It’s because some folks think that everything that happens to their kids is a vaccine injury.
Personal Stories About Vaccine-Preventable Diseases
If you are going to watch those videos and listen to their stories, getting scared in the process, be sure to also listen to the stories of parents who’s kids have suffered through actually getting a vaccine-preventable disease.
While it’s great that these diseases are much less common because most people vaccinate and protect their kids, one side effect of that progress is that we don’t have many reminders of just how terrible these diseases are anymore.Have you ever seen a baby with congenital rubella syndrome?
“Kimberly Coffey was buried three days before her high school graduation in the prom dress she didn’t get to wear. She didn’t have the opportunity to be vaccinated against Meningitis B.”
Kim’s Meningitis Story
In Kimberly‘s case, the Men B vaccine wasn’t yet available, but in many other cases, parents have shared their stories of unvaccinated children who suffered with a disease that was vaccine preventable at the time.
“From 2010 to 2016, young children continued to be at the greatest risk for influenza-associated pediatric deaths. Children without preexisting medical conditions accounted for half of all deaths. Vaccination coverage was low among influenza-associated pediatric deaths.”
Shang et al. on Influenza-Associated Pediatric Deaths in the United States, 2010–2016
Are the stories supposed to scare you into vaccinating your kids?
Of course not. Just like you shouldn’t let the myths and propaganda from the anti-vaccinate movement scare you away from vaccinating and protecting your kids.
Instead of being motivated by fear, you should make your decision because you understand that the many benefits of vaccines are far greater than their small risks.
What to Know About Vaccine-Preventable Disease Stories
Reading stories of vaccine-preventable diseases are a good reminder that these diseases are not so mild as some folks suggest, and they are instead life-threatening diseases that are best avoided by getting fully vaccinated.
If you haven’t guessed yet, as in other countries in Europe, we are seeing more deaths from measles simply because folks aren’t vaccinated and more people are getting measles.
Measles is a life-threatening disease, even in an age of modern medicine, indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, etc.
Italy, with about 1/5 the population of the United States, but about equal to the size of California, has had over 600 times as many cases of measles as we have had in the United States over the last few years. To put it in perspective, that would be like having 33,000 cases of measles in the United States.
But shouldn’t folks have a choice about getting vaccinated?
Even with the new vaccine laws, parents have a choice. As with vaccine laws in the United States, Italy’s new vaccine mandates had nothing to do with forced vaccination.
That’s unlike most of the people who died of measles in Italy. Most of them didn’t have a choice about being vaccinated and getting measles. Some were immunocompromised and couldn’t be vaccinated and at least one was too young to be vaccinated.
Parents had been set a July 10th deadline to provide schools with the relevant documentation, but it will now be possible for parents to simply submit their own confirmation that the child has been vaccinated, according to Giulia Grillo, Italy’s Health Minister, who was speaking at a press conference on Thursday.
Mandatory vaccinations: Italian parents will no longer need to provide doctor’s note
And that’s why it’s unfortunate that the a newly elected government severely watered down a vaccine law that had made getting vaccinated mandatory to go to school.
And it’s unfortunate that people continue to push misinformation about vaccines and vaccine-preventable diseases.
What to Know About the Measles Deaths in Italy
A drop in vaccination rates has led to measles outbreaks and a number of measles deaths in Italy.
Well, unlike most other vaccines, the meningococcal B vaccines are not thought to decrease nasal carriage of the meningococcal B bacteria. So if you are vaccinated and an asymptomatic carrier of the bacteria, you could theoretically spread it to someone else, as could someone who is unvaccinated.
Still, the MenB vaccines can protect you from getting actual meningococcal B disease, and if you don’t have meningococcemia or meningococcal meningitis, you won’t expose and spread it to someone else. That’s why the MenB vaccines are especially useful in outbreak situations.
Any others? After all, Dr. Bob did say that “most vaccines don’t prevent the spread of a disease.”
Vaccines That Don’t Prevent the Spread of a Disease
There are a few other examples of vaccines that don’t prevent the spread of a disease.
“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”
Dr. Bob Sears in The Vaccine Book
Of course, any vaccine that is delayed or skipped won’t work to prevent the spread of a disease.
Just like they are seeing measles outbreaks and deaths now, because of low vaccination rates, in Ukraine there were 17,387 cases of diphtheria and 646 deaths from 1992 to 1997. Also high, were cases of measles (over 23,000 cases in 1993) and pertussis (almost 7,000 cases in 1993).
And because of waning immunity, vaccines don’t do as good a job of preventing the spread of pertussis and mumps as we would like. Still, that’s only when the vaccines don’t work, and even then, as Dr. Bob says, they do work to reduce the severity of symptoms. During recent mumps outbreaks, the rates of complications are far below historical levels. The same is true for pertussis.
We typically see the same thing with flu. Even when the flu vaccine isn’t a good match or isn’t as effective as we would like, it still has a lot of benefits, including reducing your risk of dying.
