Tag: Amish

What Do We Know About the Rockland County Measles Outbreak?

Breaking News – there are 2 new cases in Rockland County, bringing the total in this ongoing outbreak to 147. (see below)

We know a lot about the measles outbreak in Rockland County, New York.

Nothing about what Del Bigtree and Sharyl Attkisson have been saying is right.
Did Del Bigtree or Sharyl Attkisson ever correct their false statements about the Rockland outbreak?

That makes it easy to spot anti-vaccine propaganda.

What Do We Know About the Rockland County Measles Outbreak?

What do we know?

We know that the outbreak is still growing.

And we know that most of the folks in the outbreak are unvaccinated.

Almost all of the measles cases in Rockland County have been unvaccinated.

What else do we know?

“At the end of September 2018, an international traveler arrived in Rockland County with a suspected case of the measles.”

Rockland County Measles Information

The outbreak is already the largest in New York State since the 1990s, before the endemic spread of measles was declared eliminated in the United States.

While it is unlikely to surpass the Ohio measles outbreak of 2014, which reached 384 cases, the Rockland County outbreak has already lasted longer.

In fact, this might will be one of the longer outbreaks we have had in a long while.

OutbreakCasesDuration
Brooklyn outbreak 2013583/13 to 6/9
Ohio outbreak 20143843/24 to 7/23
Disneyland outbreak 201514712/28 to 4/16
Minnesota outbreak 2017793/30 to 8/25
Rockland County outbreak 2018
1479/18 – ?
Brooklyn outbreak 201818110/18 – ?

The Minnesota outbreak of 2017 lasted nearly 5 months, but that includes the 42 days that they went measles-free.

Why 42 days? That’s equal to two incubation periods and if that much time has passed since the last person was infectious, there is little danger that there is still a missed case of measles in the community.

However, since there have been recent cases in Rockland County, we would be into the 6th month, mid-March, to get to that same point now.

Why has this outbreak been so hard to control?

“8 separate index cases, all with exposures to ongoing measles outbreak in Israel.”

Measles Review for Providers

Folks keep reintroducing measles into the community!

And immunization rates in the zip codes most affected by the outbreaks were as low as 54% at the start of the outbreak.

What else do we know?

Nine schools, now in compliance, were fined because they didn’t follow the Rockland County Health Commissioners order to keep unvaccinated and undervaccinated students out of school and provide immunization records and attendance records to the Rockland County Department of Health.

“ALL schools within the Village of New Square and any school with less than an 80% MMR vaccination rate within the geographical area affected by the measles outbreak (Spring Valley, Monsey) will be required to keep un- or under-vaccinated students home until 21 days have passed since the last confirmed measles case in Rockland.”

Health Department Announces Increased School Exclusions Due to Measles Outbreak

We don’t know why they aren’t quarantining all intentionally unvaccinated kids from school until the outbreak is over…

We do know that at least six people have been hospitalized in the Rockland County measles outbreak, including one child who ended up in the pediatric intensive care unit.

And we know that vaccines are safe and necessary! Get vaccinated and stop the outbreaks.

“Children 6 months through 11 months of age get an MMR vaccine now. Getting an MMR vaccine now will help give them some protection against measles. They will still have to get a vaccine at 12-15 months of age and again at 4-6 years of age.

Children 1 through 3 years of age who have already received their first MMR vaccine should get a second MMR vaccine now, as long as 28 days have passed since the first MMR vaccine was given to them. This second MMR vaccine will count for school entry.”

In fact, in Rockland County and other areas being hit with an outbreak, kids should get an early MMR, when they are six months old. And they can get their second dose early too, as early as 4 weeks after their first dose when they turn 12 months old.

Lastly, we know that you shouldn’t believe any of the anti-vaccine misinformation that is going around that might scare you away from vaccinating and protecting your kids. That’s why we have these outbreaks…

More on the The Rockland County Measles Outbreak

Updated March 19, 2019

Milestones Towards the Eradication of Polio

There is a lot more interest in polio these days, but not because we are close to eradicating this deadly disease, but rather because of the emergence of cases of acute flaccid myelitis (AFM).

Although the cases have a different cause, the symptoms of AFM are the same that we used to see during the outbreaks of polio that used to hit each summer in the pre-vaccine era.

Polio

Surprisingly, in most people, the poliovirus doesn’t actually cause any symptoms. They simply have an asymptomatic infection.

