Can you explain why we will almost certainly have the second highest number of measles cases in one year since 1994, even though we see the devastation that high rates of measles is causing in Europe and other parts of the world?
How many people will get measles in the United States this year?
Although no one is reporting on this, with several large ongoing outbreaks still not under control – it will be another record year for measles in the United States.
Even in the pre-vaccine era, when measles would kill 500 people a year in the United States, there is a very good chance that you wouldn’t have known anyone that died of measles. Of course, that doesn’t mean that nobody died of measles or chicken pox or any other now vaccine-preventable disease.
You likely know someone that plays football, right? Maybe on a youth football team or in middle school or high school? Do you know anyone that plays on a team in the NFL? While millions of kids might play football, only a few thousand play in the NFL.
Chicken pox was never a benign disease. It was considered a rite of passage because we all had to endure it, but it wasn’t something anyone looked forward to. You don’t die from a benign disease.
Part of that is actually true – “they keep you a customer for life” because you didn’t die from a vaccine-preventable disease!
Many countries don’t have the chicken pox vaccine on their routine immunization schedule because they don’t think it is cost-effective and they were concerned about what controlling chicken pox could do to rates of shingles.
“About 3 in every 1000 pregnant women in the UK catch chickenpox. Between 1985 and 1998, nine pregnant women died in the UK from chickenpox complications. Their unborn babies are also at risk from a rare condition called foetal varicella syndrome (FVS). This can result in serious long-term damage to the baby or even death, particularly if the mother catches chickenpox in the first 20 weeks of pregnancy.”
Vaccine Knowledge Project on Chickenpox (Varicella)
These countries have the same rates of shingles as countries that do use the chicken pox vaccine, but still have high rates of chicken pox and complications of chicken pox!
The UK does not vaccinate for chicken pox, but young, otherwise healthy kids die with chicken pox in the UK.
While you will be at higher risk for complications from chicken pox and most other diseases if you have a compromised immune system or are malnourished, if you are otherwise healthy, there is nothing you can do to boost your immune system to try and beat chicken pox – besides getting vaccinated.
Chicken pox parties kind of made sense in the pre-vaccine era. Since it was inevitable that your child would get chicken pox, you wanted them to get it at a young age, so they weren’t at increased risk for complications as an adult.
“Before a vaccine became available in 1963, measles was a rite of passage among American children. A red rash would spread over their bodies. They would develop a high fever. Severe cases could cause blindness or brain damage, or even death.”
CDC says measles almost eliminated in U.S.
Instead, most people develop 10 days of measles symptoms, including a high fever, cough, runny nose, watery eyes, and a rash. Photophobia, irritability, sore throat, headache, and abdominal pain are other symptoms that children with measles might have.
“From 1964 through 1971, 16.7% of the death certificates reviewed noted some underlying pathologic condition.”
Roger Barkin, MD on Measles mortality. Analysis of the primary cause of death.
It is most often children, typically young children, without any medical problems who die.
In the post-vaccination era, no one would be expected to die with measles, but those with immune system problems sometimes do, as most others are vaccinated and protected. As vaccinated rates drop though, even otherwise healthy children and adults can once again die of measles.
“Complications were reported in 672 (9.8%) cases, including otitis media in 318 (4.6%) cases, pneumonia in 178 (2.6%), diarrhea in 171 (2.5%), and encephalitis in five (0.1%). Nine hundred thirteen patients (13.3%) were hospitalized, and 10 measles-associated fatalities were reported (case-fatality rate: 1.5 deaths per 1000 reported cases). Eight of the deaths were reported in children less than 5 years of age, all of whom were unvaccinated. None had a reported underlying illness or immunodeficiency. Most deaths have been attributed to pneumonia.”
Measles — United States, First 26 Weeks, 1989
Probably not, but from 1989 to 1991 there were at least 123 measles deaths across the United States, even after measles had been declining for years with the introduction of the measles vaccine in the 1960s. Most of the deaths were otherwise healthy, without underlying medical problems.
Because we don’t typically hear any details about measles deaths, including the almost 90,000 measles deaths that continue to occur around the world each year, most people likely assume that measles only kills in third world countries, where kids are already sick or malnourished. Of course, that wouldn’t explain how over one hundred people died with measles in Europe over the past few years…
Still think that measles isn’t deadly?
Tragically, there are plenty of stories (although most are never reported in the news and we don’t hear about them) and case reports that will prove you wrong:
Olivia Dahl died with measles when she was 7-years-old (1962)
an unvaccinated 3-year-old died in Maricopa County (1970)
a 13-year-old girl who had previously been vaccinated with one of the first inactivated measles vaccines which were found to be ineffective and were replaced with the newer live vaccines died in Michigan (1978)
a 9-month-old died in Chicago (1990)
an unvaccinated 13-year-old died in Kansas (1990)
Tammy Bowman, an 11-year-old unvaccinated girl died in Michigan (1990)
an unvaccinated 13-year-old became the first person in the UK to die with measles in 14 years (2006)
a 14-year-old died of Subacute Sclerosing Panencephalitis (SSPE), a late complication of a natural measles infection (2015)
a 16-year-old who had received a heart transplant when she was 2-years-old died in France (2018)
an unvaccinated toddler in Jerusalem (2018)
Measles as a rite of passage?
