Tag: measles outbreaks

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

Dr. Bob Sears, who actually wrote a book about vaccines, seems to think that he and his podcasting sidekick have put the nail in the coffin “of trying to use the herd immunity argument to justify coerced vaccinated.”

Dr. Bob seems to think that herd immunity doesn't apply to vaccines.

The meme he shared even includes the hashtag stating that herd immunity doesn’t apply to vaccines.

Dr. Bob Puts the Nail in the Coffin of the Herd Immunity Argument

While arguing against the idea of herd immunity and for coerced vaccination are common among anti-vaccine folks, neither is true.

Herd immunity is real and no-one is going to force anyone to vaccinate their kids. Vaccine mandates do not mean forced vaccination.

What about the idea that “all vaccines wane within about 2-15 years, leaving vaccinated children & adults unprotected?”

If that were true, then wouldn’t everyone who got sick in latest outbreaks be vaccinated? Why are most folks unvaccinated?

So we are either getting a lot of outbreaks because of waning immunity or your titers are getting boosted because you are getting exposed to so much natural disease. Got it?

While waning immunity is an issue for some vaccines, like mumps and pertussis, the primary and secondary failure rates are still not as bad as Dr. Bob suggests, which is why, in an outbreak, the attack rate of disease is always higher among those who are unvaccinated and unprotected.

The numbers don't always add up correctly when anti-vax folks try to do math.
The numbers don’t always add up correctly when anti-vax folks try to do math.

Is herd immunity the main argument that’s made when experts suggest we need stronger vaccine laws? I always thought the main argument is that folks should just vaccinate and protect their kids, but maintaining herd immunity so that your intentionally unvaccinated kids don’t put everyone else at risk is a good reason too.

Does everyone see the problem with Melissa Floyd’s math? This probably won’t be on the SAT, but you still want to get this right…

Like many others are doing right now, she used state level data. Since many of the folks who don’t vaccinate their kids cluster together in the same communities and schools, the “2% of those filing for exemptions” end up making up 10, 20, or even 30% of some school’s student population.

“This means if you are a primary non-responder, you are walking around every day with a false sense of security, clinically unvaccinated for that particular disease.”

Melissa Floyd

This is the whole point of herd immunity!

Because vaccines aren’t 100% effective, we can walk around all day without actually thinking about it much, hoping that we can rely on the fact that most other people are also vaccinated and protected. That keeps disease out of our community or herd.

The system typically breaks down though, not because vaccines aren’t effective enough, but because too many folks don’t get vaccinated.

“A 2011 article in “Vaccines”, edited by Stanley Plotkin, says, “Much of the early theoretical work on herd immunity assumed that vaccines induced solid immunity against infection…” Theoretical… Assumed…”

Melissa Floyd

She should have read the whole article, or at least used the whole quote…

“Much of the early theoretical work on herd immunity assumed that vaccines induce solid immunity against infection and that populations mix at random, consistent with the simple herd immunity threshold for random vaccination of Vc = (1-1/R0), using the symbol Vc for the critical minimum proportion to be vaccinated (assuming 100% vaccine effectiveness). More recent research has addressed the complexities of imperfect immunity, heterogeneous populations, nonrandom vaccination, and freeloaders.”

Herd Immunity: A Rough Guide

It doesn’t say what she thinks it says…

“Indeed, one might argue that herd immunity, in the final analysis, is about protecting society itself.”

Herd Immunity: A Rough Guide

So why haven’t we eradicated measles like we said we would?

“What’s funny is after the measles vaccine was licensed in 1963, the medical community declared a goal of eradicating measles by 1967. But 1967 came and went and it still wasn’t gone, 1977, 1987, 2000… the dates kept getting pushed, and the result was always the same. Meanwhile they continued to increase the hypothesized “herd immunity threshold”, eventually winding up at the extremely high 95% you hear today. “

Melissa Floyd

That’s actually a good question.

What happened to the previous goals of eliminating measles?

“In 1966, the USA began an effort to eradicate the disease within its own borders. After a series of successes and setbacks, in 2000, 34 years after the initial goal was announced, measles was declared no longer to be endemic in the USA.”

Orenstein et al on Eradicating measles: a feasible goal?