In some others, the poliovirus causes flu-like symptoms, including a fever, sore throat, nausea, and a headache – symptoms that last about 3 to 5 days.

Much more rarely, the poliovirus causes meningitis or paralysis.

It is these cases of paralytic polio that most people are aware of and that panicked parents during summers in the 1940s and 50s.

In addition to respiratory problems (think iron lungs), polio causes muscle atrophy.
In addition to respiratory problems (think iron lungs), polio causes muscle atrophy. (CC BY-NC 4.0)

After having flu-like symptoms, those kids who would develop paralytic polio can develop pain and then flaccid paralysis.

“The most severe form, paralytic poliomyelitis, which is seen in less than 1% of patients, presents as excruciating episodes of pain in back and lower limbs. In children, the disease may present in biphasic form—a period of prodrome followed by a brief symptom-free period of 7 to 10 days and then appearance of asymmetrical paralysis of limbs. Flaccid paralysis is the hallmark with loss of deep tendon reflexes eventually.”

Mehndirattta et al on Poliomyelitis Historical Facts, Epidemiology, and Current Challenges in Eradication

Of course, polio wasn’t always called polio.

Other names have included infantile spinal paralysis, infantile paralysis, Heine-Medin disease, poliomyelitis anterior acuta, and acute anterior poliomyelitis.

The first use of the name “polio” came from Adolph Kussmaul, with his use of the term poliomyelitis anterior acuta, which was derived from the Greek polios “grey” and myelos “marrow” and itis “inflammation.” It was because he knew that it was caused by inflammation of the spinal cord gray matter, even if he didn’t know why.

Polio History

Polio didn’t just suddenly appear in the middle of the 20th century though, it was likely around for ages.

That this Ancient Egyptian priest's leg is smaller than the other and he uses a staff to walk suggests that he could have had polio.
That one of this Ancient Egyptian priest’s legs is smaller than the other and he uses a staff to walk could suggest that he had polio.

In addition to an Egyptian funeral stele (a stone slab used as a monument) portraying Roma the Doorkeeper from 1500 BCE that suggests he had paralytic polio, archeologists have found evidence of polio in skeletons as far back as the Neolithic period.

A medical book from 1789 likely describes people with polio.
A medical book from 1789 likely describes people with polio.

Still, we don’t really know how long polio has been around and we don’t know why we began to see more cases in the mid-20th Century, although there are theories, including, ironically, about hygiene. While we often credit improved sanitation and hygiene for helping to reduce mortality from many diseases, some think that this actually set us up for polio outbreaks, as we were no longer exposed as infants, when we still had some maternal immunity.

The one thing that we do know is that we are on the verge of eradicating polio, as there are very cases now, in just a few countries.

Polio Timeline and Milestones

In addition to the more ancient discoveries about polio, there is a lot to learn about vaccines and vaccine-preventable diseases if we look at the major milestones of this important disease.

Although in the end it is a success story, the road to figuring out what caused polio symptoms and how polio could be prevented was very long.

