An unnecessary, completely avoidable outbreak of Measles in the United States.

First, the science.

Measles vaccination protects against measles.  The measles vaccine, and so many other vaccines, are some of the biggest successes in public health, leading to almost 100% decreases in the incidence of a wide range of fatal and disabling infectious disease.

Measles cases in the United States, 1950-2001, CDC

Parental concerns

Some children have medical conditions that preclude vaccination (see CDC “Who Should Not Be Vaccinated”), but this is a small group. Some parents of healthy children believe (without any basis) that measles vaccines (and others) cause a range of negative health effects in children and, the current generation of parents born in the 1970’s, 80’s and 90’s, don’t remember how deadly infectious diseases can be. A third group of parents have religious beliefs opposed to vaccination.

The law

Most states require vaccinations before entry to the kingergarden, but may allow unvaccinated children to attend pre-school. Some states provide exemptions for religious or other objections (see the CDC database for state immunization laws).

 Current Measles vaccination behaviors

Because vaccinations have been so successful in eradication of infectious diseases, people have forgotten how terrifying and harmful the diseases were, and have focused their anxieties on the vaccines instead of the disease. This figure shows a downward trend in measles vaccine coverage in the United States, between 1980 and 2013, and the decline from initial high levels of 97 and 98% down to current levels of 91% is enough to affect herd immunity and allow the current outbreak of measles.

Measles vaccination rates in the US 1980-2013, WHO

The result – an unnecessary, completely avoidable outbreak of Measles in the United States

On the upside –

a vigorous discussion and flood of information reminding us all about the value of vaccines and the importance of vaccination, including a wide range of articles, stories and commentaries giving voice to the message.

Great overview in the The New York Times

Articles and cartoons in The New Yorker (not sure it is helpful to call people “idiots”), but an indication of the widespread involvement in the discussion.

http://www.newyorker.com/cartoons/daily-cartoon/daily-cartoon-monday-february-2nd-measles-disneyland

http://www.newyorker.com/humor/borowitz-report/zombie-jonas-salk-rises-grave-hunt-idiots

Roald Dahl’s account of his 7 year old daughter’s death from measles.