So no, childhood diseases have not become deadlier.
They have always been serious and life-threatening!
Of course, not everyone died who got them, but they were rarely a walk in the park. Remember, even a mild case of measles includes a high fever for 4 to 7 days. That’s why folks often end up seeking medical attention multiple times, even if they don’t end up having any complications and don’t need to get admitted to the hospital
But what about the Brady Bunch measles episode, Is There a Doctor in the House? Is that really why you think vaccine-preventable diseases are mild?
In 1969, when that episode first aired, there were 25,826 reported cases and 41 deaths from measles in the United States.
Believe it or not, we still don’t have cures for measles, chicken pox, congenital rubella syndrome, and hepatitis B, etc. So while these diseases haven’t become any more deadly, they haven’t become any less deadly either, even with all of the advances of modern medicine.
If vaccines work, they say, why do we care if their kids aren’t vaccinated?
Vaccines are protecting our kids, so they shouldn’t be at risk, right?
“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”
How does choosing not to immunize affect the community?
In addition to those who are intentionally unvaccinated, these others often get caught up in outbreaks of vaccine-preventable diseases.
Is My Fully Vaccinated Child at Risk from Your Unvaccinated Kids?
But there is also a risk to those who are fully vaccinated, and no, that doesn’t mean that vaccines don’t work.
It just means that they don’t work 100% of the time.
And most of us don’t think that your vaccine choice should put our kids at extra risk.
Did you hear about the one measles outbreak in 2011 that was started by someone who was fully vaccinated?
“She had documentation of receipt of MMR vaccination at 3 years and 4 years of age. There was no travel during the incubation period and no known sick contacts. However, the index patient worked at a theater frequented by tourists.”
Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011
The thing about that outbreak, is that of the 222 cases that year, she was the only one known to be vaccinated. So she was almost certainly exposed to measles by someone who wasn’t vaccinated.
As someone who was fully vaccinated, is it fair that she got caught up in those outbreaks?
getting vaccinated doesn’t prevent disease, it just makes it so you have fewer symptoms, but you still get others sick – in most cases, vaccines keep you from getting sick altogether – they so prevent disease in most cases, but yes, if you still got sick, you will likely have milder symptoms than if you were completely unvaccinated
you can’t spread a disease you don’t have – that’s true, but if you are unvaccinated and unprotected, you are at much higher risk to get these diseases and then spread them to others
getting vaccinated just turns you into a carrier – this is about the study in baboons, but it doesn’t mean you shouldn’t get vaccinated
What about the idea that you will just keep your unvaccinated kids home if they do catch something?
Looking at all of the places that the folks in the Clark County measles outbreak exposed others, it should be clear that waiting to quarantine your child if they get sick isn’t very effective.
What’s the problem?
With many diseases, you are contagious before you show symptoms. That is especially true with a disease like measles, when you may not even realize it is measles until you finally break out in a rash, after having 3 to 5 days of high fever.
We know that kids with cancer aren’t at risk from shedding if someone has recently been vaccinated.
The real risk comes from those who are unvaccinated.
People with Cancer Are at Risk from Unvaccinated Kids
Confused on how that works?
Kids with cancer typically have a compromised immune system, so are at greater risk for getting sick and catching infectious diseases. This includes a risk from vaccine-preventable diseases because they often can’t be vaccinated and any vaccines they had in the past might no longer provide protection.
Don’t believe me?
Want some examples?
a 6-year-old girl who was in remission for ALL and had just received her final dose of chemotherapy was admitted with fever and neutropenia, found to have measles, and died after 28 days of intense therapy (1989)
an 8-year-old being treated for leukemia developed chicken pox and died two weeks later (1998)
a partially vaccinated 4-year-old girl who was being treated for acute lymphoblastic leukemia (ALL) was exposed to a cousin with chicken pox and later developed multi-organ failure and died (2012)
a 26-year-old man who was being treated for chronic lymphocytic leukemia died in Switzerland after he became infected with measles (2017)
a 6-year-old boy with leukemia died in Italy after catching measles from his intentionally unvaccinated sibling (2017)
Of course, there are many more, including many kids with cancer who get exposed to a vaccine-preventable disease and have to get treated with immunoglobulin and hope they don’t get sick. And many more who do get sick and are treated in the hospital for weeks and months and thankfully, get better.