“IPV induces very low levels of immunity in the intestine. As a result, when a person immunized with IPV is infected with wild poliovirus, the virus can still multiply inside the intestines and be shed in the faeces, risking continued circulation.”
Inactivated poliovirus vaccine
Does the fact that IPV, the inactivated polio vaccine, can sometimes lead to infections and shedding mean that it doesn’t prevent infections?
Of course not!
“IPV triggers an excellent protective immune response in most people.”
Inactivated poliovirus vaccine
Most people vaccinated with IPV will be immune, won’t get wild polio, and so won’t be able to get anyone else sick.
“Vaccines reduce disease by direct protection of vaccinees and by indirect protection of nonimmune persons. Indirect protection depends on a reduction in infection transmission, and hence on protection (immunity) against infection, not just against disease. If a vaccine were to protect only against disease, and not at all against infection, then it would have no influence on infection transmission in the community and there would be no indirect protection (vaccination of one person would have no influence on any others in the community). It would be possible to reduce disease with such a vaccine but not to eradicate the infection.”
But because IPV doesn’t provide indirect protection, we still use OPV in parts of the world where polio is more of a problem.
Vaccines work. Even the few that don’t prevent the spread of infections, still help to reduce disease.
What’s the Difference Between Infections and Disease?
Wait, is there a difference between infection and disease?
Yes there is, something that Dr. Bob, who actually wrote a book about vaccines, seems to have overlooked.
An infection is simply the presence of a virus, bacteria, or other organism in your body.
A disease, on the other hand, is a virus or bacteria in your body causing signs and symptoms.
All vaccines work to prevent disease, or at least they do when you actually get vaccinated.
A very few don’t prevent infections and the spread of infections, but that is not a good reason to skip or delay your child’s vaccines. In fact, it is one of the reasons why it is important to have high vaccination rates! Even natural infections don’t always keep you from becoming asymptomatic carriers that can infected others. Many people who have natural typhoid (remember Typhoid Mary?) and hepatitis B infections go on to become chronic carriers without any symptoms, but still able to infect others.
If you understand that a few vaccines don’t prevent the spread of infections, then you should understand that you can’t hide in the herd and expect to be protected, even though most folks around you are vaccinated.
What to Know About Vaccines and the Spread of Disease
Despite what Dr. Bob says, almost all vaccines work to prevent the spread of disease and infections, at least they do when you get your kids vaccinated.
She even defends Andrew Wakefield and doesn’t believe that people died of measles once MMR vaccination rates went down after Wakefield’s study was published.
A Crazymother Visits Her Pediatrician to Talk About Vaccines
As someone who is mindful that language can promote stigmas and stereotypes, it is not a term that I chose.
It is the name of a parenting group.
Wait until you hear what this pediatrician has to say when a Crazymother informs her she will no longer be vaccinating!
“Ok, today is just a hepatitis vaccine.”
I have made the decision that I no longer want my kids to be vaccinated.
At all. So, I know that’s not what you want to hear.
“It isn’t. It scares me. It scares me a lot.”
I know. I hear that, but I also have to do what I feel is best.
“Is there a specific concern that you have?”
Oh, there is a lot of things.
“What are they?”
There’s a lot. I’m worried about a lot. I wasn’t planning on having this conversation today. I didn’t know he was getting a shot. I wasn’t prepared. I thought he coming in for a blood test today. There’s a lot of reached out and met a lot of other moms who just have a lot of really sad stories and I just kind of started doing my own research and I just don’t feel like it is best for my kids and … I’m very concerned for his health and him getting vaccinated with all of these problems that he already has isn’t going to benefit him right now so I may change my mind down the road.
That last paragraph says an awful lot about why some parents are choosing to delay or skip their children’s vaccines:
“So my job at every visit is to let you know what you are declining and what we’re trying to protect against. It’s also very important if you decide not to immunize to remember that he’s at risk for a lot of other things so if he gets a fever its going to mean something different to mean than a child who is fully immunized as a fever… so if you call us after hours and he has a fever, make sure you tell us, oh by the way, he isn’t immunized…”
How does it mean something different if a child is intentionally not vaccinated?
While a vaccine-preventable disease should be in the back of your mind for any kid if their symptoms fit the disease, since vaccines aren’t 100% effective, they move higher up your list of possibilities if you know the child is unvaccinated and unprotected.
“I also just want to tell you that there’s a very big difference between anecdotal evidence and population based evidence, so just because someone has a sad story doesn’t mean that what happened to them is truly related to the vaccine.”
Crazymothers – OMG, I can’t even with this… She said that children didn’t get the MMR and many died. That’s not true. If you look at the cases of measles after 1998 when the Lancet study was published the measles cases actually went down. Nobody died. Nobody has died in America for years and years from the measles. It is completely silly.
Measles cases went down?
“Between 2001 and 2013 there was a sharp rise in the number of UK measles cases, and three people died.”
Current measles risks in the UK and Europe
As most folks now, before Wakefield was stripped of his medical license, he practiced in the United Kingdom, and not surprisingly, that’s where we saw a big effect on MMR rates. They went down and measles cases went up.
