Tag: measles outbreaks

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

Some folks just can’t understand why we are having so many measles outbreaks these days.

It is actually really easy to figure out and find the decline in vaccination rates if you really look for it…

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

And it is easy to understand why we are having these measles outbreaks, even though overall vaccination rates in a state might be good.

The problem is the clusters of unvaccinated people in very specific areas of each city, county, and state.

MMR vaccination rates have dropped over the years in Washington (red line) and Clark County (yellow line). Can we thank Andrew Wakefield, Jenny McCarthy, and Bob Sears, etc.?

These pockets of susceptibles put everyone at risk, especially those who are too young to be vaccinated, too young to be fully vaccinated, and those with true medical exemptions who can’t be vaccinated.

Looking at the state and county level rates of MMR vaccination by kindergarten, you can see that a lot more kids haven’t been getting vaccinated since 1990. In fact, while 97.6% of kindergarteners during the 1998-99 school year had their MMR vaccination, it quickly fell to about 90%, where it remains today. In Clark County, where we are currently seeing a large outbreak of measles, the drop was even worse.

Not surprisingly, this mirrors the vaccine exemption rates in these areas.

“What’s so important about all this data is that it destroys the false narrative. Vaccination rates haven’t gone down lately. Period. Ask any epidemiologist you know to run these numbers.”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

Speaking of false narratives, many states now publish school and county level immunization rates, so it is easy to see past anti-vaccine propaganda and see that vaccination rates truly have gone down lately in areas that are dealing with outbreaks.

Immunization rates are very low at the Portland Waldorf School.

The Oregon Health Authority actually publishes annual lists of child, adolescent, and school immunization rates.

“I wanted to make sure and corroborate that data with data from the Oregon Health Authority, which they conveniently don’t publish very often, but someone sent me their data from 2014, showing that 97.1% of 7th graders in Oregon have received an MMR vaccine! Where’s the decline?”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

In 2017, 95.5% of teens in Oregon had received one dose of the MMR vaccine. Only 90% had received the recommended two doses. Rates in Multonah County, near the current outbreak in Washington, were actually a little better, at 96.7% (one dose) and 92% (2 doses).

Still, there are plenty of schools with much lower rates, creating the pockets of susceptibles that are causing these outbreaks.

Where’s the decline?

Have you checked the Portland Waldorf school?

While schools with higher rates help to boost the average rates for the county and state, the schools and communities with low rates are prime for outbreaks.

SchoolMMR Rates
Orchards Elementary School71.4%
Minnehaha Elementary School89.3%
Cornerstone Christian Academy?
Hearthwood Elementary School72.2%
Home Connection86.7%
Homelink River61.1%
Slavic Christian Academy?
Image Elementary School78%
Eisenhower Elementary School89%
Tukes Valley Primary and Middle School​?
Maple Grove School?
Evergreen High School?

In Washington, for example, the schools involved in the outbreak (at least the ones that report) all have immunization rates below the state and county levels.

If you are on the fence about vaccinating your kids, check where you’re getting your information from if what you are hearing is scaring you.

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

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

One of the pillars of the anti-vaccine movement is their belief that vaccines don’t even work.

They even think that they have graphs to prove it! They don’t…

Did Gregory Poland Really Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

To help them try and argue their point, they also seem to like to cherry pick and misuse quotes from real experts.

Anti-vaccine propaganda from Lawrence Solomon.
Is that what Dr. Poland said?

In 2012, Gregory Poland, the Editor-in-Chief of the journal Vaccine, did publish the article, The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

No where in the article does he say that the measles vaccine can’t prevent measles outbreaks.

He is just saying that since the vaccine isn’t 100% effective and because measles is so contagious, that it can’t prevent all measles outbreaks.

“Thus, measles outbreaks also occur even among highly vaccinated populations because of primary and secondary vaccine failure, which results in gradually larger pools of susceptible persons and outbreaks once measles is introduced.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

And we likely won’t be able to eradicate measles with our current measles vaccine, “even though measles can be controlled, and even eliminated in some regions for defined periods of time.”

“Thus, while an excellent vaccine, a dilemma remains.”

Poland et al on The Re-Emergence of Measles in Developed Countries: Time to Develop the Next-Generation Measles Vaccines?

The dilemma is that measles is still around and that people who are too young to be vaccinated, too young to be fully vaccinated, and those with immune system problems who can’t be vaccinated sometimes get measles, in addition to folks who are intentionally unvaccinated.

With a better vaccine, fewer people would get caught up in outbreaks that are typically triggered by folks who are intentionally unvaccinated.

Remember, most outbreaks are traced back to someone who is unvaccinated. This is the person Dr. Poland is describing when he says “once measles is introduced,” as the endemic spread of measles has been eliminated in the United States. All cases are reintroduced from outside the country, typically when someone who is intentionally not vaccinated travels overseas and then returns with measles while they are still contagious.

