of vaccination exemptions. In fact, 1 in 4 kindergartners have not received vaccinations. The Washington State governor has declared a state of emergency. The cause of the outbreak tied to parents electing not to vaccinate their children.

Outbreaks of measles are still occurring following its eradication from our country. While this may be a heated debate for some, it is life and death for others. Vaccine-preventable diseases still exist around the world and in America, despite their low prevalence. The only disease eradicated completely is currently smallpox. Polio, while close to eradication still exists. With the decision to not vaccinate increasing in number so will the incidence of vaccine-preventable disease. However, viruses move quicker than parents’ ability to decide: what started out as 10 or 50 infected people can become hundreds and thousands.

References

Aleccia, J. (2015, July 03). Undetected measles led to death of Clallam County woman in her 20s. Retrieved from https://www.seattletimes.com/seattle-news/health/undetected-measles-led-to-womans-death/

Ball, L. K., Ball, R., & Pratt, R. D. (2001). An assessment of thimerosal use in childhood vaccines. Pediatrics, 107(5), 1147-1154.

Clemmons, N. S., Gastanaduy, P. A., Fiebelkorn, A. P., Redd, S. B., & Wallace, G. S. (2015). Measles—United States, January 4–April 2, 2015. MMWR. Morbidity and mortality weekly report, 64(14), 373.

Fiebelkorn, A. P., Redd, S. B., Gastañaduy, P. A., Clemmons, N., Rota, P. A., Rota, J. S., … & Wallace, G. S. (2015). A comparison of postelimination measles epidemiology in the United States, 2009–2014 versus 2001–2008. Journal of the Pediatric Infectious Diseases Society, 6(1), 40-48.

Gastañaduy, P. A., Redd, S. B., Fiebelkorn, A. P., Rota, J. S., Rota, P. A., Bellini, W. J., … & Wallace, G. S. (2014). Measles—United States, January 1–May 23, 2014. MMWR. Morbidity and mortality weekly report, 63(22), 496.

Godlee, F., Smith, J., & Marcovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent.

Johnson, K. (2019, February 8). The measles outbreak continues to be an emergency in Washington state. Retrieved from https://www.post-gazette.com/news/health/2019/02/07/outbreak-measles-cases-Clark-County-Washington-state-vaccination-emergency/stories/201902010163

Novella, S. (2016). The anti-vaccination movement. Skeptical Inquirer, 31, 26-31.

Offit, P. A., & Jew, R. K. (2003). Addressing parents’ concerns: do vaccines contain harmful preservatives, adjuvants, additives, or residuals?. Pediatrics, 112(6), 1394-1397.

Schuchat, A. (2015). Measles in our time: the US experience. Future virology, 10(7), 809-812.

Sudfeld, C. R., Navar, A. M., & Halsey, N. A. (2010). Effectiveness of measles vaccination and vitamin A treatment. International journal of epidemiology, 39(suppl_1), i48-i55.

Sugarman, S. D. (2007). Cases in vaccine court—legal battles over vaccines and autism. New England Journal of Medicine, 357(13), 1275-1277.

UNICEF. (1996). Vaccines bring 7 diseases under control. Retrieved from https://www.unicef.org/pon96/hevaccin.htm

Volkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50(1‐2), 108-115.

Wakefield, A. (2016). Vaxxed: from Cover‐Up to Catastrophe. Burbank, CA.: Cinema Libre Studio.

Woodard, T. (2019, January 10). Measles, still present after all these years! Retrieved from https://www.akpeds.com/pediatric-peeps/2019/1


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