Tag: measles deaths

Why Do We Only Worry About Measles?

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.

And health officials don’t just worry about measles. They work to control outbreaks of mumps, pertussis, hepatitis A, and all other diseases too.

Why We Worry About Measles Outbreaks

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

In the late 1980s, when we had large outbreaks between 1989 to 1991, with 55,622 cases and 123 deaths, it meant that we weren’t vaccinating enough kids because Federal support for vaccine programs had dropped.

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.

How do you fix that?

Hopefully with education.

Why You Should Worry About Measles Outbreaks

Did you know that after the measles outbreaks of 1989, we also saw outbreaks of rubella and congenital rubella syndrome?

  • 396 cases of rubella, 4 deaths, and 2 cases of congenital rubella syndrome in 1989
  • 1,125 cases of rubella, 8 deaths, and 32 cases of congenital rubella syndrome in 1990
  • 1,401 cases of rubella, 1 death, and 34 cases of congenital rubella syndrome in 1991

Did you know that because they have overall lower vaccination rates, measles outbreaks in Europe grow far larger, into the tens of thousands of cases, with dozens of deaths?

“We must not tolerate a world in which a child dies from a disease that can be easily prevented with a low-cost vaccine.”

Dr Tedros, WHO Director-General on World Immunization Week 2018

We worry about measles outbreaks, because we don’t want to go back to anti-vaccine folks push us back to pre-vaccine era levels of disease and deaths.

We know what happens when vaccine levels drop too low.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this NY Times article reports.

We know that vaccines are safe and necessary.

You should know that anti-vaccine propaganda that scares parents away from vaccinating and protecting their kids is rooted in myths and misinformation. They often get away with it because most parents today ahve never seen how devastating measles and other diseases can really be, so they believe stories about the Brady Bunch, instead of the advice of real experts.

You hopefully understand that’s a mistake.

More on Worrying About Measles Outbreaks

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 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
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

Comparing Lightning Strikes to Measles Deaths

Have you ever heard that your child has more of a chance of getting hit by lightning than getting measles?

Since getting struck by lightning is rare, folks like to use it in comparisons to other things that they also think are low risk when trying to make a point.

There are problems with this type of argument though.

Understanding Risk Perception

In an age when many folks are overly anxious about things, it is important to understand the difference between real and perceived risks. Unfortunately, our biases often lead us to worry about the wrong things, sometimes with tragic consequences.

“No intervention is absolutely risk free. Even the journey to a physician’s office with the intention to receive a vaccination carries the risk of getting injured in an accident. With regards to risks of vaccination per se, one has to distinguish between real and perceived or alleged risks.”

Heininger on A risk–benefit analysis of vaccination

Vaccines have risks, but they are small risks, as we know that vaccines are safe and necessary and the decision to skip or delay your child’s vaccines carries with it a much greater risk.

Comparing Lightning Strikes to Vaccine Preventable Diseases

How common or rare do you think it is to get hit by lightning?

  • odds of being hit by lightning – 1 in 1,171,000 (each year)
  • odds of ever being hit by lightning – 1 in 14,600 (lifetime risk)
  • on average, 26 people die after being struck by lightning each year (since 2007), which is down from a recent historical average of 45 deaths per year (30 year average) and way down from when we used to see 400 lightning strike deaths each year before 1950
  • on average, 252 people are injured after being struck by lightning each year
Actually, just since 2000, at least 5 people have died of measles in Canada.
Actually, just since 2000, at least 6 people have died of measles in Canada.

Although 26 people dying after lightning strikes sounds like way too many to me, especially since one recent death was a 7-year-old boy in Tennessee playing under a tree, with 1 in 1,171,000 odds of getting hit, it sounds like we are pretty safe.

But is it fair to use those odds to justify your decision to keep your kids unvaccinated?

Of course not!

Why is our risk of getting struck by lightning so low?

What happens when we hear thunder or see lightning?