  • Michael Underwood describes what is thought to be paralytic polio in his book A Treatise on the Diseases of Children, with General Directions for the Management of Infants from Birth  in a section on “Debility of the Lower Extremities” (1789)
  • first reported outbreak of polio in Worksop, England (1835)
  • Jacob von Heine, head of an orthopedic hospital in Germany, publishes a monograph that describes 29 cases of paralytic polio, and actually attributes the condition to inflammation of the anterior horns of the spinal cord, although the cause was still not known (1840)
  • first use of the term poliomyelitis by Adolph Kussmaul (1874)
  • Nils August Bergenholtz reports on an outbreak of paralytic polio in Sweden (1881)
  • Karl-Oskar Medin, a pediatrician who reported on a polio epidemic in Sweden (1887), later presents his findings at the Tenth International Conference in Berlin (1890)
  • the first major outbreak in the United States is documented in Rutland County, Vermont and causes 132 cases of paralysis and 18 deaths (1894)
  • Ivar Wickman tracks cases of polio during an epidemic in Sweden in 1905 and was the first to suggest that polio was contagious and that you could get it from “those afflicted with the abortive type” (1907)
  • although they don’t actually identify the poliovirus, Dr. Karl Landsteiner and Dr. Erwin Popper  identify that a virus causes polio when they inject material from the spinal cord of a child who had recently died with polio into the peritoneum of two monkeys, both of which soon developed paralytic polio (1908)
  • Simon Flexner, first discovers polio antibodies (1911), but unlike other researchers at the time, pushes the theory that polio was spread by the olfactory route, instead of the fecal-oral route, which was why we saw the development of nose sprays, etc., to try and prevent polio, none of which worked of course
  • a large polio epidemic in the United States causes at least 27,000 cases and 6,000 deaths (1916)
  • Philip Drinker and Louis Agassiz Shaw invent the first iron lung, the Drinker respirator (1929)
  • Frank M. Burnet and Jean Macnamara proposed that there were antigenically different strains of poliovirus (1931)
  • John R. Paul and James D. Trask help figure out how polio was spread by identifying the polio virus in human waste and sewage samples (1932)
  • Maurice Brodie and John Kolmer have unsuccessful field trials of early polio vaccines, including allergic reactions and vaccine induced polio because of poor attenuation (1935)
  • Sister Elizabeth Kenny establishes a clinic in Australia to treat polio survivors (1932) and later publishes her treatment recommendations, Infantile Paralysis and Cerebral Diplegia (1937)
  • the National Foundation for Infantile Paralysis is founded by FDR to stop polio (1937)
  • the first March of Dimes fundraisers to stop polio (1938)
  • Carl Kling found traces of the poliovirus in the Stockholm sewage system (1942)
  • the Sister Kenny Institute is built in Minneapolis, as her treatment methods become widely accepted after years of controversy (1942)
  • the U.S. Army Neurotropic Virus Commission, including Albert Sabin, gets a grant from the NFIP to study polio in North Africa (1943)
  • Isabel Morgan actually developed the first inactivated polio vaccine, but only tested it on monkeys (1949)
  • John Enders, with T. H. Weller and F. C. Robbins, received the Nobel Prize in 1954 for their work on the cultivation of the poliomyelitis viruses (1949)
  • David Bodian creates the monkey model using field isolates of poliovirus and with Jonas Salk, identifies the three poliovirus serotyes (1950s)
  • Hilary Koprowki develops the first oral, live polio vaccine, (1950) although Sabin’s vaccine eventually gets licensed because it is thought to be less neurovirulent in monkeys and undergoes more testing
  • there are 58,000 cases of paralytic polio in the United States (1952)
  • Renato Dulbecco, with Marguerite Vogt, successfully grows and purifies polio virus (1952)
  • the Polio Pioneers vaccine field trial, led by Thomas Francis Jr.,  that proves that Jonas Salk’s polio vaccine is safe and effective begins (1954)
  • Jonas Salk gets approval for his polio vaccine (1955)
  • improperly inactivated polio vaccine from Cutter Laboratories (Cutter Incident) causes 40,000 cases of polio, 200 cases of paralysis, and kills ten people (1955)
  • Albert Sabin develops the first live, oral polio vaccine, which replaced Jonas Salk’s inactivated polio vaccine (1961)
  • that polio survivors can develop new, late complications or post-polio syndrome begins to get reported (1969)
  • last endemic case of polio in the United States (1979)
  • the National Foundation for Infantile Paralysis officially changes its name to the March of Dimes Birth Defects Foundation (1979)
  • the World Health Assembly adopts a resolution for the worldwide eradication of polio by 2000 and the the Global Polio Eradication Initiative is launched (1988)
  • last imported case of polio in the United States (1993)
  • the WHO Region of the Americas is declared polio free (1994)
  • “last” case of VAPP that was acquired in the United States (1999)
  • last case of wild poliovirus type 2 (1999)
  • the WHO Western Pacific Region is declared polio free (2000)
  • the United States switches back to using the an inactivated polio vaccine because of concerns over VAPP (2000)
  • the WHO European Region is declared polio free (2002)
  • outbreak of vaccine derived polio among a group of unvaccinated Amish in Minnesota (2005)
  • last case of VAPP that was acquired outside the United States, an unvaccinated 22-year-old U.S. college student who became infected with polio vaccine virus while traveling in Costa Rica in a university-sponsored study-abroad program (2005)
  • last case of VAPP in the United States, a patient with a long-standing combined immunodeficiency who was probably infected in the late 1990s (2009)
  • last case of type 3 poliovirus (2012)
  • seasonal reports of acute flaccid myelitis in the late summer and early fall, which might be caused by a non-polio enterovirus, are reminiscent of polio epidemics in the early part of the 20th century (2014)
  • type 2 poliovirus eradicated (2015)
  • Bob Sears says that it is okay to delay the polio vaccine on his alternative vaccine schedule because “we don’t have polio in the United States” (2015)
  • a global switch from trivalent OPV to bivalent OPV in routine immunization programs (2016)
  • polio remains endemic in just two countries, Afghanistan and Pakistan (2018)