But even as measles cases and deaths have gone down globally, measles outbreaks and measles deaths have been much worse in the rest of Europe.
Even in the United States, cases have gone way up since we hit a record low of 37 cases in 2004 and there have been deaths, with the last in 2015.
“Again, this was very contentious and you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines.”
It is amazing how many times you hear the phrase “that’s not true” in this video about things that are so easy to confirm as facts.
“Continue to give it some thought because to me vaccines are modern miracles and it scares me to death to have people not getting vaccinated… He’ll probably be okay, but that’s because I’ve vaccinated my kids the other day, so we’re protecting your kid… The more people who stop doing it, forget about it, it’s going to go back to the old days where people are dying all of the time.”
Crazymothers – There’s that herd immunity myth. She says that your kid is going to be okay because I’m doing the right thing. I’m vaccinating my child. And anybody who studies this knows that’s not true! Herd immunity is a myth. Go outside and talk to a 30-year-old, 40-year-old, 50-year-old, who hasn’t been recently vaccinated and you can clearly see, plain as day…
As far as I know, we have indoor plumbing, we have sewage systems, we have clean water, and we have access to whole foods, we have ways to supplement with vitamins and minerals, we have all of these amazing things and that is what actually brings disease rates down.
Proper sanitation, sewage systems, all of the modern things that we take for granted – that is what is actually bringing the disease down, because clearly, in under-developed countries, we still see the diseases rampant, right?
But herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if someone has immunity against hepatitis A or Hib. Also, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated, because vaccinated kids are less likely to become infectious.
There is only clearly one modern thing that that anti-vaccine folks take for granted – vaccines.
My uncle got polio around 1950, in Brooklyn, just before the first polio vaccine was developed.
You know what?
They had indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, and medicine – he was hospitalized for six months – yet many people still died of polio.
At that time, during the pre-vaccine era, many people also died of measles, tetanus, pertussis, chicken pox, and many other diseases that are now prevented with vaccines.
And unfortunately, many under-developed countries still don’t have proper sanitation, sewage systems, or good nutrition, but do you know what they also don’t have?
We are very close to eradicating polio all over the world. Only two countries, Afghanistan and Pakistan still have cases of wild polio today. And so far this year, there have only been 11 cases. Did every other country in the world suddenly get proper sanitation, sewage systems, and good nutrition? Is that why we are so close to eradicating polio?
Of course not. It’s the polio vaccine.
Vaccines work. Vaccines are safe and necessary. They have few risks and many benefits. You won’t learn any of that from the Crazymothers group and that’s likely why you have made the decision that you no longer want your kids to be vaccinated.
What to Know About Crazymothers Propaganda
Don’t let Crazymothers propaganda scare you away from vaccinating and protecting your kids.
Anti-vaccine folks often claim that health officials only worry about measles and measles outbreaks.
They can’t understand why anyone gets concerned by a few measles cases here and there, not understanding that a lot of work goes into containing measles outbreaks and making sure that they don’t grow beyond a few cases.
We do get concerned about measles outbreaks though.
“Whenever measles strikes, it’s more than just an outbreak of a single disease, or an indication that children aren’t receiving their measles shots; it’s also a warning that immunization coverage in general, for all vaccine-preventable diseases, is lower than it should be.
To put it another way: When rates of routine vaccination—children receiving all their shots on schedule, as a preventive measure rather than a reaction to an outbreak—start to fall, the first sign is usually a measles outbreak.”
Seth Berkley on Measles Outbreaks Are a Sign of Bigger Problems
The measles vaccine is among the most effective vaccines we have, so if we are seeing outbreaks, even though measles is very contagious, it means there is a problem.
“A focus on measles surveillance can help detect populations unreached by immunization systems and, by extension, program weaknesses. Measles serves as the ‘canary in the coal mine’ for detecting problems with immunization programs, a characteristic whose importance has recently been highlighted in the context of global health security.”
Orenstein et al on Measles and Rubella Global Strategic Plan 2012–2020 midterm review
As much as anti-vaccine folks like to try and minimize how serious measles can be, it is easy to see that measles is indeed a serious, life-threatening disease. We had good nutrition, proper sanitation, and modern health care in 1990, and still, a lot of people died with measles. Rates of subacute sclerosing panencephalitis (SSPE), a late complication of measles, went up too, in the years after these outbreaks.
“Measles is a wholly preventable disease, and it was almost eradicated from the country in 1983, when only 1,497 cases were reported. But by 1990, after Federal budget cuts and the end of the Government’s monitoring of immunization programs, more than 30,000 cases of measles and more than 60 deaths were reported.”
Panel Ties Measles Epidemic to Breakdown in Health System
Those outbreaks were fixed, as we improved access to help kids get vaccinated and protected. Unfortunately, the issue with outbreaks today isn’t about access to vaccines, at least not in the developed world. It is about parents intentionally skipping or delaying vaccines.
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 ones in New York City and 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
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
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.