“But he also said that sometimes people who oppose the vaccines will pick out one sentence in the scientific study and extrapolate it to mean things that it does not mean… He said that measles is the most contagious disease that we know, and yet we found that fear and ignorance is more so.”

Senator Carla Nelson on The Anti-vaxxers Might Wish that What was Lost had not been Found

Unfortunately, a better measles vaccine still won’t protect us from anti-vaccine propaganda.

Vaccines are safe, with few risks, and necessary. Get vaccinated and stop the outbreaks. You don’t have to wait for a new measles vaccine…

More on Did Gregory Poland Say That MMR Vaccines Can’t Prevent Measles Outbreaks?

About Those Vaccine Strains in Measles Outbreaks…

A lot happens to control and contain a measles outbreak these days.

For one thing, you have to confirm that everyone with measles symptoms actually has measles. If you miss anyone, because measles is so contagious, then they could expose other people and the outbreak will keep getting bigger.

How do they confirm who has measles and who doesn’t?

While you could just make a clinical diagnosis, simply relying on the person’s history and pattern of symptoms, typically everyone just gets tested.

About Those Vaccine Strains in Measles Outbreaks…

What kind of testing?

“Laboratory confirmation is essential for all sporadic measles cases and all outbreaks. Detection of measles-specific IgM antibody and measles RNA by real-time polymerase chain reaction (RT-PCR) are the most common methods for confirming measles infection. Healthcare providers should obtain both a serum sample and a throat swab (or nasopharyngeal swab) from patients suspected to have measles at first contact with them. Urine samples may also contain virus, and when feasible to do so, collecting both respiratory and urine samples can increase the likelihood of detecting measles virus.”

Measles For Healthcare Professionals

It depends, but often a throat swab or a throat swab and urine are collected for PCR testing, especially if it has been 7 or fewer days since the patient came down with their rash.

If it has been longer than 7 days, then testing using urine and blood specimens can be performed.

“Molecular analysis can also be conducted to determine the genotype of the measles virus. Genotyping is used to map the transmission pathways of measles viruses. The genetic data can help to link or unlink cases and can suggest a source for imported cases. Genotyping is the only way to distinguish between wild-type measles virus infection and a rash caused by a recent measles vaccination.”

Measles For Healthcare Professionals

Because many people get vaccinated during an outbreak and a rash and fever is a side effect of the MMR vaccine, testing becomes very important in those who were recently vaccinated.

Statistics from the 2015 Disneyland measles outbreak...
Statistics from the 2015 Disneyland measles outbreak. Anti-vaccine folks, this slide doesn’t mean what you think it means.

After getting vaccinated, testing helps confirm that someone has vaccine strain measles and not wild type, a vaccine reaction, and don’t actually have measles.

“Here, we describe a real-time reverse transcription-PCR (RT-PCR) method that detects the vaccine genotype (MeVA RT-quantitative PCR [RT-qPCR]) and that can provide rapid discrimination between wild-type-virus infections and vaccine reactions.”

Roy et al on Rapid Identification of Measles Virus Vaccine Genotype by Real-Time PCR

An no, the vaccine reaction is not that they developed measles! They developed a rash and/or fever, a common side effect of the MMR vaccine.

“During outbreaks, measles vaccine is administered to help control the outbreak, and in these situations, vaccine reactions may be mistakenly classified as measles cases.”

CDC on Genetic Analysis of Measles Viruses

So the reports that you might have seen that 31 people in the California measles outbreak had a vaccine strain of measles aren’t true. There were at least 31 people who were recently vaccinated during the outbreak and had a rash and/or fever, and they tested positive for the vaccine strain, proving that they weren’t actually part of the outbreak. None of them actually had measles though.

Has anyone ever gotten the measles after being vaccinated?

“Vaccine‐associated measles is a possible, but extremely rare event.”

Sood et al on Vaccine‐associated measles in an immunocompetent child

Yes, there are a few case reports.

Very rare case reports.

Who's to blame for low immunization rates and continuing outbreaks?
Who’s to blame for low immunization rates and continuing outbreaks?

We know who’s responsible for the rise in measles outbreaks and no, it ain’t folks who have recently been vaccinated. Vaccines are safe and necessary.

Get vaccinated. Stop the outbreaks.

More on Vaccine Strains in Measles Outbreaks

What Do We Know About the Rockland County Measles Outbreak?

Breaking News – there are 5 new cases in Rockland County, bringing the total in this ongoing outbreak to 135. (see below)

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

Nothing about what Del Bigtree and Sharyl Attkisson have been saying is right.
Nothing about what Del Bigtree and Sharyl Attkisson have been saying is right.

That makes it easy to spot anti-vaccine propaganda.

