Tag: misinformation

How Could Seven of My Vaccinated Kids Have the Measles Right Now?

Seven vaccinated kids with measles?!?

But doesn’t the measles rash typically show up after three to five days of fever?

Wait, that couldn’t really happen, could it? Seven vaccinated kids with measles in one family?

How Could Seven of My Vaccinated Kids Have the Measles Right Now?

While anything is possible, this story is very improbable once you look at the details…

“When her 12-year-old son spiked a fever and started complaining of a sore throat right before Passover, Mrs. Pearl (not her real name) wasn’t worried. She confidently crossed off a host of possible infections that he was fully vaccinated for.

She thought he had strep throat, like two of his siblings.

They headed to urgent care for a rapid strep test, but the result was negative. Undeterred, she put her son on antibiotics at the nurse’s recommendation, and sent her son to bed.

He’d worsened by morning.

He woke feeling feverish and broken out in a rash.”

Jennifer Margulis

Could that be measles?

He ended up testing positive for measles, even though he was fully vaccinated. Only two days of fever before he developed his rash though, and no word that the fever continued, as you would expect with measles…

“Not long after, Mrs. Pearl’s 10-year-old broke out in a similar rash.

This child didn’t spike a fever but his breathing was labored and he complained that his eyes hurt.

He also tested positive for the measles.”

Jennifer Margulis

Although they all could have been exposed to someone else, it is important to note that the incubation period for measles is 7 to 14 days. The “not long after” scenario sounds like too short a time to get “measles” from his brother. Also, no fever, which would be very strange for measles…

But the other five kids had more classic symptoms of measles, right?

Nope.

“Of the seven other children that Mrs. Pearl had tested—all of whom had been fully vaccinated—five more showed no immunity to measles.”

Jennifer Margulis

What about the negative titer tests?

That’s actually not unusual after measles vaccination. It’s not proof or any kind of indication that the vaccine didn’t work. It has been long known that most vaccinated people who have negative measles titers will show an anamnestic immune response if they get another dose of MMR.

What does that mean? It means that they were likely immune, even with the negative titer.

“In the event that a HCP who has 2 documented doses of MMR vaccine is tested serologically and determined to have negative or equivocal measles titer results, it is not recommended that the person receive an additional dose of MMR vaccine. Such persons should be considered to have presumptive evidence of measles immunity. Documented age-appropriate vaccination supersedes the results of subsequent serologic testing.”

Immunization of Health-Care Personnel: Recommendations of the Advisory Committee on Immunization Practices

In fact, we don’t routinely check titers after MMR, at least not for measles.

And their symptoms?

“Two hours after getting the MMR booster, Mrs. Pearl’s 16-year-old spiked a 102-degree fever and broke out in a measles rash.

Four days later her three other children, all of whom had received the MMR booster, all had measles rashes, canker sores in their mouths, gastrointestinal problems, and lethargy.”

Jennifer Margulis

Canker sores with measles? Kids with measles get Koplik spots, but no one describes them as canker sores.

Fever and a rash developing at the same time?

Yeah, none of that sounds like measles. At all.

Remember, the classic symptoms of measles include 3 to 5 days of a high fever with cough, coryza, and conjunctivitis, followed by a rash, with continued fever.

“According to Mrs. Pearl, the health department official also told her that measles vaccine failure is common and that about half the people getting measles in the current measles clusters in Brooklyn are fully vaccinated.”

Jennifer Margulis

Actually, only 27 of the 566 people in Brooklyn with measles have been known to be fully vaccinated, with two doses of MMR. How much less than half is that? It is less than 5% of cases.

Measles vaccine failure is not common at all.

Why Did They Say That Seven of My Vaccinated Kids Have Measles?

So how do you explain what happened to this family?

Besides the likelihood that they had another, more common virus causing their symptoms? With mouth ulcers and diarrhea, like maybe Coxsackie virus?

Do you really need another explanation?

How do you explain the positive measles tests?

They were almost certainly a false positive.

“The test kits in use have been shown to have high sensitivity and specificity. However, cross-reactions with other viral diseases, e.g. rubella and Parvovirus, may occur.”

Dietz et al on The laboratory confirmation of suspected measles cases in settings of low measles transmission: conclusions from the experience in the Americas.