Consider what a group of anti-vaccine folks did with the above post about a child with severe complications to a chicken pox infection…
What are some of the big complications of chicken pox infections? Complications that help make chicken pox deadly?
That’s right, secondary skin and soft tissue bacterial infections (cellulitis and necrotizing fasciitis). In fact, bacterial super-infections of the skin are the most common complication of chicken pox infections.
“Necrotizing fasciitis can lead to sepsis, shock, and organ failure. It can also result in life-long complications from loss of limbs or severe scarring due to surgically removing infected tissue. Even with treatment, up to 1 in 3 people with necrotizing fasciitis die from the infection.”
Necrotizing Fasciitis: All You Need to Know
No, chicken pox is not necrotizing fasciitis, but all of the breaks in the skin from chicken pox lesions give bacteria, including group A Streptococcus (group A strep) and Staphylococcus aureus, plenty of opportunities to enter a child’s body and quickly spread.
We often hear that chicken pox isn’t serious in other countries that don’t routinely use the chicken pox vaccine. Don’t believe them.
On average, about two young children die in the Netherlands each year due to chicken pox.
“Based on the results presented in this study we estimate that between 3 to 8% of all Dutch patients with varicella, depending on age, consult a GP due to a complication. Our findings are similar to data from Germany, France and the United States of America, were it is estimated that in approximately 2 to 6% of cases attending a general practice. Furthermore of these varicella patients 1.7% experiences complications severe enough to seek hospital care.”
Pierik et al on Epidemiological characteristics and societal burden of varicella zoster virus in the Netherlands
And folks in the Netherlands have similar rates of complications as we did in the United States in the pre-vaccine era and many are hospitalized.
Remember, a vaccine mandate that says you have to be vaccinated to attend daycare or school does not force anyone to get vaccinated. Folks still have a choice to not get vaccinated, even without access to non-medical vaccine exemptions, although they might not like what that choice entails, such as homeschooling or not being able to attend daycare or summer camp.
“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”
The National Catholic Bioethics Center FAQ on the Use of Vaccines
Of course you should vaccinate them. But in getting them vaccinated and protected, you are not just protecting everyone else in the community. Getting vaccinated also protects your own child!
If the people they expose are too young to be vaccinated, too young to be fully vaccinated and protected, or anyone with a problem with their immune system, the results can be tragic.
Is it ethical that someone decides to skip or delay their child’s vaccines and then, through no fault of their own, someone else dies after getting exposed to this unvaccinated child when they develop measles or chicken pox?
Remember the measles outbreaks of 2015? In addition to the large Disney Land measles outbreak, 2015 was infamous for a smaller outbreak in Clallam County.
“The death of a Clallam County woman this spring was due to an undetected measles infection that was discovered at autopsy. The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County. She was there at the same time as a person who later developed a rash and was contagious for measles. The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death. The cause of death was pneumonia due to measles. This tragic situation illustrates the importance of immunizing as many people as possible to provide a high level of community protection against measles.”
Measles led to death of Clallam Co. woman
There were five measles cases in that 2015 Clallam County, Washington outbreak, including four who were not vaccinated. The outbreak cost at least $223,223 to contain and led to the death of a woman who just happened to be at a health clinic as one of the infected people.
Want to dismiss this case as being too rare to worry about? Just look at what is happening across Europe, with the rise in measles cases and measles deaths over the last few years.
Ethically, why should you vaccinate?
That’s easy, so that your kids don’t get a life-threatening vaccine-preventable disease. And so that they don’t expose others, potentially giving them a life-threatening disease that they are too young to be vaccinated against, couldn’t be vaccinated against because they had a true medical exemption, or were vaccinated against but are still susceptible to because they now have a problem with their immune system.
“It is UNETHICAL to expect me to sacrifice my child for yours—especially when I know that sacrifice won’t even stop the disease from spreading. It’s time for people to stop touting their “moral superiority and selflessness” when it comes to this topic; because if you really understood how this all works, there would be nothing for you to be proud of.”
Melissa Floyd (she apparently does a podcast with Dr. Bob)
Here is where the misinformed consent comes in and ethics go out the window:
And for the record, few of us think that we are morally superior to anyone else for vaccinating and protecting our kids. We just understand that many anti-vaccine folks are victims of their cognitive biases and need to do more research. And we know that it is UNETHICAL for parents to sacrifice their kids to anti-vaccine propaganda.