What Do We Know About the Rockland County Measles Outbreak?

What do we know?

We know that the outbreak is still growing.

Almost all of the measles cases in Rockland County are unvaccinated.

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

What else do we know?

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

Rockland County Measles Information

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

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

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

OutbreakCasesDuration
Brooklyn outbreak 2013583/13 to 6/9
Ohio outbreak 20143843/24 to 7/23
Disneyland outbreak 201514712/28 to 4/16
Minnesota outbreak 2017793/30 to 8/25
Rockland County outbreak 2018
1359/18 – ?
Brooklyn outbreak 20187310/18 – ?

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

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

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

Why has this outbreak been so hard to control?

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

Measles Review for Providers

Folks keep reintroducing measles into the community!

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

What else do we know?

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

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

Health Department Announces Increased School Exclusions Due to Measles Outbreak

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

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

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

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

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

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

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

More on the The Rockland County Measles Outbreak

Updated February 13, 2019

Did CNN Apologize for Using a Fake Measles Photo?

We have seen a lot of fake stories since the measles outbreaks started.

Will these folks apologize when they realize that it wasn't a photo of a child suffering an adverse reaction to the measles vaccine?
Will these folks apologize when they realize that it wasn’t a photo of a child suffering an adverse reaction to the measles vaccine?

And they are all from the usual suspects.

Did CNN Apologize for Using a Fake Measles Photo?

And no, I’m not talking about the photo from CNN.

It's not a conspiracy...
It’s not a conspiracy…

So what’s up with the photo?

This photo is in the CDC archives.
This photo is in the CDC archives.

The child in the photo doesn’t actually have measles, although he does have a rash that looks like measles.

“This 1968 image depicted the face and back of a young child after receiving a smallpox vaccination in the right shoulder region. Note the erythematous halo surrounding the vaccination site, which can also be seen in PHIL 13321 and 13323, as well as a morbilliform skin rash, i.e., resembling measles, consisting of numerous flattened erythematous, amorphous macules. This child was subsequently diagnosed with roseola vaccinia.”

Public Health Image Library (PHIL)

And it is a photo of a child of a vaccine reaction, a reaction to his smallpox vaccine.

Why did CDC use that photo?

Who knows, but there aren’t a lot of photos of kids with measles out there. They likely found a stock photo of a kid with a rash that looked like measles and used it.

Learn the risk of following the advice of Brandy Vaughan.
Learn the risk of following the advice of Brandy Vaughan.

Still, while they didn’t use a photo of a child with measles, they also didn’t use a photo of a child that got measles from the vaccine, as Brandy Vaughan claims.

And of course, the rest of the story about Washington being under a state of emergency still stands, as measles cases continue to rise.

More on Did CNN Apologize for Using a Fake Measles Photo?

Fact Checking Sharyl Attkisson on the Measles Outbreaks

Breaking News!

Erin Elizabeth and Sharyl Attkisson reporting on measles outbreaks. What could go right?
Erin Elizabeth and Sharyl Attkisson reporting on measles outbreaks. What could go right?

Anti-vaccine folks are spreading fake news and propaganda from Sharyl Attkisson again.

Fact Checking Sharyl Attkisson on the Measles Outbreaks

While that’s probably not really news to anyone, let’s see what we got here…

“Bottom line is that they say that 31 of the 124 are not vaccinated. So guess what that means? You do the math, the rest are vaccinated.”

Erin Elizabeth

Her source?

An abc7NY article, Health Alert: 124 cases of measles now confirmed in Rockland County, which apparently was talking about both the outbreak in New York and another outbreak in Washington.

There are 35 cases in Washington, and “officials confirm that 31 of those confirmed patients had not been vaccinated against measles.”

What about in New York?

When this was published, there were 96 cases in Rockland County, 50 cases in Brooklyn, and 6 cases in Orange County. Almost all cases were unvaccinated.
When this was published, there were fewer cases in the outbreak, but still, almost all cases were unvaccinated.

Although the case counts have gone up – 128 in Rockland County and 64 in Brooklyn, it is unlikely that the percentages of unvaccinated to vaccinated have changed that much.

You do the math, even with the extra cases, you can’t get to 93 vaccinated people in the outbreak.

Bottom line, as in every other measles outbreak, the kids in the New York measles outbreak are almost all unvaccinated.

At it's worst, measles causes encephalitis or kills you! What's wrong with these people?
At it’s worst, measles causes encephalitis or kills you! What’s wrong with these people?

Anti-vaccine folks are panicking over the outbreaks and are putting out misinformation in overdrive.

“This is a very big article for us.”

Erin Elizabeth

Erin apparently thought she had a scoop. She “found” the first measles outbreak in which most kids were vaccinated! Except she didn’t… If she had done a little research and checked the outbreak stats on the health department website, she would have seen that.