So it should be clear, that despite what some folks think, polio wasn’t conquered overnight. And Salk and Sabin obviously had a lot of help, although those are the names we most commonly hear connected with polio eradication.

“Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries.”

Global Polio Eradication Initiative on Endemic Countries

And to be clear, polio hasn’t yet been conquered.

There is still some work to do unless we want to see cases of polio and paralytic polio return.

That’s why it is important that you don’t skip your child’s vaccines, even for diseases that we don’t have in the United States anymore.

More on the History of Polio

Does Congress Really Agree About Vaccines?

Believe it or not, Congress has a lot to do with whether or not folks get vaccinated.

“As Members of Congress, we have a critical role to play in supporting the availability and use of vaccines to protect Americans from deadly disease.”

Sens. Lamar Alexander et al Dear Colleague Letter

We saw what happened in the mid-1980s when Federal funding for vaccine programs went down – we got measles outbreaks.

Congress and Vaccines

But it isn’t just that members of Congress have their fingers on the purse strings.

Over the years, while the great majority of lawmakers do agree that vaccines work and that they are safe and necessary, a few have created unnecessary fear about vaccines and have likely scared parents away from vaccinating and protecting their kids.

Remember when Michele Bachmann went on the Today Show with Matt Lauer and told her HPV vaccine story?
Remember when Michele Bachmann went on the Today Show with Matt Lauer and told her HPV vaccine story?

And then there are the Congressional hearings…

Remember Dan Burton?

The former Republican member of the U.S. House of Representatives from Indiana (1983-2013) has been described as being “antivaccine through and through” and “organized quackery’s best friend in Congress.”

Dan Burton held over 20 Congressional hearings trying to prove that there was a link between vaccines and autism.

Because he thinks that his grandson developed autism from vaccines, Dan Burton continues to believe that vaccines are associated with autism.
Because he thinks that his grandson developed autism from vaccines, Dan Burton continues to believe that vaccines are associated with autism.

Hearings that gave a high profile platform to Andrew Wakefield and are best described as:

“carefully choreographed to generate as much negative feeling toward the vaccination system as possible.”

Arthur Allen on Vaccine The Controversial Story of Medicine’s Greatest Lifesaver

Who replaced Dan Burton?

It seems to be U.S. Congressman Bill Posey (R-FL), who has been described as “vying to take over the title of the most antivaccine legislator in the U.S. Congress since Dan Burton retired.”

He got a little help from Rep. Darrell Issa, who conducted a meeting of the Subcommittee of Government Operations in 2014, Examining the Federal Response to Autism Spectrum Disorders.

“Okay. Let’s stop it right there. Because every time we have ever talked about doing one of those studies, some idiot in the media says I am suggesting that children intentionally don’t get vaccinated. And I don’t know that anybody ever has ever proposed that. But there are plenty of children whose parents will not allow them to be vaccinated. There are plenty of cultures where children are not vaccinated. And there are other reasons children are not vaccinated. And there are children who take large doses of vaccination, and children whose parents decide to have them take one vaccination at a time to avoid thimerosal. And I have not been able to ascertain that there has actually been a legitimate study done that wasn’t tainted by the touch of the international colossal scumbag Poul Thorsen.”

Rep. Bill Posey questioning NIH Director Thomas R. Insel, M.D. in the Congressional hearing on Examining the Federal Response to Autism Spectrum Disorders

Who else might be joining him?

Since the verbal evidence she hears says kids are getting too many vaccines, Rep Maloney asks the CDC Director why we can't just space out the vaccines kids get...
Since the verbal evidence she hears says kids are getting too many vaccines, Rep Maloney asks the CDC Director why we can’t just space out the vaccines kids get…

There is Rep. Carolyn Maloney (D-NY).

Maloney also spoke at a 2012 hearing planned by Rep. Darrell Issa (R-CA) on the federal response to rising autism rates.