They didn’t state which test was done, but it is important to note that several are available. This includes an immunoglobulin test, PCR from a throat swab, and PCR from a urine specimen. The most accurate testing is done by the CDC.

“Detection of specific IgM antibodies in a serum sample collected within the first few days of rash onset can provide presumptive evidence of a current or recent measles virus infection. However, because no assay is 100% specific, serologic testing of non-measles cases using any assay will occasionally produce false positive IgM results.”

Serologic Testing for Measles in Low Prevalence Setting

Did they have confirmatory tests, after their initial positive test? Were they done at a state lab? Did all of her other kids test positive for measles?

“She’s angry at the measles vaccine failure and worried about her family members, especially her pregnant daughter.”

Jennifer Margulis

She should be angry at folks pushing misininformation in her community.

“I used to think people who don’t vaccinate were crazy,” Mrs. Pearl says. “Now I’m not so sure. Maybe they’re right. Maybe my body doesn’t want to take garbage. Something is a red flag. After my story, I’m not so sure where the measles started. I’m legit. I did vaccinate. All my kids are up to date. Children ages 22 to 7 all getting the measles?”

Jennifer Margulis

Something is indeed a red flag. To get to the bottom of it, Mrs. Pearl should revisit the idea that her kids really had measles.

More on Vaccinated Kids with Measles

Decoding Anti-Vaccine Protests

Yes, even in this age of record–breaking measles cases, there are some anti-vaccine folks protesting because they want to keep their kids unvaccinated and unprotected.

Decoding Anti-Vaccine Protests

What reasons do they have to intentionally not vaccinate their kids?

Who's protecting us from the people protesting against vaccines?
Who’s protecting us from the people protesting against vaccines?

As many reasons as there are anti-vaccine talking points…

What is truly disturbing though, is that today’s anti-vaccine protestors are co-opting many symbols, language, and slogans and using them to get attention.

Del Bigtree wasn't the only one to wear a yellow star during anti-vaccine protests.
Del Bigtree wasn’t the only one to wear a yellow star during anti-vaccine protests.

Remember when anti-vaccine folks had to be called out for using Holocaust imagery to protest against vaccines.

How Did These Become Anti-Vaccine Slogans?

That’s not all they are doing though.

Did you know that they are also using:

If you do not consent, you won't get vaccinated and protected.
  • Me Too – a movement to support survivors and end sexual violence, anti-vaccine folks use it to when they talk about vaccine injuries.
  • I do not consent – typically about limiting searches when police don’t have a warrant, the anti-vaccine movement abuses it for something that they do have to consent for – getting vaccinated! If you do not consent, you won’t get vaccinated and protected.
  • Informed consent – again, this is something anti-vaccine folks abuse, as their decisions are being influenced by myths and misinformation, so it is not informed consent. It’s more like misinformed consent.

And then there are the anti-vaxxers who use “choice” as their argument.

If you weren't aware, this post makes it obvious where the choice argument comes from. No, it's not AoA, but from the pro-choice movement.
If you weren’t aware, this post makes it obvious where the choice argument comes from. No, it’s not AoA, but from the pro-choice movement.

Anti-vaxxers are only pro-choice for not vaccinating their kids though. They don’t care if we have a choice about wanting to be protected from being exposed to vaccine-preventable diseases.

Dog Whistles for Refusing Vaccines

What’s the big problem with choice as an argument for anti-vaccine folks?

Parents already have a choice to leave their kids unvaccinated and at risk for measles and other vaccine-preventable diseases.

They already have choices!

No one is forcing them to vaccinate their kids.

Of course, what they want is more choices. They want the option to send their intentionally unvaccinated kids to daycare and school, where they would pose a risk to others. They want to limit our choices for decreasing the risks of keeping our kids safe from vaccine-preventable diseases.

How? Their intentionally unvaccinated kids are at greater risk to get measles and other vaccine-preventable diseases, which they can then spread to others.

What does all of this really mean?

Just realize that all of these slogans are being co-opted and are being used as dog whistles for the anti-vaccine movement, diluting their original meaning.

More on Decoding Anti-Vaccine Protests

Who Is Arthur Caplan?

Plenty of folks claim to be experts on vaccines.

Some are experts because they study epidemiology, others because they study immunology or infectious disease.

And then there are the experts in vaccination ethics.