When Thunder Roars, Go Indoors!

What happens when a thunder storm approaches and you are at your kids soccer or baseball game?

“Postpone or suspend activity if a thunderstorm appears imminent before or during an activity or contest (irrespective of whether lightning is seen or thunder heard) until the hazard has passed. Signs of imminent thunderstorm activity are darkening clouds, high winds, and thunder or lightning activity.”

UIL on Lightning Safety

Many ball fields now have lightning detectors to alert officials of nearby storms. And just about everyone has access to weather apps on a smart phone that can alert them to an approaching thunder storm or nearby lightning strikes.

The point is that most of us understand that lightning is dangerous, so we go far out of our away to avoid getting hit. The risk of getting hit by lightning isn’t 1 in 1,171,000 with folks running around outside waving golf clubs in the air during thunder storms or sitting on their roofs under an umbrella watching the storm.

The risk of getting hit by lightning is 1 in 1,171,000 because most of us go inside once we know lightning is nearby.

“Based on the media reports of the fatal incidents, many victims were either headed to safety at the time of the fatal strike or were just steps away from safety. Continued efforts are needed to convince people to get inside a safe place before the lightning threat becomes significant. For many activities, situational awareness and proper planning are essential to safety.”

A Detailed Analysis of Lightning Deaths in the United States from 2006 through 2017

And the same is true with measles and other vaccine-preventable diseases. They aren’t as common as they once were because most of us are vaccinated and protected.

If you skip or delay your child’s vaccines, you will increase the risk that they will get one of these vaccine-preventable diseases. And you will increase the risk that they will get someone else sick.

“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

And if enough people don’t get vaccinated, herd immunity fails, and we will see a return of pre-vaccine era levels of disease.

What to Know About Vaccines and Risk Perception

Folks often misuse lightning strikes when they think about risks, not understanding that the risk of getting hit by lightning is low because we take a lot of precautions to avoid getting hit by lightning.

More on Vaccines and Risk Perception

How Many People Die from Vaccine Preventable Diseases These Days?

People don’t often die from vaccine-preventable diseases these days.

At least not in industrial countries.

Deaths from Vaccine-Preventable Diseases Today

Well, they aren’t supposed to.

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
Dr. Bob Sears actually reassured parents that measles wasn’t deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe – another well-nourished population with lower vaccination rates than the U.S.

Tragically, we are seeing more and more deaths from vaccine-preventable diseases every day in countries that once had these diseases under good control:

  • over 100 measles deaths across Europe and a measles death in the United States a few years ago
  • diphtheria deaths in Australia, Belgium, South Africa, and Venezuela
  • life-threatening tetanus cases in Australia, Canada, New Zealand, and Ukraine
  • a rabies death in the United States in a child who’s parents skipped the post-exposure rabies vaccine
  • pertussis deaths in the United States
  • influenza – a record number of deaths in the United States, with most kids unvaccinated
  • rotavirus – yes, unvaccinated kids still die of rotavirus in the United States in the 21st Century! In a recent outbreak in California, in which a child died, almost all of the kids were unvaccinated.

And not surprisingly, these deaths are almost always in unvaccinated children.

Deaths from Vaccine-Preventable Diseases in the Pre-Vaccine Era

While tragic, we are still fortunate that these deaths are no where close to the levels we once saw before we had vaccines to protect our kids.