“Are you looking at vaccination? Is that part of your studies? I have a question. Are you looking at vaccination? Are you having a study on vaccination and the fact that they’re cramming them down and having kids have nine at one time. Is that a cause? Do you have any studies on vaccination?”

Rep. Carolyn Maloney (D-NY) in a hearing on Rising Autism Rates

Rep. Carolyn Maloney was also a co-sponsor of Rep. Bill Posey’s 2015 Vaccine Safety Study Act bill, which called for “a comprehensive study comparing total health outcomes, including risk of autism, in vaccinated populations in the United States with such outcomes in unvaccinated populations in the United States, and for other purposes,” even though many experts have long pointed out the problems with using intentionally unvaccinated folks as a comparison group.

But Rep Maloney got her start long before Bill Posey ever came to Congress…

In 2006, in response to a series of articles by Dan Olmstead, who later created the website, Age of Autism, Rep Maloney held a briefing at the National Press Club where she proposed the Comprehensive Study of Autism Epidemic Act of 2006, a bill that sounds awfully similar to Posey’s Vaccine Safety Study Act.

Rep. John Duncan (R-TN) was another co-sponsor.

But we shouldn’t forget Rep. Dave Weldon MD (R-Fl), who introduced the Mercury-Free Vaccines Act of 2004 and the Vaccine Safety and Public Confidence Assurance Act of 2007. Weldon also sent a number of letters to Julie Gerberding questioning a study about thimerosal by Thomas Verstraeten, a study that was investigated and cleared by Senator Mike Enzi (R-WY) and the Senate Health, Education, Labor and Pensions (HELP) Committee in 2005. Because he was a doctor, Rep. Burton also had Weldon do a lot of the questioning during his hearings.

And there is also Rep. Christopher Smith (R-NJ), who was a cosponsor when  Maloney reintroduced the Vaccine Safety and Public Confidence Assurance Act in 2009.

Not surprisingly, many of these members of Congress have been getting donations from anti-vaccine organizations.

Henry Waxman was a featured speaker at the 2015 AAP Legislative Conference.
Henry Waxman was a featured speaker at the 2015 AAP Legislative Conference.

In contrast to all of the folks above, there was Rep. Henry A Waxman (D-CA), who retired after 40 years in Congress, but not before:

  • fighting back against Dan Burton’s misinformation in his hearings about vaccines
  • introducing the Vaccine Access and Supply Act of 2005
  • authoring the stand-alone Vaccines for Children legislation that was included in the Omnibus Budget Reconciliation Act of 1993 that created the Vaccines for Children (VFC) Program
  • introducing the National Childhood Vaccine Injury Act of 1986

But his work on vaccines has probably been the most low-profile thing that Waxman did, which is why he is often described as “one of the most important Congressman ever.”

You’ll never hear that said about Dan Burton, Bill Posey, Dave Weldon, or Carolyn Maloney…

More on Congress and Vaccines

Costs of a Measles Outbreak

The endemic spread of measles was eliminated in the United States in 2000, but unfortunately, that hasn’t stopped us from having outbreaks of measles each year.

Since reaching a record low of just 37 cases of measles in 2004, other milestones in the measles timeline we should all know about include that there were:

  • 220 measles cases in 2011, a 15-year record and the highest number of cases since 1996 at least until 2014, when we had at least 667 cases
  • 58 cases in the 2013 New York City measles outbreak and for a short time, the largest outbreak since the endemic spread of measles was eliminated in the United States
  • 382 cases in the 2014 measles outbreak in Ohio and now the largest outbreak since the endemic spread of measles was eliminated in the United States
  • 170 measles cases in the first few months of 2015, including a large outbreak in California that was linked to Disneyland.
  • 188 cases and a measles death in 2015

That’s still far below where we used to be though, especially when you consider that before the first measles vaccine was licensed, there was an average of about 549,000 measles cases and 495 measles deaths in the United States each year.

Containing a Measles Outbreak

Several factors help to limit the measles outbreaks that we continue to see in the United States. Most important is that fact that despite the talk of personal belief vaccine exemptions and vaccine-hesitant parents not getting their kids vaccinated, we still have high population immunity.