Or she could have just read the article…

The 31 unvaccinated folks in the abc7NY article are clearly from the Oregon/Washington Outbreak.
The 31 unvaccinated folks in the abc7NY article are clearly from the Oregon/Washington Outbreak.

Don’t let them scare you into keeping your kids unvaccinated and at risk, especially when measles is on the rise.

More on Fact Checking Sharyl Attkisson on the Measles Outbreaks

More Measles Hysteria From Bob Sears

Most folks remember Dr. Bob’s response to the measles outbreak in his home town.

He told folks DON’T PANIC!!!!

More Measles Hysteria From Bob Sears

That was nearly four years ago, during the Disneyland measles outbreak.

So what’s he saying now?

From panic to hysteria - Dr. Bob on the measles outbreaks.

He’s moved from panic (a sudden overpowering fright) to hysteria (behavior exhibiting overwhelming or unmanageable fear or emotional excess), but is still pushing his usual talking points.

He has changed the way he is talking about measles deaths though.

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.

Remember how he used to say that measles wasn’t deadly and that no one had died of measles in a long time? Now, instead of acknowledging that a woman got caught up in the 2015 outbreaks in Washington and died, he has shifted to saying that there hasn’t been a pediatric death in a long time.

Either way, it is important to understand something he leaves out. There are few deaths from measles these days because most folks are vaccinated!

When did Dr. Bob’s book about vaccines come out? The one with the alternative vaccine schedule?

Whatever his motivation, let’s take a look at what Dr. Bob is saying about measles…

“Measles hysteria is everywhere. And it’s clear the hysteria is a result of media fear around this disease, a disease every child used to get (and handle virtually without complication) not that long ago.”

Dr. Bob Sears

Not that long ago?

I’ve been a pediatrician for 22 years and I have never seen a child with measles. Neither did I have measles, as I was fortunate enough to grow up in the post-vaccine era for measles – a vaccine that has been available for since the 1960s.

And while every child did indeed once get measles, in the pre-vaccine era, not all handled it without complications, which is why measles was called the harmless killer.

Anti-vaccine folks try to hide the risks of measles in mortality rates, but the reality of it is that about 500 people died each year up until the early 1960s when the first measles vaccine was developed.

And I guess that wasn’t that long ago, after all, we had good hygiene and sanitation and healthcare at the time, and yet, a lot of people still died.

“There is another side to this measles conversation: how we’ve unintentionally shifted the burden of disease to babies and adults, both groups who are more likely to experience complications, by vaccinating all schoolchildren and losing natural immunity.”

Dr. Bob Sears

There is really only one side to this.

Folks who are intentionally not vaccinating their kids are getting measles and other vaccine-preventable diseases and are putting us all at risk to get sick.

After all, the MMR vaccine provides life-long immunity to most people. That’s not the problem.

If we went back to the pre-vaccine era, when everyone got measles naturally, as Dr. Bob seems to be advocating for, not only would those kids have to earn their immunity, but many babies (those who hadn’t had measles yet) and adults (those with immune system problems) would still be at great risk.

Are you starting to see how silly his arguments are?

We almost had measles beat!

Consider that there were just 37 measles cases in the United States in 2004. And that we have already had more than twice that amount this month alone!

And while measles was cyclical in the pre-vaccine era, it shouldn’t be when folks are vaccinated and protected. What happened to the cycles between 1997 and 2007?

“Unlike natural immunity, the measles vaccine does NOT offer lifelong protection. Estimates of its protection average around 15 years, and describe a phenomenon in the vaccine world known as “waning immunity.”

Melissa Floyd

The measles vaccine provides lifelong protection. Waning immunity only refers to protection against mumps. And no, there is no call for a third MMR dose for extra protection against measles.

“The other trend we’ve seen over the past 10 years is an increase in adult measles cases. “

Melissa Floyd

Dr. Bob’s sidekick neglects to mention that in addition to unvaccinated kis with measles, the trend is an increase in measles cases in unvaccinated adults! After all, most folks who get measles in these outbreaks are unvaccinated.

“To recap: by losing natural immunity for measles for children 5-19 years old, we’ve exposed babies, pregnant women, and adults to measles—all vulnerable groups who are more likely to experience serious complications from the disease.”

Melissa Floyd

Perhaps the only true statement that they make – “we’ve exposed babies, pregnant women, and adults to measles—all vulnerable groups who are more likely to experience serious complications from the disease.”

And no, vitamin A is not a proven therapy or measles in developed countries. It mainly helps prevent complications in kids who have a vitamin A deficiency.

Hopefully, it is becoming evident that what we need to stop is the anti-vaccine propaganda that keeps folks from vaccinating and protecting their kids. We need to stop the outbreaks.

More on More Measles Hysteria From Bob Sears