In the pre-vaccine era, we used to see:

  • up to 15,000 deaths and 200,000 diphtheria cases each year until the 1940s
  • an average of 175,000 cases of pertussis each year in the early 1940s, with about 1,118 deaths from pertussis in 1950 and 467 deaths from pertussis in 1955
  • up to 20,000 cases of paralytic polio each year until the early 1950s
  • an average of about 186,000 cases of mumps each year before 1967, with an average of 40 deaths a year
  • up to 500 deaths and 500,000 measles cases each year until the early 1960s
  • a rubella epidemic in 1964-65 that caused 12.5 million rubella virus infections and “resulted in 11,250 therapeutic or spontaneous abortions, 2,100 neonatal deaths, and 20,000 infants born with congenital rubella syndrome”
  • up to 20,000 cases of invasive H. influenzae (Hib) disease each year, with more than half of them having meningitis, and about 300 to 600 deaths, mostly children under age 2 years. In 1980, 45 children died with epiglottitis and there were an additional 222 deaths from Hib meningitis.
  • up to 11,000 hospitalizations and 100 chicken pox deaths each year until 1995
  • up to 17,000 cases of invasive pneumococcal disease in children younger than 5 years each year (before 2000), including 13,000 cases of bacteremia (blood infection) and 700 cases of pneumococcal meningitis, with 200 deaths.
  • just over 400,000 visits to the doctor and up to 272,000 visits to the emergency room, 70,000 hospitalizations and 20 to 60 deaths each year in children under age 5 years because of rotavirus infections until 2006

But that deaths from vaccine-preventable diseases aren’t common is hardly a reason to skip or delay your child’s vaccines, as some might suggest. It is just testament to the fact that vaccines work.

That these deaths from vaccine-preventable diseases quickly rise as rates of vaccinations drop is a tragic reminder that vaccines are necessary.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

And what makes it even more tragic is that this was all predicted and could have been prevented if folks didn’t listen to anti-vaccine propaganda that scares them away from vaccinating and protecting their kids.

Worldwide Deaths from Vaccine-Preventable Diseases

Of course, talk of deaths from vaccine-preventable diseases shouldn’t stop with the developed or industrial world.

Even as a lot of progress is being made, as more and more people get vaccinated, worldwide, there were:

  • about 89,780 measles deaths, mostly young children
  • about 215,000 deaths from rotavirus infections
  • at least 1 million deaths from hepatitis B
  • almost 200,000 deaths from Hib
  • over 4,200 deaths from chicken pox
  • about 50,000 deaths from meningococcal infections
  • about 160,000 deaths from pertussis
  • about 826,000 deaths from pneumococcal infections
  • almost 60,000 deaths from rabies
  • just over 70,000 deaths from tetanus
  • about 222,000 deaths from typhoid
  • between 30,000 to 60,000 deaths from yellow fever

As you can see, most of these diseases are still big killers around the world.

“You hear about people who don’t like to vaccinate their kids in the Western world, which I suppose is a personal choice, but when you’re out there, the result of your children not being vaccinated is that they’ll likely die, or be horribly maimed. So yes, I saw a real desire to have their children protected, and also a real understanding of it – I didn’t seem to come across anybody who went ‘What is it?’ Or ‘What does it do?’ They all seemed to know about it.”

Ewan McGregor on Cold Chain Mission

In most of these countries, the problem is access to vaccines though, not parents refusing to get their kids vaccinated.

What to Know About Deaths from Vaccine Preventable Diseases

Unvaccinated kids are still dying from vaccine-preventable diseases.

More on Deaths from Vaccine Preventable Diseases

Do Vaccine Mandates Force Parents to Vaccinate Their Kids?

Listening to some parents talk about new vaccine laws, you would think that pediatricians are going to start kidnapping babies or simply hold them down to force them to get vaccinated and follow the latest immunization schedule.

Is there any truth to that?

Of course not.

The History of Vaccine Mandates

There have been vaccine mandates in the United States since 1827, when Boston became the first city to require all children attending public schools to be vaccinated against smallpox.

Surprisingly though, it took a long time to get vaccine mandates protecting more children. It wasn’t until the 1980-81 school year that there were laws in all 50 states mandating that children required vaccinations before starting school.

This followed continued measles outbreaks in the mid-1970s and studies showing that states with vaccine mandates had much lower rates of measles than states that didn’t. And it likely explains why there were 10 measles deaths in the United States as late as 1980, even though the first measles vaccine was introduced in 1963.