Who Is Arthur Caplan?

With a Ph.D. in the history of philosophy of science, Dr. Art Caplan went on to co-found The Hastings Center, a bioethics research institute.

Arthur Caplan does a good job of calling out folks who push anti-vaccine misinformation.
Arthur Caplan does a good job of calling out folks who push anti-vaccine misinformation.

He has since written dozens of books and nearly a thousand articles in peer-reviewed journals, working most recently at New York University’s Langone Medical Center, where he is the founding head of the Division of Medical Ethics.

“When politicians ignore the evidence, fail to cite appropriate medical authorities, and rely on hearsay and rumor, with the result that people — out of ignorance or error — don’t vaccinate their children, we can and should deny them elective office. When a doctor does so, we should demand that he forfeit his right to use his medical degree to misinform, confuse or lie.”

Arthur L. Caplan on Revoke the license of any doctor who opposes vaccination

It shouldn’t be a surprise that Art Caplan has a lot to say about vaccines.

“Faulty ethical thinking is to blame. We are elevating parents’ rights to make misinformed decisions over the rights of children to get important vaccines. Infants and young children are blocked from receiving their routine childhood immunizations by parents who espouse an aberrant ideology of choice or are being duped by anti-vaccine groups. In so doing, they are violating children’s rights to health, welfare and equal opportunity.”

Arthur L. Caplan and Peter J. Hotez on Anti-vaccine misinformation denies children’s rights

He also has a lot to say about measles, other vaccine-preventable diseases, and how to get control back before these outbreaks turn into true epidemics.

“What should we be doing to protect our communities, our children, and ourselves? We should halt the spread of anti-vaccine misinformation and take steps to stop nonmedical vaccine exemptions. We need to restore vaccines and vaccinations as the “new normal” in America.”

Arthur L Caplan on Let’s Treat Measles Seriously

Are you still thinking about skipping or delaying your child’s vaccines?

After reading some of Dr. Caplan’s work, you should know that it’s not safe, has no benefits, and isn’t the ethical thing to do.

More on Arthur Caplan and Vaccine Ethics

How Do Anti-Vaccine Folks Respond to New Information?

Ever wonder why most anti-vaccine folks don’t change their mind and get their kids vaccinated and protected when they “do their research” and “get educated” about vaccines?

You would think that they would, considering that anti-vaccine talking points are all based on myths and misinformation.

How Do Anti-Vaccine Folks Respond to New Information?

While some do change their mind, even before they are faced with an outbreak or their child getting sick, the biggest reason that others don’t is that they are stuck in an echo-chamber of like-minded folks.

This discussion is a good example of how this works.

The original poster wasn’t aware that measles was on the rise all over the world and that people are dying.

How do you respond to the fact that people are dying of measles?

So do they understand that reason behind the deaths is because those folks were unvaccinated?

Why didn’t “extreme poverty, poor nutrition, and a lack of sanitation” cause more measles deaths in Ukraine, Philippines, and Brazil before now?

Nope.

It’s always the vaccine with these folks…

It is anything and everything except that they weren’t vaccinated!

According to whom? You can actually go to the national health sites for each of these countries and find the data for yourself, if you were really interested in doing research.

And that they aren’t in America!

That’s not America… yet. Our measles cases are rising though and sooner or later we will start seeing measles deaths.

So what’s wrong with their thinking?

To start, these countries aren’t underdeveloped!

Brazil and the Philippines are newly industrialized countries and while Ukraine is considered a developing country, it is hardly the developing country without sanitation and nutrition that these folks make it out to be.

The problem in all of these countries isn’t a lack of nutrition, clean water, or health care. It is that too many folks are unvaccinated!

That becomes easier to see when you look at where else we are seeing a lot of measles deaths – the rest of Europe.

In the past 12 months, there have been 22 deaths from measles in Romania, Italy, France, and Greece.

Are folks in Italy suffering from malnutrition? Do they not have clean water?

There have been 64 deaths in Romania since there outbreaks started a few years ago.

Although Romania is a developing country, it isn’t a lack of clean water and sanitation that is causing measles deaths. It is that too many people in Romania are unvaccinated!

And too many people are listening to anti-vaccine propaganda.

Vaccines are safe, with few risks, and are obviously necessary.

More on How Anti-Vaccine Folks Respond to New Information