“We baby boomers were apparently the last generation whose doctors, and therefore parents, accepted the measles as just one more annoying rite of passage of childhood that also happened to prime the immune system and provide lifelong immunity. Medical texts prior to the advent of the vaccine described measles as a benign, selflimiting (sic) childhood infectious disease that posed little risk to the average well-nourished child.”
Darrerl Crain, DC on The Great Measles Misunderstanding
While early pediatric textbooks did a great job describing the symptoms of measles, they also did a great job of documenting that measles was never a benign disease, something anti-vaccine folks still misunderstand because vaccines can do such a good job controlling the disease.
Do benign, self-limiting childhood infections diseases kill hundreds of children every year?
Measles as a rite of passage is something we don’t want to have to go back to. It was a rite of passage that was endured because there was no other choice.
“Chickenpox (varicella) is generally a much milder illness in children than in adults, with considerably lower rates of severe disease and death. Varicella is also virtually universal in many populations, meaning that very few individuals escape infection over a lifetime. Thus, a sound logic underlies the idea of chickenpox parties, at which susceptible children can acquire the contagious causative pathogen, varicella zoster virus (VZV), from their peers. However, chickenpox is not without risks, even for children of this age; severe, complicated, and occasionally fatal varicella occur in previously healthy children, as well as the immunocompromised (who are at very considerable risk).”
Hambleton et al on Chickenpox Party or Varicella Vaccine?
Most folks understand that. They get their kids vaccinated and have helped get chicken pox under very good control, with outbreaks of chicken pox declining over 95%.
“Each year, more than 3.5 million cases of varicella, 9,000 hospitalizations, and 100 deaths are prevented by varicella vaccination in the United States”
CDC on Monitoring the Impact of Varicella Vaccination
Apparently, not everyone has gotten the message though.
Remember when CPS had to investigate the mom who was having chicken pox parties in Plano, Texas a few years ago?
“On the page, parents post where they live and ask if anyone with a child who has the chicken pox would be willing to send saliva, infected lollipops or clothing through the mail.”
CBS 5 Investigates mail order diseases
Or when anti-vaccine folks were selling and mailing lollipops contaminated with chicken pox to folks so that they could skip the trouble of finding a chicken pox party?
And then there’s that time that a family served chicken pox contaminated punch at their chicken pox party. Oh wait, that was The Simpsons…
So what are they up to now?
More of the same…
Apparently, there are still plenty of folks looking for chicken pox parties to infect their kids.
It is easy to see a lot of cognitive biases at play in the decision to host or bring a child to a chicken pox party, including ambiguity aversion (prefer what they think are the known risks of getting the disease), bandwagoning (they think everyone else is doing it, because in their echo chambers of anti-vaccine propaganda, everyone might), and optimism bias, etc.
There is also a very poor perception of risks, as the risks from a natural chicken pox infection are far, far greater than any risk from the vaccine.
In bigger news, Facebook has groups who’s mission is “finding pox,” so that parents can get their kids sick!
How many other PoX type groups are there on Facebook?
Do they understand the consequences of having these pox parties?
Of course, an investigation from CPS, the health department, or a medical board isn’t the most serious consequence that should discourage folks from hosting or attending a chicken pox party.
Chicken pox can be a serious, even life-threatening infection. Sure, many kids just get a mild case, but others get more serious cases and have bad complications, including skin infections, encephalitis, sepsis, or stroke.
And some people do still die from chicken pox, which is supposed to be a mild, childhood illness.
“This report describes a varicella death in an unvaccinated, previously healthy adolescent aged 15 years.”
Varicella Death of an Unvaccinated, Previously Healthy Adolescent — Ohio, 2009
Fortunately, these deaths have been nearly eliminated thanks to the chicken pox vaccine.
And that’s why parents who are on a mission for “finding pox” should rethink things and switch to a mission to get their kids vaccinated and protected.
Analogies and metaphors are a good way to explain things, including that vaccines are safe and necessary.
Here are some of my favorite vaccine analogies and metaphors.
Getting vaccinated is like:
applying sunscreen before going to the beach
applying insect repellent before going camping in the woods
making sure that your kids are wearing a seat belt or sitting in an age-appropriate car seat or booster seat when you get in the car
installing anti-virus software on your new computer
When do you put on your seat belt? When you get in the car, before you get in an accident. Just like a vaccine. You get it before you get sick. Yes, some vaccines do work after you have been exposed to an illness, but they don’t work after you are already sick.