It took even longer for the vaccine mandates to cover kids in all grades and not just those entering school, to cover kids in daycare, and to cover kids in college. And tragically, it didn’t take long for politicians to chip away at those vaccine mandates. Over just a few years, from 1998 to 2000, 15 states added personal belief vaccine exemptions.

Still, even before the addition of personal belief vaccine exemptions and without the abuse of religious exemptions and medical exemptions, vaccine mandates have never equaled forced vaccination.

Even the Vaccination Act of 1853 in the UK, which required everyone to get a small pox vaccine, didn’t actually force them to get vaccinated. It originally levied fines on people until they got the vaccine, but they soon allowed a conscientious exemption to vaccination, which many people took advantage of. Over the years, so many people were claiming conscientious vaccine exemptions in the UK, that in 1946, they repealed their vaccine requirements altogether.

What Is a Vaccine Mandate?

Since a mandate is typically defined as an official order to do something, a vaccine mandate would be an order to get a vaccine. But it is hardly an order to hold down and force a vaccine on someone.

Likewise, state laws that mandate vaccines aren’t forcing kids to get vaccinated. They are typically mandates to get vaccinated before attending daycare, public and private schools, and/or college.

Is your child going to camp this year? They might mandate certain vaccines if kids want to attend.

Do Vaccine Mandates Force Parents to Vaccinate Their Kids?

Do vaccine mandates take away a person’s choice about getting vaccinated?

Anti-vaccine folks go to great lengths to scare you into thinking that someone is going to force you to vaccinate your kids. They aren't...
Anti-vaccine folks go to great lengths to scare you into thinking that someone is going to force you to vaccinate your kids. They aren’t…

Of course not.

Again. We are not talking about forced vaccination.

For example, if you work in a hospital that requires a yearly flu vaccine, you can decide to work somewhere else. Sure, you no longer simply have the choice between getting vaccinated or leaving yourself unprotected and continuing to work at the same job, but you can still decide to skip the vaccine and look for another job.

These are mandates with a choice.

The same is true with vaccine mandates for kids to attend school or daycare. If you choose to skip one or more vaccines for a non-medical reason, then even if you are in a state that doesn’t allow religious or philosophical vaccine exemptions, you won’t be forced to get vaccinated. While it may not be an option you are happy with, homeschooling is an option for those who don’t want to vaccinate their kids.

That is your vaccine choice.

Public education is a benefit of those who comply with mandates or compulsory vaccination laws.

These state immunization laws and vaccine mandates have nothing to do with forced vaccination. They also don’t take away your informed consent, are not against the Nuremberg Code, and are not unconstitutional.

Have kids ever been forced to get vaccinations?

Not routinely, but there have been cases of health officials getting court orders to get kids vaccinated and protected, usually during outbreaks of a vaccine-preventable disease.

In 1991, for example, a judge ruled that parents of unvaccinated children who were members of the Faith Tabernacle Congregation in Pennsylvania had to get a measles vaccine. As a measles outbreak spread through Faith Tabernacle, an associated church, and the rest of the city, there were at least 486 cases of measles in the church, mostly among children, and 6 deaths.

“Parents are free to become martyrs themselves. But it does not follow that they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves.”

Prince v. Massachusetts

In addition to being unvaccinated, these children didn’t get any medical care, as their families instead relied on prayer. Finally, after the order was appealed all the way to the state Supreme Court, only nine children got vaccinated.

When parents disagree about vaccines, a judge might also step in decide that a child be vaccinated over one parent’s objections. A child might also get vaccinated against their parents wishes if they have lost custody for reasons that have nothing to do with the child’s medical issues and so a legal guardian, which might be the state, is making those decisions now.

Still, these are not the usual circumstances we are talking about with state vaccine laws. They are simply laws to get kids vaccinated and protected before they are allowed to attend daycare or school.

What to Know About Vaccine Mandates and Forced Vaccinations

Vaccine mandates do not force parents to vaccinate their kids.

