Our community owes Gritman Medical Center tremendous thanks for their quick recognition of a recent measles case (a child less than 12 months old) and prompt implementation of protective measures. Measles is so contagious that up to 90 percent of unprotected people close to a person with active measles are likely to become infected.
The World Health Organization estimates that vaccination prevents 2-3 million deaths annually. According to the CDC, prior to the introduction of the measles vaccine in the United States (1963), 3-4 million people contracted the disease annually with 400-500 deaths, 48,000 hospitalizations, and 1,000 cases of encephalitis (swelling of the brain). At that time, the mortality rate was 13.3 per 100,000 cases in the U.S., which has dropped to 0.2 per 100,000 thanks to improved nutritional and health status.
In the U.S. we are still using the same vaccine that was licensed in 1968, although it is combined with vaccines for mumps and rubella (MMR vaccine). The side effects, if any, include potential for a sore arm, fever and mild rash. Teenagers and adult women can experience temporary pain and joint stiffness from the rubella component of the vaccine. Older infants run a risk of experiencing febrile seizures, but these are not associated with any long-term negative effects (and vaccination at a younger age carries less risk). The most severe side effects come from rare allergic reactions to the components of the MMR vaccine (e.g., the antibiotic neomycin). It is impossible to say that no deaths can be attributed to this vaccine, but the evidence suggests the risk or mortality or permanent disability from an MMR vaccination is vanishingly small.
Because measles is so infectious, we need 93-95 percent of the population to be vaccinated or else outbreaks will happen. With a population of about 327 million in the U.S., that means only about 16 million can go unvaccinated without disrupting protection against outbreaks. Unfortunately, not everyone can be vaccinated due to a variety of medical reasons. These include infants (4 million per year), people living with HIV (1.2 million), people fighting cancer (between 1.7 and 14 million depending on state of treatment and recovery), at least 250,000 people with immunodeficiency disorders, and several hundred thousand with autoimmune disorders or that are living with organ transplants. Essentially, to meet the threshold for herd immunity against measles, we need everyone vaccinated who is not prevented for medical reasons.
When people object to vaccination, this may come from simple distrust of the medical establishment, and the current opioid epidemic certainly gives reason to be skeptical at some level. Unlike the opioid epidemic, however, vaccines are not an addictive drug and money-making potential is limited. According the World Health Organization vaccines make up less than 2 percent of total revenue for Big Pharma in 2013. The recent Clark County outbreak cost Washington state taxpayers over $1 million, and according to the CDC, a single complicated measles case can cost more than $40,000.
Some people still buy into the much discredited story vaccination is linked to autism, and these folks will clearly believe anything. Speaking of which, religious exemptions are a leading “reason” for refusing vaccination. Scripture does not say anything about vaccination; the first vaccine was employed in the year 1796. Unvaccinated visitors and missionaries in underdeveloped countries are a significant risk to the local population where the mortality rate can be nearly 10,000 times greater than in the U.S.
The risk from measles to those who cannot be vaccinated (probably about 15 million Americans, including 4 million infants annually) is considerable. The state can’t force someone to be vaccinated, but the state can compel such behavior (e.g., requirements for school attendance) to limit the potential harm to others from anti-vaxxers. If risk of side-effects is your rationale for avoiding vaccines like MMR, consider the much greater risks you are willing to accept daily, including automobile travel (14.2 and 7.6 deaths/100,000 annually in Idaho and Washington, respectively).
Polite commentaries have been published in this paper extolling people to do the right thing, but here’s the reality — if you are refusing vaccination for MMR for religious or other reasons, you are contributing to the risk of life-threatening illness to millions of Americans who are unable to defend themselves. If perceived “risk” is your primary motivation, your decision is pure hypocrisy considering the risks that you tolerate daily. Frankly, refusal to protect those who cannot protect themselves by such as simple act as vaccination raises serious questions about self-indulgent character flaws.
Douglas Call is a microbiologist. He and his family have lived on the Palouse for more than 20 years.