In the United States, 90.8% of children get at least one dose of the MMR vaccine by the time they are 35 months old and 91.1% of teens have two doses. While not perfect, that is still far higher than the 81% immunization rates the UK saw from 2002 to 2004, when Andrew Wakefield started the scare about the MMR vaccine. Instead of overall low immunization rates, in the U.S., we have “clusters of intentionally under-vaccinated children.”

It also helps that the measles vaccine is highly effective. One dose of a measles vaccine provides about 95% protection against measles infection. A second, “booster” dose helps to improve the effectiveness of the measles vaccine to over 99%.

To further help limit the spread of measles, there are a lot of immediate control measures that go into effect once a case of measles has been suspected, from initiating contact investigations and identifying the source of the measles infection to offering postexposure prophylaxis or quarantining close contacts.

That’s an awful lot of work.

A 2013 measles outbreak in Texas required 1,122 staff hours and 222 volunteer hours from the local health department to contain.

Costs of a Measles Outbreak

In addition to requiring a lot of work, containing a measles outbreak is expensive.

A study reviewing the impact of 16 outbreaks in the United States in 2011 concluded that “investigating and responding to measles outbreaks imposes a significant economic burden on local and state health institutions. Such impact is compounded by the duration of the outbreak and the number of potentially susceptible contacts.”

We still don’t know what it cost to contain many big outbreaks, like the one in Ohio, but we do know that it cost:

  • over $2.3 million to contain the 2017 outbreak in Minnesota – 75 people got measles, 71 were unvaccinated, and more than 500 people were quarantined over a 5 month period
  • up to an estimated $3.91 million (but likely much more) to contain the 2015 outbreaks in California
  • $394,448 and 10,054 personnel hours in total personnel time and total direct cost to the New York City Department of Health and Mental Hygiene responding to and controlling the 2013 outbreak in NYC
  • two unrelated cases in Colorado in 2016 cost $49,769 and $18,423, respectively to investigate
  • $50,758.93 to contain an outbreak at a megachurch in Texas
  • $150,000 to contain (13 cases) an outbreak in Cook County, Illinois
  • $223,223 to contain (5 cases, almost all unvaccinated) to contain another outbreak in Clallam County, Washington, an outbreak that was linked to the death of an immunocompromised woman.
  • more than $190,000 of personnel costs in Alameda County, with 6 cases and >700 contacts, it is estimated that over 56 staff spent at least 3,770 hours working to contain the outbreak
  • $5,655 to respond to all of the people who were exposed when a 13-year-old with measles was seen in an ambulatory pediatric clinic in 2013
  • $130,000 to contain a 2011 measles outbreak in Utah
  • $24,569 to contain a 2010 measles outbreak in Kentucky
  • $800,000 to contain (14 cases, all unvaccinated) a 2008 measles outbreak at two hospitals in Tuscon, Arizona
  • $176,980 to contain a 2008 measles outbreak in California
  • $167,685 to contain a 2005 measles outbreak in Indiana – unvaccinated 17-year-old catches measles on church mission trip to Romania, leading to 34 people getting sick, including an under-vaccinated hospital worker who ends up on a ventilator for 6 days
  • $181,679 (state and local health department costs) to contain a 2004 measles outbreak in Iowa triggered by a unvaccinated college student’s trip to India

Ending with 667 cases, 2014 became the worst year for measles in the United States since 1994.
Ending with 667 cases, 2014 became the worst year for measles in the United States since 1994. How much did these outbreaks cost to contain?

It is important to keep in mind that these costs are often only for the direct public health costs to the county health department, including staff hours and the value of volunteer hours, etc. Additional costs that come with a measles outbreak can also include direct medical charges to care for sick ($14,000 to $16,000) and exposed people, direct and indirect costs for quarantined families (up to $775 per child), and outbreak–response costs to schools and hospitals, etc.

We should also consider what happens when our state and local health departments have to divert so much time and resources to deal with these types of vaccine-preventable diseases instead of other public health matters in the community. Do other public health matters take a back seat as they spend a few months responding to a measles outbreak?

There were 220 cases of measles in the United States in 2011. To contain just 107 of those cases in 16 outbreaks, “the corresponding total estimated costs for the public response accrued to local and state public health departments ranged from $2.7 million to $5.3 million US dollars.”

In contrast, it will costs about $77 to $102 to get a dose of the MMR vaccine if you don’t have insurance. So not only do vaccines work, they are also cost effective.

