The Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services have reported that the ongoing measles epidemic has, as of 19 September 2019, has resulted in 1241 cases in 31 states. This makes 2019 (which is around 9 months old) the worst year for measles since 1992, when there were 963 cases for all 12 months.
At this rate, we can expect well over 1500 measles cases for 2019, making it the worst year since the major measles epidemics of the late 1980s.
One of their favorite pseudoscientists of the anti-vaccine religion is Tetyana Obukhanych, someone who appears to have great credentials. Unfortunately, once you dig below the surface her claims, there is no credible evidence in support.
One of the most irritating problems I have with the anti-vaccine movement is their over-reliance on false authorities – they overrate publications (often in worthless predatory journals) or commentary from someone who appears to have all of the credentials to be a part of the discussion on vaccines, but really isn’t close to being a real vaccine scientist.
Nevertheless, credentials don’t matter – an “authority” on vaccines must follow the evidence that vaccines are safe and effective unless those “authorities” can provide robust, peer-reviewed, published evidence that vaccines aren’t. False authorities, like Tetyana Obukhanych, almost never do.
For example, Christopher Shaw and Lucija Tomljenovic, two researchers in the Department of Ophthalmology at the University of British Columbia, have, for all intents and purposes, sterling credentials in medicine and science. However, they publish nonsense research (usually filled with the weakest of epidemiology trying to show a population-level correlation between vaccines and adverse events) in low ranked scientific journals.
A recent recurrent claim in the anti-vaccine group is that the MMR vaccine puts babies at higher risk than they were before vaccines when measles outbreaks were large and frequent. The claim is that because vaccinated mothers transfer less immunity than mothers who had wild measles to their babies, babies are less well protected, and hence more at risk. This matters, because rates of complications are higher in babies than others.
The anti-vaccine claim is incorrect and deeply morally problematic. It’s incorrect because the difference in immunity between vaccinated mothers and mothers who had measles is real, but not huge; and because even if babies of vaccinated mothers are more likely to get measles if exposed, babies were much more likely to be exposed before vaccines.
It’s morally troubling because it assumes that it is acceptable – even desirable – to sacrifice girls to measles so that the survivors will serve to protect their future babies. Embedded in this assumption is a view that girls matter less, or that girls’ importance is in their role as future mothers, not individuals. Continue reading “Babies are safer in the Age of MMR Vaccine than Age of Measles”
The old myth of the huge Big Pharma vaccine profits – it’s the subject of so many memes, tropes, and outright lies from the anti-vaccine religion. These vaccine deniers, who not only lack knowledge of science but also of basic corporate finance, believe that every Big Pharma CEO relies on vaccines for their next bonus check, which they use to buy their new Ferrari to show off to imaginary vaccine-injured children.
I am not naive – public corporations have an obligation to their shareholders and employees to maximize profits. That’s capitalism, I suppose.
But where this trope goes off the rails is when you realize that vaccine profits would be eclipsed by medical industry profits if Big Pharma simply stopped producing vaccines. It’s ironic that the anti-vaxxers claim that Big Pharma’s greed gives us vaccines, but if they were truly greedy they’d be out of the vaccine business.
This article is not going to be as much science as I usually do (just read the recent article on natural immunity) – it’s going to focus on finance and accounting. Yes, I’m finance and accounting geek as much as I am a science aficionado.
Dr. Robert Sears vaccine info is false and misleading. On January 16, 2015, Sears, who refers to himself as Dr. Bob, is a California pediatrician and author of a controversial book on vaccines (critiqued here, pdf, or here by the fine folks at Science-Based Medicine).
He wrote in his Dr. Bob’s Daily and published on his Facebook page that measles is only rarely fatal in developed countries and that serious complications are rare. (In the likely event that Dr. Sears decides to delete his misleading comments, it’s archived here permanently.)
And they were irresponsible. In a way that can put people – including children, including his patients – at serious risk. This is not the first time Dr. Bob Sears has made inaccurate claims about a vaccine-preventable disease, but on the background of the current measles outbreaks, the risk from his behavior is more imminent and more obvious. It is appropriate to react. Continue reading “Dr. Robert Sears vaccine info misleads parents about measles”
“Natural immunity” is the trope du jour of the anti-vaccine world – they want us to believe that contracting a dangerous pathogen is somehow better than preventing that disease with a vaccine. Their pseudoscientific beliefs rely upon logical fallacies, a complete misunderstanding of how the immune system works, and a healthy dose of bad math.