More on Vaccine Mandates and Forced Vaccinations

 

Why Didn’t Everyone Die with Our 1980s Level of Vaccination Rates?

This is actually a real question that someone recently asked:

“Can someone please explain how we survived the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines? Why didn’t everyone die?”

J.B. Handley

Mr. Handley even provides a nice chart to give his question some context.

Vaccination rates for 2 year old children in 1985.
The chart shows vaccination rates for 2 year old children in 1985.

So why didn’t everyone die?

That’s easy.

While vaccine-preventable diseases can be life-threatening, they certainly don’t kill everyone who gets them. They are not 100% fatal. Well, rabies usually is, but not surprisingly, rabies wasn’t on his little chart…

Deaths from Vaccine-Preventable Diseases, 1985

What else does Mr. Handley miss?

“Comparisons between rates obtained from immunization records versus the total sample (records and recall) conducted on data collected between 1979 and 1983 showed that the USIS, which accepted parental recall, underestimated the true vaccination rate in preschoolers by as much as 23% for some antigens.”

Simpson et al on Forty years and four surveys: How does our measuring measure up?

The vaccination rates he is citing were based on a phone survey that wasn’t thought to be very accurate, underestimating true vaccination rates. It was last used in 1985.

While vaccination rates weren’t great at the time, they just weren’t as horrible as he makes it seem, but we still had some deaths from vaccine-preventable diseases. Not as bad as the pre-vaccine era though, when hundreds of people died with measles each year.

Here’s the data from the CDC for 1985:

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/E/reported-cases.pdf

  • 23 deaths from tetanus
  • 4 deaths from pertussis
  • 4 deaths from measles
  • 1 death from rubella
  • 2 cases of congenital rubella syndrome

Unfortunately, it got worse. This was just before the large measles outbreaks from 1989 to 1991, when 123 people died. During those three years, there were also 28 deaths from pertussis, 6 deaths from mumps, 13 deaths from rubella and 77 cases of congenital rubella syndrome!

But then we learned our lesson and we got kids vaccinated. But most of the problems then were about access to vaccines, not parents who intentionally skipped or delayed vaccines for their kids.

Deaths from non-Vaccine-Preventable Diseases, 1985

The CDC Morbidity and Motality Weekly Report includes summaries of notifiable diseases in the United States.Many of the diseases on J.B. Handley’s chart weren’t yet vaccine-preventable in 1985. They were quite deadly though, which is why vaccines were being developed and were eventually added to the schedule to protect our kids from getting them.

But in 1985 (*or in the years before the vaccine was introduced), tragically, the CDC lists:

  • 80 deaths from hepatitis A
  • 490 deaths from hepatitis B
  • 68 deaths from chicken pox
  • 219 deaths from Hib meningitis in children and about another 45 deaths from Hib epiglotittis
  • at least 200 deaths from pneumococcal disease in children*
  • 257 deaths from meningococcal infections
  • 20 to 60 deaths each year from rotavirus infections*

Want us to Turn Back the Clock and go back to an immunization plan (the Jenny McCarthy schedule) that didn’t include vaccines against any of these diseases? We would end up back to when kids still died of meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

And the answer to Mr. Handley’s question becomes even more obvious.

How did we survive the 1980s with vaccination rates well below “herd immunity” thresholds and far fewer vaccines?

Many people didn’t.

What to Know About Deaths and Vaccination Rates

Poor vaccination rates and fewer vaccines led to more deaths from now vaccine preventable diseases in the mid-1980s.

More on Deaths and Vaccination Rates

 

When Was the Last Measles Death in the United States?

How many measles deaths have there been in the United States in the past ten years? Dr. Bob Sears frequently says that there have been none. It is easy to see that Dr. Bob is wrong, not even counting the latest death in 2015.

Measles Deaths in the United States

Measles deaths are thought to occur in about 1 in every 500 to 1,000 reported cases. This is not just in developing countries or in people with chronic medical conditions.