Along the way, we have gone from an estimated 100 million cases and 5.8 million deaths in 1980 and an estimated 44 million cases and 1.1 deaths in 1995 to “just” 7 million cases and 89,780 deaths in 2016.

“Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.”

Measles

While there is doubt that we can truly eradicate measles with the current vaccine, we can certainly control and eliminate measles if folks stop listening to anti-vaccine propaganda and they get vaccinated and protected.

More on Dr. Bob and His Herd Immunity Arguments

Vaccinated vs Unvaccinated – Measles Outbreak Edition

There are two big reasons that we are still having to talk about how it’s mainly unvaccinated folks that get sick in measles outbreaks.

Some folks keep spreading misinformation about measles, such as how most of the people who got sick in the Disney outbreak were vaccinated!?!

And other folks believe them!

Vaccinated vs Unvaccinated – Measles Outbreak Edition

Fortunately, misinformation about the number of vaccinated vs unvaccinated in an outbreak is among the easiest things to fact check.

Although folks will try to misrepresent this slide, as you can easily see, most of the folks in the Disneyland outbreak were unvaccinated.

That’s not how any of this works…

For example, if you wanted to assume that the 20 people who said that they were vaccinated really were, then you have to assume that the rest of those folks weren’t. And you also have to raise the number of folks who had their immunization status verified.

But you really shouldn’t make assumptions. All you can really say for sure from this data is that 15 (13 + 2) of the people, out of the 131 cases, were fully vaccinated.

What about the New York outbreak in 2011? Was it really started by someone who was fully vaccinated?

Surprisingly, it was!

“This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. Secondary patients had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts.”

Rosen et al on Outbreak of measles among persons with prior evidence of immunity, New York City, 2011.

And it was a very big deal because it was the first time it had ever been reported as happening!

“During 2011, a provisional total of 222 measles cases were reported from 31 states. The median age of the patients was 14 years (range: 3 months to 84 years); 27 (14%) were aged <12 months, 51 (26%) were aged 1–4 years, 42 (21%) were aged 5–19 years, and 76 (39%) were aged ≥20 years. Most patients were unvaccinated (65%) or had unknown vaccination status (21%).”

Measles — United States, 2011

That’s in contrast to all of the other measles cases that year. Remember, there were a total of 222 measles cases in the United States in 2011. Few were vaccinated.

What about other measles outbreaks?

Only 4% of people in the Rockland County measles outbreak have been fully vaccinated.
Only 4% of people in the Rockland County measles outbreak have been fully vaccinated.

As much as folks try and report that most of the people in recent outbreaks are vaccinated, they aren’t.

Only one person, out of 53 cases of measles, is known to have had a dose of MMR in the Clark County measles outbreak.

What about other measles outbreaks?

OutbreaksYearVaccinatedUnvaccinatedUnknown
California – 24 cases201724
Minnesota – 75 cases20175682
Tennessee – 7 cases201616
Ohio – 383 cases2014534038
California – 58 cases2014112518
Texas – 21 cases2013165
Florida – 5 cases20135
Brooklyn – 58 cases201358
North Carolina – 23 cases20132183
Minnesota – 21 cases2011183
San Diego – 12 cases200812

We don’t even have to do the math.

“The majority of people who got measles were unvaccinated.”

Measles Cases and Outbreaks

It is easy to see that most folks in these outbreaks are unvaccinated!

Get vaccinated and stop the outbreaks. Vaccines are safe, with few risks, and necessary.

More on Vaccinated vs Unvaccinated – Measles Outbreak Edition

More Measles Myths

It’s kind of sad that some folks still believe many of the measles myths that were being told in 1963.

Folks once accepted measles as inevitable because they had no choice, but that changed when we got a vaccine.
Measles was long known as a harmless killer

Wait, measles isn’t harmless?

But what about that Brady Bunch episode!?!

More Measles Myths

What other myths about measles have you heard?

Have you heard that folks never worried about measles before we had a vaccine? That it never even made the newspaper?

There were newspaper articles warning about measles in 1959 - a measles year.

The other myths they push are just as easily disproven

Which of these myths do you believe?

Which ones are keeping you from vaccinating and protecting your kids?

More on Measles Myths

Remembering Measles

I don’t remember treating any kids with measles in medical school or residency.