It is very easy to get confused when thinking or talking about chicken pox and shingles.
Remembering a few things should help though:
shingles (herpes zoster) is a reactivation of chicken pox (varicella zoster) – since they are caused by the same virus, you had to have been exposed to the chicken pox virus (varicella zoster virus) to later get shingles
exposure to the chicken pox virus can come from a natural chicken pox infection or from getting vaccinated against chicken pox, as it is a live, attenuated vaccine (Varivax)
So no, getting the chicken pox vaccine will not prevent you from later getting shingles. The shingles vaccine is a different vaccine that is given to seniors to help prevent them from getting shingles.
Can You Still Get Shingles After Having the Chicken Pox Vaccine?
Have you ever heard of a child vaccinated against chicken pox getting shingles? It can happen. It’s not a vaccine injury.
Remember that you can get shingles at any age – it is not just a disease of senior citizens. Even preschools or teens can get shingles, with the risk increasing with age.
Although the chicken pox vaccine won’t prevent you from getting shingles, it does work well to prevent you from getting chicken pox.
And it is thought that getting vaccinated and protected against chicken pox will decrease your risk of later getting shingles, even before you ever get the shingles vaccine.
“In the early post-varicella vaccination period, incidence rates of medically attended herpes zoster did not increase for the overall population and decreased moderately for children 9 years and younger, the age group targeted for varicella vaccination.”
Tanuseputro et al on Population-based incidence of herpes zoster after introduction of a publicly funded varicella vaccination program
And chicken pox parties, while not as common as some folks imagine, were definitely a thing, because you didn’t want your child to become an adult and get chicken pox, when it was more dangerous. But since most kids got chicken pox so easily, most got it when they were kids, even without a chicken pox parties, and tragically, many learned that it wasn’t only dangerous to adults.
These days, most cases and outbreaks of chicken pox are in unvaccinated children and adults.
7 new cases in the outbreak associated with the Asheville Waldorf School in West Asheville, North Carolina, bringing the case count to 41 in that outbreak, including 4 cases in the community as the outbreak continues to spread (Nov 2018)
6 new cases at the Asheville Waldorf School in West Asheville, North Carolina, bringing the case count to 34 in that outbreak (Nov 2018)
at least 5 cases at Daybreak Primary School in Battle Ground in Clark County, Washington, leading to quarantine of at least 38 unvaccinated students who will be kept out of class for at least 21 days (Oct 2018)
at least 5 cases at two schools in Ottawa County, Michigan, including Waukazoo Elementary and Kids First – Early Childhood Center in Jenison, leading to the quarantine of at least 34 children (Oct 2018)
a cluster of chicken pox cases in Grant County, Washington at Park Orchard Elementary, North Elementary and Longview Elementary schools (Sept 2018)
at least 5 cases at the The Little Red School House Too daycare in Westbrook, Maine (May 2016)
These cases are just the tip of the iceberg though, as there are still about 7,000 to 10,000 chickenpox cases reported in the United States each year. And that’s with some states, like Oregon and Washington, not reporting cases of this Nationally Notifiable Condition to the CDC.
Still, since chicken pox caused a few hundred deaths and at least 10,000 hospitalizations each year less than twenty-five years ago, that’s a lot of progress.
Getting Chicken Pox
How do you get chicken pox?
Since it is very contagious, if your child is exposed to someone with chicken pox or shingles, then they might develop chicken pox in about 10 to 21 days (incubation period).
are unvaccinated, either intentionally, because they have a true medical exemption, or because they are too young for the vaccine, which is first given when kids are 12-months-old
are partially vaccinated, with only one dose of the chicken pox vaccine
have a problem with their immune system, including kids getting chemotherapy
In addition to being at risk for chicken pox, non-immune pregnant women, newborns born to women who develop chicken pox at around the time of delivery, premature babies, and those are immunocompromised can be at risk for severe disease.
Avoiding Chicken Pox
Want to avoid chicken pox and the chance of ending up in a chicken pox quarantine and having to stay out of school for 3 weeks or more?
That’s not an option for some kids with true medical exemptions though, including most kids who are immunocompromised. When they get caught up in one of these outbreaks and get exposed to chicken pox, it becomes a matter of life and death to work to try and prevent their getting chicken pox.