Consider that in an outbreak in the United States from 1989 to 1991, amid 55,622 cases, there were 123 deaths.

More recently, measles cases and measles deaths in the United States include:

  • 2000 – 86 cases – 1 measles death (infant)  – endemic spread of measles eliminated in U.S.
  • 2001 – 116 cases – 1 measles death
  • 2002 – 44 cases
  • 2003 – 55 cases – 1 measles death (1 year old)
  • 2004 – 37 cases – record low number of measles cases
  • 2005 – 66 cases – 1 measles death (1 year old)
  • 2006 – 55 cases
  • 2007 – 43 cases
  • 2008 – 140 cases
  • 2009 – 71 cases – 2 measles deaths
  • 2010 – 63 cases – 2 measles deaths
  • 2011 – 220 cases
  • 2012 – 55 cases – 2 measles deaths
  • 2013 – 187 cases (large outbreak in New York City – 58 cases)
  • 2014 – 667 cases (the worst year for measles since 1994, including the largest single outbreak since the endemic spread of measles was eliminated – 377 cases in Ohio)
  • 2015 – 188 cases – got off to a strong start with a big outbreak in California – 1 measles death
  • 2016 – 86 cases
  • 2017 – 118 cases

So that’s 11 measles deaths since 2000 and at least 8 measles deaths since 2005.

Why do people say that there have been no measles deaths in the United States in the past 10 years? Whether they are misinformed or intentionally trying to misinform people, they are wrong.

The Last Verifiable Measles Death in the United States

The CDC is actually contributing a bit to the confusion over measles deaths, in that when asked, they have  said that “the last verifiable death in the United States from acute measles infection occurred in 2003 when there were 2 reported deaths.”

They explain the discrepancy between that statement and other CDC reports, like the recently published “Summary of Notifiable Diseases — United States, 2012,” which clearly documents measles deaths in 2005, 2009, and 2010, by saying that those reports are based on “statistical information about deaths in the United States.”

But that statistical information comes from death certificates that are sent in from all over the United States to the National Vital Statistics System. The system isn’t like VAERS, where just anyone can send in a report. You don’t necessarily have to be a doctor to sign and file a death certificate though either, which is why the CDC is probably hung up on saying that the last verifiable measles deaths were in 2003.

To be more precise when talking about measles deaths in the United States, since it doesn’t seem like the CDC has verified each and every measles death after 2003, it is likely best to say that death certificates have been filed in 2005, 2009 (2), 2010 (2), and 2012 (2) that listed measles as a cause of death code.

Of course, that still means that there have been measles deaths in the United States since 2003.

SSPE – More Measles Deaths

Lately, in addition to deaths from acute measles infections, there have been even more deaths from subacute sclerosing panencephalitis (SSPE).

About 6 to 8 years after having measles, children with SSPE develop progressive neurological symptoms, including memory loss, behavior changes, uncontrollable movements, and even seizures. As symptoms progress, they may become blind, develop stiff muscles, become unable to walk, and eventually deteriorate to a persistent vegetative state.

Children with SSPE usually die within 1 to 3 years of first developing symptoms, including in the United States:

  • 2000 – 5 SSPE deaths
  • 2001 – 2 SSPE deaths
  • 2002 – 5 SSPE deaths
  • 2003 – 0
  • 2004 – 1 SSPE death
  • 2005 – 2 SSPE deaths
  • 2006 – 3 SSPE deaths
  • 2007 – 3 SSPE deaths
  • 2008 – 3 SSPE deaths
  • 2009 – 2 SSPE deaths
  • 2010 – 0
  • 2011 – 4 SSPE deaths
  • 2012 – 1 SSPE death
  • 2013 – 1 SSPE death
  • 2014 – 0
  • 2015 – 0
  • 2016 – 0
  • 2017 – 0

That’s 32 SSPE deaths since 2000 and at least 19 SSPE deaths since 2005. Why so many? Many of them can likely be attributed to the large number of cases associated with measles outbreaks from 1989 to 1991.