We certainly saw a lot of other now vaccine-preventable diseases when I was in training, from rotavirus and pneumococcal disease to meningococcal disease.

“When I graduated from medical school, many of the current vaccines were either not yet invented or just beginning to be widely used. I still remember what health care was like in the pre-vaccine era, and I remember that there seemed to be at least one child in each neighborhood who spent much of her life in an iron lung because of polio. As a young resident in pediatrics, I heard, on the whooping-cough ward, the coughing and choking of children with pneumonia. I remember the brain damage from encephalitis caused by measles, and the birth defects of babies whose mothers had had German measles during pregnancy. In my first years in pediatric practice, I remember making hospital rounds every morning and treating children with meningitis, and complications of chicken pox and other illnesses that have been either eliminated or lessened in severity by the widespread use of vaccines. Also, I remember more than a decade ago when Great Britain temporarily stopped the routine use of the DTP vaccine because of a reaction scare (which later turned out to be a false alarm) and consequently suffered a resurgence of whooping cough. Because of my “historical” perspective, I have grown to appreciate the value of vaccines as a necessary public-health measure. Currently in our pediatric practice, we follow the vaccine schedule recommended by the American Academy of Pediatrics.”

Dr. William Sears on Ask Dr. Sears: Vaccination/Immunization Concerns

But I trained in the post-elimination era for measles.

Remembering Measles

Although some folks only seem to have the Brady Bunch to use as a guide, fortunately there are many other ways to discover what measles used to be like.

I asked some of my old instructors…

“Typical case of measles – a couple days of high fever, with a sick (miserable) looking kid with running nose, bad cough, and red eyes. You can see Koplik’s spots if you know to look for them on the buccal mucosa (I describe them as grains of salts on red tablecloth). Fever gets higher and rash appears at peak of fever (day 3-4). The rash disappears with a brawny hyperpigmented appearance. The child frequently gets diagnosed with an ear infection. If no complications (ear infection or pneumonia), recovery is quick once the fever resolves, but these kids look really sick, miserable, and sad during the acute phase. They have a measly look.”

Jeed Gan, MD

After reading that account, I’m glad my kids are all vaccinated and protected and hopefully won’t ever get measles, as it sounds horrible.

Although I have never seen it, I can certainly imagine that measly look…

A child with measles and four days of the classic measles rash.
A child with measles and four days of the classic measles rash. Photo by CDC/NIP/ Barbara Rice

What else can you imagine?

“I’ve often called measles ‘the harmless killer’ because, although most youngsters recover uneventfully, the disease a certain amount of really serious damage.”

Dr. Joseph Molner

Can you imagine intentionally leaving your kids unvaccinated and at risk of a harmless killer disease?

In this 1959 article in the Madera Tribune, Dr. Bundesen warns parents to take measles seriously.
In this 1959 article in the Madera Tribune, Dr. Bundesen warns parents to take measles seriously.

It is important to note that even a “mild” attack included a fever that could hit 104F or higher and, altogether the symptoms could last up to 12 days, as the cough often lingers after the rash has cleared up.

Measles is definitely contagious.
Measles is definitely contagious.

And in the pre-vaccine era, everyone ended up having measles, as it was so contagious.

Not everyone survived having measles though.

Even after improved sanitation and hygiene dropped mortality rates for measles and other diseases in the early part of the 20th Century, a lot of kids still died with measles.
Even after improved sanitation and hygiene dropped mortality rates for measles and other diseases in the early part of the 20th Century, a lot of kids still died with measles.

It was once well known that measles was not always so easy on kids.

1953 medical advice column
1953 medical advice column

Why have so many folks forgotten that fact?

Do you think that a 106F fever comes with a mild disease?
Do you think that a 106F fever comes with a mild disease?

Is it because vaccines work so well that we don’t see or hear about measles that much anymore?

Kids with measles feel awful.

At least we don’t hear about them until immunization rates drop and we start having more and more outbreaks.

Is that what it’s going to take to get you to vaccinate your kids? An outbreak in your city? Your child’s school? Or are you going to wait until your kids get sick?

More on Remembering Measles

What Are the Signs and Symptoms of Measles?

The first measles vaccine was developed in 1963 and its use led to a quick drop in measles cases in the United States.

