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”
Unless you’ve been living on an interplanetary spaceship lacking Earth news services, you probably are aware of a serious outbreak of measles at the Happiest Place on Earth, that is, Disneyland (in Anaheim, CA). The park hosts about 40-50 thousand people a day, the bulk of which are children and parents of children, so if there could be a ground zero for a vaccine preventable pathogen outbreak, Disneyland would be the almost perfect place.
According to the California Department of Public Health (as of 30 January 2015), there have been 91 measles cases statewide since the beginning of the new year, with 58 of those cases related (either primarily or through secondary or tertiary contact) to a visit to Disneyland. About a third of those positive for measles are over the age of 20, an unusual statistic (and more on that later).
Some of those infected may have carried the disease outside of the state, but those are being tracked by their home state, so it makes it a bit difficult to get an actual number, but the CDC is monitoring the situation and will give updates weekly. The total number of those who might have contracted measles from Disneyland could be as high as 70-90 individuals.
The measles vaccine, usually a part of the MMR vaccine (for measles, mumps and rubella) or the MMRV vaccine (MMR plus varicella, also known as chickenpox), successfully prevents measles, is a highly contagious respiratory disease caused by a virus. Measles starts with a fever, runny nose, cough, red eyes, and sore throat, similar to common cold. However, the initial symptoms are followed by a rash that spreads all over the body.
Despite what you think is happening when you read antivaccination blogs, most people in the developed world vaccinate their children. And in the relatively undeveloped world, they are demanding more vaccines so that their children will live longer. In the USA alone, far less than 1% of children, 19-35 months, are completely unvaccinated. The problem, at least in the USA, is that those unvaccinated children tend to be clustered in small geographical areas where individuals who share the typical characteristics of many vaccine deniers tend to live.
The complication is that the herd immunity can break down rather quickly when the vaccination uptake drops below 80-90% in these clusters. And all it takes is one person carrying a vaccine preventable disease from an area, where it is endemic, to then start an outbreak or epidemic very quickly in one of these low vaccine uptake clusters. For a disease like measles, which is very contagious, it jumps from an infected person to unvaccinated individuals quite rapidly, sometimes before public health authorities can contain it. Measles is easily prevented with the MMRV vaccine (which also protects children against mumps, rubella, and chickenpox).
And once again, this is simple, third grade math. Let’s see if the typical antivaccination cult member can understand this!
The AV nuts are always asking, “If vaccines work so well, why are you concerned about my unvaccinated kid? Aren’t yours protected?” For this discussion, let’s leave out the usual list of people who cannot be vaccinated, the list of people the AV’ers will callously consider not their problem. Let’s not get into the idea that maybe it’s OK for me to worry about their kids too, kids who through no fault of their own are the poker chips these parents are waging while they confidently try to call a bluff on virtually every expert on the planet. Let me, for a moment, be as thoughtless and selfish as they are, and answer the question being asked. Is their unvaccinated child putting my child at risk, if the vaccines I believe in work so damn well?
No. Probably not. But they are putting somebody’s vaccinated child at risk.
Let’s do some real simple math here. The variables for infection rates and vaccine effectiveness vary by disease, and the equations get pretty complicated as they interact with each other, so I’m going to round off and keep it as simple as possible. Statistically, if you expose 100 unvaccinated people to measles, 95 of them will catch it. If you expose 100 people who have had one dose of the vaccine (MMR or MMRV), 5 of those partially vaccinated people will still catch measles. If you expose 100 people who have had two doses of the vaccine, 1 of those fully vaccinated people will still catch measles. Those are the numbers, roughly. Different diseases are different. Measles is on the extreme end of both factors: It is extremely contagious, but the vaccine also works extremely well.
Let’s say a child goes on a trip to some exotic place where measles is common due to low vaccination, like India or Southern California. If that child comes in contact with measles, an unvaccinated child will almost certainly (95% chance) catch the disease, where a vaccinated child will almost certainly not (1% chance) catch the disease. The vaccinated child comes back from his vacation with a statue of Vishnu or some Mickey Mouse ears, while the unvaccinated child comes back as Patient Zero.
Let’s assume the kid has become contagious before returning from his trip. He gets on a Boeing 737 with 200 other people. Even if every single person on that flight is vaccinated, 2 of them will contract measles. Anyone who is unvaccinated will almost certainly (95% chance) catch it. You go through the airport, get your luggage, and possibly infect a few more on the way.
Monday comes around, and it’s time to go back to school. Let’s go with the national average, and say 90% of the students are vaccinated, and that child comes in contact with 500 students. Of the 50 students that are unvaccinated, 42 of them will catch measles. Out of the 450 students that are fully vaccinated, 4 of them will still catch measles.
You can adjust these numbers how you see fit: for how infectious the disease is, how effective the vaccine is, or how many people the child will come in contact with, but you will never come to an equation that justifies this kind of reckless endangerment.
I think we can stop there, and not get into shopping malls, taking a subway, visiting our newborn cousin in the hospital, etc. And we still have that list of people who cannot be vaccinated that I generously ignored for this exercise, but sure as hell would not ignore when one of them died in the real world. Statistically speaking, my kids are a hundred times more likely to be one of the 446 vaccinated children at that school who were protected than the unlucky 4 the vaccine did not work for. So yeah, I guess you got me there. I’m not worried your unvaccinated child is going to infect mine. But that doesn’t mean I can’t be pissed on behalf of the 46 students your bluff call did infect. I can be concerned about the people on the plane you infected who went off and started their own school outbreaks. And I can do everything possible to hold you accountable for the damage you’ve caused for absolutely no good reason. When you try to call a bluff like that and are wrong, you are expected to pay up.
Even though the vaccine deniers champion the trope that these diseases are “not serious,” real evidence from real infectious disease medical specialists say otherwise. Measles, mumps and rubella can be dangerous diseases with debilitating complications, including death, for both children and adults. And as you can see in the map (click on it for greater detail), outbreaks of measles (in red), mumps (in olive) and rubella (in blue) are larger than it should be in both the developed and the developing world than it should be, given the easy access to the MMR (or MMRV) vaccines. Continue reading “Measles, mumps, rubella outbreaks–the culpability of Andrew Wakefield”
Current studies do not support the hypothesis that multiple vaccines overwhelm, weaken, or “use up” the immune system. On the contrary, young infants have an enormous capacity to respond to multiple vaccines, as well as to the many other challenges present in the environment. By providing protection against a number of bacterial and viral pathogens, vaccines prevent the “weakening” of the immune system and consequent secondary bacterial infections occasionally caused by natural infection.