Fortunately, as the number of measles cases has been dropping in the post-vaccine era, so have the number of SSPE deaths.

The National Registry for SSPE, reported that there were at least 453 cases between 1960 and 1976. There were 225 deaths from SSPE between 1979 and 1998. The registry wasn’t established until 1969 though, and it is now becoming clear that the risk of developing SSPE is much higher than once thought.

A recent study of measles in Germany has found that the risk of developing SSPE is about 1 in 1,700 to 1 in 3,300 cases of measles.

Other Myths About Measles Deaths

One of the classic measles myths we hear is that measles was disappearing even before the measles vaccine was developed. It is true that measles deaths had been dropping since the turn of the century.

The measles death rate (deaths per 100,000 people) in the United States was:

  • 1900 – 13.3 (about 7000 deaths)
  • 1910 – 12.4
  • 1920 – 8.8
  • 1930 – 3.2
  • 1935 – 3.1
  • 1940 – 0.5
  • 1945 – 0.2
  • 1950 – 0.3 (468 deaths)
  • 1955 – 0.2 (345 deaths)
  • 1960 – 0.2 (380 deaths)
  • 1963 – first measles vaccine licensed
  • 1965 – 0.1 (276 deaths)
  • 1970 – 0.0 (89 deaths)
  • 1975 – 0.0 (20 deaths)
  • 1980 – 0.0 (11 deaths)
  • 1985 – 0.0 (4 deaths)

That’s not surprising though. The general death rate had dropped from 17.8 in 1900 to 7.6 in 1960. For infants under age 12 months, the death rate dropped from 162.4 in 1933 to 27 in 1960.

This simply reflects that vaccines were not the only medical technology that helped to save lives in the 20th century and not that measles was already disappearing. Penicillin, insulin, vitamin D, blood typing (allows transfusions of blood that has been typed and cross-matched), dialysis machines, and mechanical ventilators were all discovered in the early 1900s.

anti-vax-measles-graph
Despite how anti-vaccine charts try and mislead you, measles was still very deadly when the first measles vaccines were introduced.

If you notice though, the death rate for measles got stuck after the 1940s at about 0.2 to 0.3, even as modern medicine continued to advance. That’s about 300 to 500 measles deaths each year in the United States. This was after World War II and through the 1950s and early 1960s, hardly a time of poor hygiene or poor nutrition or when Americans were without access to medical care.

It took about 20 years for those deaths to start dropping again, and it took the coming of the measles vaccine to do it.

So if we stop vaccinating, we won’t get to 7,000 measles deaths a year again in the United States. Modern medicine has improved a great deal since 1900. We would eventually get to about 320 to 960 measles deaths a year though (using our current population of 320 million people and a measles death rate between 0.1 and 0.3).

Other Facts About Measles Deaths

People still die of measles.

What else do you need to know about measles deaths?

  • SSPE is caused by wild type measles. Vaccine strain measles has never been found in the brain tissue of anyone who has ever died of SSPE.
  • Although SSPE was first described by Dr. James R. Dawson, JR as a new type of epidemic encephalitis in 1933 (Dawson’s disease), that it is a late complication of a natural measles infection wasn’t discovered until much later.
  • People have recently died of measles in other industrial countries too. Basically anywhere there have been measles outbreaks, there have been measles deaths, including Canada, Japan, Germany, the Netherlands, the UK, and France, etc.
  • Worldwide, about 400 people die each and every day from measles.

The latest measles deaths we have been hearing about?

Dozens of infants, children, and adults, almost all unvaccinated have died in large outbreaks since the beginning of 2016 in Europe.

What To Know about Measles Deaths

Measles is still deadly, even in this era of modern medicine, sanitation and good nutrition.

More on Measles Deaths