In fact, as most people know, the endemic spread of measles was declared eliminated in the United States in 2000.

What does that mean?

A typical case of measles, as described in 1920, doesn't sound very mild or marvelous as some folks claim it to be.
A typical case of measles, as described in 1920, doesn’t sound very mild or marvelous as some folks claim it to be.

For one thing, it means that many people in the United States have never actually seen anyone with measles.

What Are the Signs and Symptoms of Measles?

As we are seeing more and more measles cases each year, it makes it important for everyone to learn how to recognize what measles looks like. Measles is so contagious, that missing just one case can lead to a lot of other people getting exposed unnecessarily and can keep an outbreak going.

So what does measles look like?

Call before you go to the ER or to see your doctor if you think your child has measles so that you don't put others at risk.
Call before you go to the ER or to see your doctor if you think your child has measles so that you don’t put others at risk.

After being exposed, kids with measles will develop:

  • a high fever
  • cough and/or runny nose
  • red, watery eyes with photophobia (dislike of bright light)
  • sore throat
  • irritability
  • decreased appetite

That sounds like many other viral infections that kids get though, which is why measles is so hard to diagnose, at least at the beginning stages of the illness, when kids only have the first signs of measles – the fever, cough, runny nose, and conjunctivitis.

Koplik spots, small gray-white spots in your mouth, are another clue that a child might have measles. They can develop on the second or third day of fever.

Next, after having the high fever for 3 to 5 days, kids develop a worsening fever and the classic measles rash. It is important to note that you are contagious well before you get the rash though, up to about four days before the rash develops, providing plenty of chances to expose others before you ever know you have measles.

“It usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, trunk, arms, legs, and feet. Small raised bumps may also appear on top of the flat red spots. The spots may become joined together as they spread from the head to the rest of the body.”

Measles Signs and Symptoms

While many diseases have a fever with or followed by a rash, it is very characteristic of measles that the fever continues for a few more days as the child develops the rash.

“You’ll usually feel most ill on the first or second day after the rash develops.”

Measles Symptoms

This is when most kids get diagnosed, typically with laboratory confirmation.

Unfortunately, because of the high fever and irritability, they may have sought medical attention a few times and could have exposed a lot of people already, especially as you continue to be contagious until you have had the rash for at least four days.

“After a few days, the fever subsides and the rash fades.”

Measles Signs and Symptoms

All together, these classic measles symptoms typically last about a week. As the rash fades, parents might notice staining and then a fine desquamation (skin peeling).

Of course, if any complications develop, the symptoms can last much longer.

What complications? Remember, measles was once called a harmless killer

Complications of measles can include:

  • ear infections
  • diarrhea
  • croup
  • pneumonia
  • seizures
  • encephalitis
  • myocarditis

And tragically, some kids don’t survive having measles.

“Furthermore, the risk of contracting other infections or dying remains high for several months after recovery from acute measles infection.”

Treating Measles in Children

And although most do survive the acute infection, we know that these kids are still at risk for getting other infections in the next few months and are at a later risk for SSPE.

Get vaccinated. Stop the outbreaks. There is no good reason that our kids should have to get measles today.

More on the Signs and Symptoms of Measles

Everything You Need to Know About the Measles Vaccine

The measles vaccine is one of the most effective vaccines we have.

It is also one of the safest, having very few serious side effects.

Everything You Need to Know About the Measles Vaccine

So why are some parents still afraid to allow their kids to get vaccinated and protected, putting them at risk to get measles, a life-threatening disease?

“Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.”

Cochrane Systematic Review on Vaccines for measles, mumps and rubella in children

Let’s see if you still are after we get all of your questions about the measles vaccine answered…

Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
Schools in California were closed for at least two weeks in 1917 because of measles epidemics.
  1. How long has the measles vaccine been around? The very first measles vaccine was licensed by John Enders in 1963. An improved measles vaccine was developed by Maurice Hilleman and licensed in 1968, and that is the measles vaccine that we still use today, at least in the United States. It was combined into the MMR vaccine in 1971.
  2. How effective is the measles vaccine? A single dose of the measles vaccine is about 93% effective at preventing a measles infection. Two doses (the second dose was added to the routine immunization schedule in 1994) are up to 97% effective. That’s why almost all of the people who get measles in an outbreak are unvaccinated.
  3. How long does immunity from the measles vaccine last? Immunity from the measles vaccine is thought to be life-long. It is important to understand that the second dose isn’t a booster dose, but is instead for those few folks who don’t respond to the first dose.
  4. Who should get the measles vaccine? Everyone without a true medical contraindication should get the measles vaccine (MMR), with the first dose at 12-15 months and a second dose at 4-6 years.
  5. Can my kids get their measles vaccine early? An advanced immunization schedule is available for kids in an outbreak or if they will be traveling out of the country. The first dose can be given as early as age 6-months, but is repeated when the child is 12 months because of concerns of interference with maternal antibodies. The official second dose can be given early too, as early as 4 weeks after the first dose, as long as the child is at least 12 months old.
  6. Do I need a booster dose of the measles vaccine? People who are fully immunized do not need a booster dose of the MMR vaccine, but it is important to understand whether or not you are really fully immunized to see if you need a second dose. Some adults who are not high risk are considered fully vaccinated with only one dose, while others should have two doses. Are you at high risk to get measles? Do you travel, live in an area where there are measles outbreaks, go to college, or work as a health care professional?
  7. Should I check my measles titers? In general, it is not necessary to check your titers for measles. If you haven’t had two doses of the MMR vaccine, then get a second dose. If you have had two doses of the MMR vaccine, then you are considered protected. Keep in mind that there is no recommendation to get a third dose of MMR for measles protection, although it is sometimes recommended for mumps protection during a mumps outbreak.
  8. If my child gets a rash after getting his MMR, does that mean that he has measles? No. This is a common, very mild vaccine reaction and not a sign of measles.
  9. Can the measles vaccine cause seizures? The MMR vaccine can cause febrile seizures. It is important to remember that without other risk factors, kids who develop febrile seizures after a vaccine are at the same small risk for developing epilepsy as other kids. And know that vaccines aren’t the only cause of febrile seizures. Vaccine-preventable diseases can cause both febrile seizures and more serious non-febrile seizures.
  10. Why do people think that that the measles vaccine is associated with autism? It is well known that this idea originated with Andrew Wakefield, but the real question should be why do some people still think that vaccines are associated with autism after so much evidence has said that they aren’t?
  11. What are the risks of the measles vaccine? Like other vaccines, the MMR vaccine has mild risks or side effects, including fever, rash, and soreness at the injection site. Some more moderate reactions that can rarely occur include febrile seizures, joint pain, and a temporary low platelet count. More serious reactions are even rarer, but can include deafness, long-term seizures, coma, or lowered consciousness, brain damage, and life-threatening allergic reactions.
  12. Why are there so many reports of measles vaccine deaths? There are extremely few deaths after vaccines. The reports of measles vaccine deaths you see on the Internet are just reports to VAERS and are not actually reports that have been proven to be caused by a vaccine. As with other vaccines, the risks from having a vaccine-preventable disease are much greater than the risks of the vaccine. The only reason that it might not seem like that now is because far fewer people get measles now than they did in the pre-vaccine era, when about 500 people died with measles each year.
  13. When did they take mercury out of the measles vaccine? Measles vaccines, including the MMR, have never, ever contained mercury or thimerosal.
  14. Why do we still have outbreaks if we have had a measles vaccine since 1963? In the United States, although the endemic spread of measles was declared eliminated in 2000, many cases are still imported from other countries. As measles cases increase around the world, that is translating to an increase in outbreaks here. Even though overall vaccination rates are good, because there are many pockets of susceptible people in areas that don’t vaccinate their kids, they get hit with outbreaks.
  15. Can we eradicate measles? Because measles is so contagious, the vaccine does have failures, and some folks still don’t get vaccinated, there is some doubt that we can eradicate measles without a better vaccine. That doesn’t mean that the current measles vaccines can’t prevent outbreaks though…

Are you ready to get your kids their MMR vaccine so that they are vaccinated and protected against measles, mumps, and rubella?

If not, what other questions do you have?

While you are thinking, here is a question for you – Do know why they used to call measles a harmless killer?

More on the Everything You Need to Know About the Measles Vaccine

Fact Checking an Anti-Vaccine Measles Outbreak Quiz

Anti-vaccine folks have gotten pretty good at pushing propaganda to keep you scared to vaccinate and protect your kids.