In other words, the same old same old from our anti-vaxxer “friends.”
The purpose of this article is to discuss why natural immunity is a bogus concept when it comes to vaccines. I need to make one warning upfront – immunology is complicated and cannot be described in 1000 words or less. So, I’m going to do a lot of linking to good articles that describe various things about the immune system.
Good news for those of us who want to stop vaccine-preventable diseases – the German government has backed a bill for a mandatory measles vaccine for all children entering school or kindergarten. I’m sure the science-denying anti-vaccine crowd in Germany are angry.
If the German parliament approves the bill, which is almost certain, parents will have to provide evidence that their child has received the measles vaccine before they are enrolled in school. If the parents have failed to do so, they will be subject to fines up to €2,500 ($2,800).
If this bill is passed, Germany will join France and Italy as the other European countries with a mandatory vaccines law. Many other European countries have such high vaccination rates that they have little need for mandatory measles vaccine, but I’m sure they are watching carefully considering the rather large measles epidemic that has hit Europe over the past year.
The USA does not have a Federal mandatory measles vaccine law, but all 50 states and the District of Columbia require children to be fully vaccinated (according to the CDC immunization schedule, which includes the MMR vaccine for measles, mumps, and rubella) before entering school. However, many states allow so-called “personal belief exemptions,” which allow parents to easily skip some or all vaccines based on whatever they want.
As a result, some states have either implemented or are considering strict laws to make certain that children entering school are fully vaccinated. California, Maine, New York, Washington, Mississippi, and West Virginia have mostly eliminated personal belief exemptions, only allowing medical exemptions, where the child has some contraindications to some vaccines. The German law also does the same – it only allows medical exemptions.
The German state of Brandenburg recently passed its own law instituting a mandatory measles vaccine for children entering kindergarten. The state government was concerned about Brandenburg’s relatively low measles vaccination rate, 72.5%, far below the 92.9% rate for the whole country.
The German government was motivated to consider a law because of pockets of anti-vaccine parents (like in the USA) along with Europe’s aforementioned measles epidemic. According to the European Centre for Disease Prevention and Control, Germany has reported 429 measles cases for 2019 through June 14.
This bears repeating. The measles is easily prevented by a vaccine.
A quick measles primer
Measles (also called rubeola, not to be confused with rubella, or German measles, which despite its name, isn’t the issue in Germany) is a respiratory disease caused by the measles virus. Measles virus normally grows in the cells that line the back of the throat and lungs.
The virus is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious — 90% of people without immunity sharing living space with an infected person will catch it.
There are no specific treatments for the disease. There are no miracle preventions.
The oft-repeated, and highly inaccurate, claim that vitamin A supplements can cure or prevent measles completely misses the mark. It’s important to supplement with vitamin A to prevent blindness as a result of measles, but it doesn’t reduce mortality or prevent some neurological issues. Moreover, it is most useful in children with vitamin A deficiency, not exactly a major issue in well-fed children in developed countries.
Which leads me to remind everyone that measles is not a harmless disease, despite the false claims of the anti-vaccine religion. According to the CDC, some of the many measles complications are:
About 30% of measles cases develop one or more complications.
Pneumonia, which is the complication that is most often the cause of death in young children.
Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
Diarrhea is reported in about 8% of cases.
As many as 1 out of every 20 children with measles gets pneumonia.
About 1 child in every 1,000 who get measles will develop encephalitis, an inflammation of the brain that can lead to convulsions, deafness, and other long-term neurological deficits.
About 1-2 children, out of 1000 who contract measles, may develop subacute sclerosing panencephalitis (SSPE), a rare chronic, progressive encephalitis that affects primarily children and young adults– it is caused by a persistent infection of the measles virus. The disease starts with measles infection, usually before the age of 2 years, followed by approximately 6-15 asymptomatic years. Some researchers think the asymptomatic period is around 5-8 years after the initial disease. Gradually, the disease progresses with psychological and neurological deterioration, which can include personality changes, seizures, and coma. It is always ultimately fatal.