There is a problem with these metaphors though; they don’t include the risks to other people.
taking driver’s ed and getting your license before driving
taking swimming lessons before going in the water without a life jacket
putting your gun in a locked safe
putting a fence around your backyard so that no one in your neighborhood can drown in your pool
making sure folks don’t text and drive
Vaccination equals protection.
And not just protection for the person getting vaccinated. Being unvaccinated puts others at risk too, as you might start an outbreak.
Getting your kids vaccinated is like taking them to swimming lessons instead of just throwing them in the lake. Either way they can learn to swim and have protection/immunity from drowning. But one method (throwing them in the lake) is much more dangerous than the other.
“Vaccines are a like a wanted poster, they just show your body what the bad guys look like, so when faced with them for real you are ready, prepared, and able to stop them before they cause harm.”
Can vaccines overwhelm the immune system?
Are there analogies that explain the idea of free-riders – folks who intentionally don’t vaccinate their kids and attempt to hide in the herd?
“If all my child’s friends are vaccinated, won’t he be protected by herd immunity? Why should I put my child at risk for vaccine reactions if all the other children around him are already immune?
This is like riding in a carpool where everyone contributes each month to pay for gas, repairs and parking. One morning, a new neighbor shows up and says, “I think I’ll ride along with you. But I’m not going to pay, since you’re going downtown anyway and you have an empty seat.” If enough people choose to take a free ride on other children’s immunity, herd immunity will soon disappear.”
“I have found that it sometimes helps to give parents an analogy. I ask them the following: If they were to put gas in their car and then later got a flat tire, would that mean putting gas in the car had caused the flat tire? No. The two events were just a coincidence.”
There are plenty of other good analogies that help to explain the importance of vaccines.
“Clusters of unvaccinated people are like patches of dry grass that, with a single match, can start a wildfire that will burn not only dry material, but sometimes wet as well. The match could be a student who returns from a trip abroad with measles or a train commuter with whooping cough.”
It’s also important to remember that anyone, even those who are well prepared, can get burned in a wildfire. That’s why the analogy works so well.
“Vaccinating one’s children is like paying taxes. We all have a moral and a legal duty to pay taxes because we have a moral and a legal duty to contribute to the upkeep of our society and to its public goods (e.g., a good public health system, national defence, etc.).”
Vaccine Refusal Is Like Tax Evasion
Why are we concerned about those who are unvaccinated if our own children are fully vaccinated?
“Think of camping as an analogy. If everyone at a campground properly stores their food, bears won’t be enticed to come around. If even one person leaves their food unprotected, it invites bears in to investigate all the campsites for opportunities to eat.”
How does choosing not to immunize affect the community?
“Being intentionally unvaccinated against highly contagious diseases is, to carry Holmes’ analogy a bit further, like walking down a street randomly swinging your fists without warning. You may not hit an innocent bystander, but you’ve substantially increased the chances that you will.
One might usefully analogize the risk of disease to a crapshoot. A person’s chance of being infected is, as Dr. Singer acknowledges, a matter of luck. But is it really OK for the unvaccinated to load the dice to increase the odds against other people? If so, by how much?”
Ronald Bailey on Vaccines and the Responsibility To Not Put Others at Risk
Of course, there are plenty of bad vaccine analogies and metaphors that anti-vaccine folks push:
“genes load the gun but the vaccines pull the trigger”
vaccine manufacturers are like tobacco manufacturers
I won’t set my child on fire to keep yours warm (this doesn’t work as a vaccine analogy, mostly because there is no benefit to setting your child on fire. Would an anti-vaxxer let their child start a campfire to keep their friends from dying in the cold?)
getting a vaccine is like eating a handful of M&Ms out of a big bowl when you know that a few have been poisoned
getting a child vaccinated is like giving 1,000 kids 1,000 cupcakes, telling them to pick one and eat it, knowing that one of the cupcakes is poisoned (it’s maybe like letting a child with a severe peanut allergy choose a cupcake, knowing that there is a one in a million chance that the cupcake he chooses has been made with peanuts…)
I want safer cars, but that doesn’t make me anti-car
You understand why the anti-car one is a bad analogy, right? Folks who want safer cars generally still drive and ride in cars!
Have you heard any good or bad analogies or mataphors about vaccines?
almost 80% of all compensated awards by the NVICP come as a “result of a negotiated settlement between the parties in which HHS has not concluded, based upon review of the evidence, that the alleged vaccine(s) caused the alleged injury.”
the NVICP settlements are funded by an excise tax on vaccines
the NVICP cases are published by the U.S. Court of Federal Claims, so all information is disclosed to the public and no safety concerns are hidden
So what does the National Vaccine Injury Compensation Program (VICP) really prove?