Now, they even have quizzes to help test how much of that misinformation you remember!

Fact Checking an Anti-Vaccine Measles Outbreak Quiz

A quiz about measles outbreaks by the ironically named Physicians for Informed Consent was recently promoted by Dr. Bob Sears.

How did Dr. Bob get 12 out of 12 correct if most of the answers are really wrong?
How did Dr. Bob get 12 out of 12 correct if most of the answers are really wrong?

Let’s take a look at some of the questions and the anti-vaccine answers

There is only so much that better hygiene, sanitation, and nutrition can do, which is why about 400 to 500 people were dying of measles in the 1950s and early 1960s just before the first measles vaccines were developed.
There is only so much that better hygiene, sanitation, and nutrition can do, which is why about 400 to 500 people were dying of measles in the 1950s and early 1960s just before the first measles vaccines were developed.

While mortality rates did indeed decline for most diseases and conditions in the early part of the 20th century because of advancements in living conditions, nutrition, and health care, that effect had plateaued by the mid-1930s.

Being unvaccinated and unprotected is the main reason why people in underdeveloped countries die from measles, not low vitamin A…

It is true that vitamin A deficiency increases the risk for more severe complications and death from measles, which is why it can be more deadly in undeveloped countries where malnutrition is a big problem.

“Because of gaps in vaccination coverage, measles outbreaks occurred in all regions, while there were an estimated 110 000 deaths related to the disease.”

Measles cases spike globally due to gaps in vaccination coverage

Unfortunately, the other big problem in many of these countries is that these kids are unvaccinated because of a lack of access to vaccines.

This child doesn’t appear to have measles…

Immune globulin is a treatment option if you have been exposed to measles, but it is not actually a treatment once you have measles. And high dose vitamin A mainly benefits those with a vitamin A deficiency, which is unlikely in an industrial country, like the United States.

The only benefit of having measles, which you have to earn by having measles and surviving without complications, is that you will have developed immunity to measles.

In addition to having no other benefits, you will then be at risk for SSPE and may have wiped out your immune system for a few years.

While you are at risk for encephalitis and seizures after a natural infection, after getting a dose of MMR, one risk is a febrile seizure, which is typically thought to be benign.

The risk of having a febrile seizure after the first dose of the MMR vaccine is about 1 in 2,500 doses. There is also a small risk of having a febrile seizure if the flu vaccine is given at the same time as a Prevnar or DTaP vaccine.

It is important to note that vaccines are not the only reason that children have febrile seizures. Many infections, including vaccine preventable infections, can trigger febrile seizures, in addition to causing more serious types of non-febrile seizures.

This is not true.

It is very unlikely that any of the kids who develop febrile seizures after a vaccine will later develop epilepsy.

“Febrile seizures can be frightening, but nearly all children who have a febrile seizure recover quickly, are healthy afterwards, and do not have any permanent neurological damage. Febrile seizures do not make children more likely to develop epilepsy or any other seizure disorder.”

Febrile Seizures Following Childhood Vaccinations, Including Influenza Vaccination

Without any risk factors (parent or sibling with epilepsy, having complex febrile seizures, or abnormal development), a child with febrile seizures has the same risk of developing epilepsy has any other child.

Do anti-vaccine folks really read the inserts?

Like many other vaccines, the package insert for MMR does say that it has “has not been evaluated for carcinogenic or mutagenic potential, or potential to impair fertility.” That doesn’t mean that it hasn’t undergone safety studies for its potential to cause cancer, genetic mutations, and impaired fertility though.

Wait, what? Yeah, all vaccines have preclinical toxicology studies, including single and/or repeat dose, reproductive and developmental, mutagenicity, carcinogenicity, and safety pharmacology. If any issues are found, further studies are done.

The only way to think that a natural measles infection is safer than the MMR vaccine is if you believe that all reports to VAERS have been confirmed as being caused by the vaccine (they aren’t) and you don’t think about the fact that relatively few people get measles any more (so you don’t see or hear about many measles deaths) because most folks are vaccinated and protected!

How did you do on the quiz?

Did you easily spot all of the anti-vaccine propaganda?

More on Fact Checking an Anti-Vaccine Measles Outbreak Quiz