And sadly, for every 1,000 children who get measles, 1 or 2 will die from it.
These measles complications are more common among children under 5 years of age and adults over 20 years old (usually those with lapsed immunity).
Even in previously healthy children, measles can be a serious illness requiring hospitalization. Measles also can make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.
There is only one good way to prevent measles unless you want your child to live in a hermetically-sealed bubble forever – get the MMR vaccine.
Serious complications to measles can be as high as 3 out of every 10 children who get the disease. Serious complications from the MMR vaccine is approximately 1 out of every 1 million vaccine doses. The benefit to risk calculation is way over on the side of vaccines.
Summary
Measles is a dangerous, highly contagious disease that can permanently harm or even kill healthy children. It is not a disease that should be ignored.
The German mandatory measles vaccine law is what needs to be done to protect the children of the country. It is great that Germany is taking this step – I’m sure other countries will do the same.
Vaccines save lives. And the German government knows this and is moving to make sure every child is protected.
The locations of the current US measles outbreak (or epidemic) was predicted by researchers in an article recently published in Lancet Infectious Diseases. The amazingly prescient predictions were not based on magic, but on a scientific analysis of two factors – the vaccination rate and international travel tendencies by county in the United States.
And the statistical website, Five Thirty-Eight, took the predictions and listed out what happened during this US measles outbreak. The predictions were spot on.
Time to look at this study and its predicted results.
Sometimes, there’s excellent news with the fight to end vaccine-preventable diseases. On 13 June 2019, Governor Andrew M. Cuomo (see Note 1) signed a bill whereby the state of New York ended vaccine religious exemptions.
As a result of this new law, New York joins California, Arizona, Mississippi (yes, Mississippi), West Virginia (ditto), and Maine as the only states that do not allow religious exemptions, that is, allowing parents to claim that their religious beliefs are not compatible with vaccinations.
Since there are no mainstream religions that are opposed to vaccines, I have always found that this type of exemption was bogus and an excuse for parents to formalize their pseudoscientific beliefs. This put children at risk of dangerous and deadly vaccine-preventable diseases.
For New York, the removal of the religious exemption is critical. The center of the current US measles epidemic, which has struck over 1000 individuals, seems to be in the ultra-orthodox Jewish population in the state who have abused the exemptions. This gave us an unvaccinated population, concentrated in a small area, that was susceptible to a highly contagious and dangerous disease.
The tension over the issue was readily apparent in the Capitol on Thursday as hundreds of angry opponents — many with young children and infants — pleaded with lawmakers to reject the bill, sometimes invoking the will of God, other times their rights as parents. The show of raw emotion affected even supporters of the bill.
Assemblyman Michael Montesano, a Long Island Republican, framed the bill as “an attack on people’s First Amendment rights.” He added, “It’s still the individual parent, who is raising this child, that has the fundamental right to decide what happens with their child in all facets of their life.”
As the Assembly vote slowly came in, the speaker, Carl E. Heastie, was forced to come to the floor and count votes, calling recalcitrant members to coax the bill toward the 76-vote threshold needed for passage. Several prominent Democrats, including the chairman of the health committee, Richard N. Gottfried, bucked Assembly leadership and voted no. In the end, it narrowly passed, 77 to 53.
As soon the vote count was called, shouts of “shame” — and more colorful invective — erupted from the Assembly gallery, where opponents had gathered to watch the proceedings. Assemblyman Jeffrion L. Aubry attempted to restore order, but the screams continued; unable to stop the shouting, Mr. Aubry took the chamber into recess as furious opponents headed into Capitol hallways.
The only shame that I see are recalcitrant legislators not voting to protect the health of children.
Nevertheless, the pro-science, pro-children, pro-health side won. And Governor Cuomo signed it into law.
This is how we stop the measles epidemic and save the lives of innocent children. Vaccines save lives. So thanks – New York eliminates vaccine religious exemptions!
Notes
When I was in graduate school, studying real biomedical science as opposed to anti-vaccine pseudoscience, I was a canvasser for Governor Cuomo’s father, Mario Cuomo who was subsequently elected governor of New York. Thus, I was 0.000047% responsible for this bill. You can thank me by buying me a beer.
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