What to Know About the Costs of a Measles Outbreak

Containing a measles outbreak is expensive – far more expensive than simply getting vaccinated and protected.

More on the Costs of a Measles Outbreak

Myths About Thimerosal in Vaccines

Over the years, especially since thimerosal was removed from most vaccines, the myths about thimerosal have surprising been increasing.

“Currently, the actions taken by the vaccine manufacturers, the FDA and the CDC have increased the possible maximum childhood exposure to mercury from vaccines to twice the level that triggered the 1999 call to remove mercury from all vaccines as soon as possible!”

Rev. Lisa K. Sykes on “Ten Lies” Told About Mercury in Vaccines

Of course, none of them are true.

Myths About Thimerosal in Vaccines

To begin with, there was no “call to remove mercury from all vaccines as soon as possible.”

Instead, as a “precautionary measure,” the AAP asked vaccine manufacturers “for a clear commitment and a plan to eliminate or reduce as expeditiously as possible the mercury content of their vaccines.”

“In addition, today most tetanus shots and the multi-dose Sanofi Menomune vaccine that are approved by the US Food and Drug Administration (FDA) still contain 25-micrograms-a-dose mercury.”

Rev. Lisa K. Sykes on “Ten Lies” Told About Mercury in Vaccines

Other myths about thimerosal include that:

  • After “realizing” the amount of mercury in the childhood vaccination schedule recommended by the CDC exceeded all national and global maximum safety limits, the American Academy of Pediatrics and the United States Public Health Service called for the immediate removal of Thimerosal from all vaccines on July 7, 1999. – the amount of thimerosal in the childhood immunization schedule actually only exceeded EPA guidelines and was well below the guidelines of the Agency for Toxic Substances Disease Registry (ATSDR) or the FDA. Also, since thimerosal-free versions of DTaP and Hib have always been available, only “a minority of infants could receive as much as 187.5 mg of ethylmercury during the first 6 months of life.”
  • children are getting even more mercury from vaccines today than when mercury was removed from vaccines, because pregnant women and kids get flu shots now – this theory doesn’t take into account that thimerosal-free flu vaccines have been available since 2003 and until recently, many kids didn’t get flu shots. For example, during the 2008-09 flu season, only 25% infants and toddlers were fully vaccinated against flu and even fewer pregnant women got flu shots (about 15%). The only way this myth could possibly be true would be if these folks all got a flu vaccine with thimerosal each and every year.
  • even as thimerosal was removed from the DTaP, Hib, and hepatitis B vaccines, kids still got exposed to thimerosal from other vaccines, like Menomume, the meningococcal vaccine –  Although Menomume contained thimerosal, it had only been recommended for high risk kids since it was approved in 1981. It was later replaced by Menactra and Menveo, both of which are thimerosal-free, and which were recommended to all kids as they provided better coverage. Menomume was discontinued in 2017 and it is unlikely that many kids got it once Menactra and Menveo became available.
  • kids still get a tetanus shot with thimerosal – yes, they did, at least until the Tdap vaccines were approved in 2006. Tdap is thimerosal-free.
  • Thimerosal has never undergone even one modern safety test. – although mercury can be toxic, the thimerosal in vaccines has been shown to be safe. That’s not surprising – remember, “the dose makes the poison.”
  • Published studies have shown that Thimerosal and its mercury breakdown product contribute to: Alzheimer’s, Cancer, Autism Spectrum Disorders, Attention Deficit Disorders, Bipolar Disorder, Asthma, Sudden Infant Death Syndrome, Arthritis, Food Allergies, Premature Puberty, and Infertility. – thimerosal in vaccines doesn’t cause any of these things, but you can probably find a published study somewhere saying that thimerosal causes Alzheimer’s, cancer, or food allergies, etc., but that just points to how important it is to look to trusted sources of information, as almost anyone can publish a bad study
  • Contrary to sound bites you hear on the nightly news, to be “anti-mercury” is not to be “anti-vaccine.” – if this is true, then why did Robert F. Kennedy, Jr write an editorial against University of Colorado students who passed a resolution for meningococcal B vaccines, which are thimerosal-free? And why push so much propaganda about thimerosal?
  • Corresponding to the sharply increasing level of mercury in the immunization schedule globally, which started in the late 1980’s, there has been an increasing rate of autism among children. This also explains why autism among 40-, 50-, 60-, 70- and 80-year-olds is not epidemic, but rather rare. – this is one of the main problems of the anti-vaccine movement… if you believe that autism is an epidemic, then there must be a cause and it becomes easy to blame vaccines. You also have to ignore the fact that there are plenty of autistic adults.
  • Among the Amish who do not vaccinate, the rate of autism is strikingly low. – there are autistic Amish
  • Unused vaccines with a preservative level of Thimerosal, however, are considered hazardous waste because of their high mercury content. If not injected into patients, discarded vials of these mercury-preserved vaccines, therefore, must be disposed of in steel drums, by law. – this is not true – at all… you also don’t have to call a Hazmat team if you break an unused vaccine vial with thimerosal…
  • …instead of requiring immediate removal, the CDC allowed the pharmaceutical companies to save money by using up their inventories of mercury-containing vaccines. By 2003, the industry had finally used up stocks of thimerosal-containing vaccines and Thimerosal is no longer used in these three vaccines. – the only basis for this statement is that the last thimerosal containing DTaP, Hib, and hepatitis B vaccines expired in 2003, but it is important to keep in mind that most vaccines are used well before their expiration date. In fact, many doctors order vaccines every month, so as to not keep large supplies of vaccines in their office, and since thimerosal-free versions were already available, those likely would have been ordered.
  • The term “trace amounts” means less than 1 microgram (mcg). Thimerosal-containing flu shots contain what in biochemical terms is actually a massive dose of mercury: 25 mcg. – vaccines labeled as having a trace amount of thimerosal have less than or equal to 1mcg, while others are clearly labeled as having up to 25mcg.
  • Why do I call that massive? Because the Environmental Protection Agency’s maximum exposure limits for methyl mercury is .1 microgram per 1 kilogram of bodyweight, which means a baby would have to weigh 550 pounds to safely absorb 25 micrograms of mercury. At these levels, a growing fetus in a mother receiving the flu shot could get up to a million times the EPA’s safe levels. – wait, what? First, that is the maximum recommended daily exposure limit based on the assumption that the exposure to mercury will continue for long periods of time. That’s not the case when a pregnant woman gets a one time flu shot. And it is the pregnant mother who is getting the flu shot, not the baby. Although some thimerosal will cross the placenta, it is still not in levels that will cause harm, so calling the dose massive ends up just being an obvious propaganda tool to scare folks.

The review, Thimerosal and Autism?, explains why autism and mercury poison really don't share symptoms.
The review, Thimerosal and Autism?, explains why autism and mercury poison really don’t share the same symptoms.

  • Autism and mercury poisoning have the same symptoms. – they don’t… In fact, there are many reports of epidemics of mercury poisoning throughout history that weren’t associated with autism, including in Minamata and Niigata, Japan, exposures from mercury in teething powders and worm medicines (pink disease), and food contamination in many countries.

“Yet mercury had long been the every-day treatment of infants at the time of teething in the form of teething powders.”

Ann Dally on The Rise and Fall of Pink Disease

Although it is hard to believe now, mercury wasn’t taken out of teething powders until 1957, after which time pink disease quickly disappeared. Why was mercury in teething powders in the first place? Unlike thimerosal in vaccines, I don’t think it was acting as a preservative, as it sounds like it was present in very high doses. So there was a lot of risk with no benefit.

Sounds like the opposite of what we had with thimerosal in vaccines – lots of benefit (vaccines didn’t get contaminated) with no risk.

But taking thimerosal out of vaccines was risk-free too, wasn’t it?

Nope. That’s another myth.

“Unfortunately, the precautions taken by the AAP and CDC calling for thimerosal removal from vaccines appears to have led to unintended risks. In particular, inappropriate recommendations by autism advocacy groups regarding treatment of autism (e.g., use of chelation) and avoidance of vaccines (e.g., influenza vaccine) may mislead parents to place children at unnecessary risks.”

Hurley et al on Thimerosal-Containing Vaccines and Autism: A Review of Recent Epidemiologic Studies

In addition to anti-vaccine folks continuing to push myths about thimerosal to scare parents away from vaccinating and protecting their kids, some missed out on getting vaccinated and caught life-threatening vaccine-preventable diseases.

What to Know About Thimerosal in Vaccines Myths

Don’t believe any of the myths about thimerosal in vaccines. Vaccines are safe and necessary.

More on Thimerosal in Vaccines Myths