Tag: shedding

Did New York Declare Medical Martial Law over a Measles Outbreak?

You have to admire anti-vaccine folks for one thing, they are consistent.

Well, actually, no.

Admire is the wrong word…

Did New York Declare Medical Martial Law over a Measles Outbreak?

As most folks know, Rockland County Executive Ed Day made an emergency declaration banning unvaccinated kids from public places.

I guess because he was anticipating a freak-out from anti-vaccine folks, he went out of his way to say that the emergency declaration does not mean that law enforcement will be asking for vaccine records and that they are just trying to get the attention of parents, some of whom weren’t cooperating when their kids were sick.

So what was the reaction?

About as you would expect…

Martial law?

Medical martial law? An emergency declaration saying you will get a class B misdemeanor if your unvaccinated kid goes to the mall is the same thing as martial law? Ordinary laws have been suspended and the military is taking over?

If you listened to the press conference, the problem isn’t really that we need new laws, it is that some folks aren’t cooperating with existing ones. Again, in the middle of the longest outbreak in recent history, some parents who have kids sick with measles aren’t talking to health department officials who simply want to control and stop the outbreak.

What else is wrong with the Natural News post?

Of course, it is the stuff about shedding and “improperly weakened viral strains.”

In truth, measles outbreaks are started when unvaccinated folks travel out of the country, get measles, and bring it back to a community with a lot of other unvaccinated people. And tragically, sometimes folks who are too young to be vaccinated or who have true medical contraindications to getting vaccinated get caught up in these outbreaks.

Did they listen to the press conference? When did he say that they would be going door-to-door?

Hillary Simpson telling folks in New York to riot.

Is it actually legal to tell folks to riot and incite them to open civil disobedience?

Kate Tietje calling for open civil disobedience.

Surpriginsly, most went to straight to comments about Hitler and concentration camps.

It is offensive to compare the emergency declaration in Rockland county to putting people in concentration camps.
It is offensive to compare the emergency declaration in Rockland county to putting people in concentration camps.

This is the modern anti-vaccine movement.

These are the leaders and heroes of the anti-vaccine movement.

Larry Cook on the emergency ban in Rockland County.

To be clear, rabbis in the community have been telling folks to get vaccinated and protected!

“Whoever isn’t vaccinated is a murderer” reads a rabbinic letter recently signed by leading charedi rabbis in Israel, according to Yeshiva World News. The kol koreh was distributed after a spread of Measles in the ultra-Orthodox communities in Israel and around the world. Earlier this month an unvaccinated infant died, and more than 1300 people have been infected with a preventable disease. The Gedolim who signed the Kol Koreh include: Rav Yitzchak Silberstein, Rav Shimon Ba’adani, Rav Sriel Rosenberg, Rav Moshe Shaul Klein Rav Menachem Mendel Lubin.

As Measles Spread, Leading Charedi Rabbis Come Out Strongly Against Anti-Vaxxers

I wonder what the people in these communities would think of all of this holocaust imagery that anti-vaccine folks are using to try and keep the outbreaks going?

The National Vaccine Information Center is exploiting a photo of five year old Avram Rosenthal and his two year old brother Emanuel of the Kovno ghetto in Lithuania. Both boys were later deported to the death camp at Majdanek where they were murdered.
This is a photo of five year old Avram Rosenthal and his two year old brother Emanuel of the Kovno ghetto in Lithuania. Both boys were later deported to the death camp at Majdanek where they were murdered. Why is it being used in an article about measles outbreaks?

It is very clear that this is not about religion.

“The Orthodox Union (OU) and the Rabbinical Council of America (RCA) strongly urge all parents to vaccinate their healthy children on the timetable recommended by their pediatrician.”

Statement on Vaccinations from the OU and Rabbinical Council of America

People in these communities have been misled and misinformed by anti-vaccine propaganda.

How about we make folks who push anti-vaccine misinformation wear dunce caps?
How about dunce caps on folks who push anti-vaccine misinformation?

Don’t let them make it worse.

More on the Emergency Declaration in Rockland County

What is Eczema Vaccinatum?

Did you know that having eczema is a contraindication to getting a vaccine?

Which vaccine?

The smallpox vaccine!

Yes, smallpox has been eradicated, but the vaccine is sometimes still used in very specific situations, especially in the military.

What is Eczema Vaccinatum?

Not only is eczema a contraindication to getting the smallpox vaccine, you shouldn’t even get it if a household contact has eczema.

Why not?

Shedding.

Yes, although anti-vaccine folks needlessly worry about shedding when kids get routine childhood vaccines and even talk about a shedding season, with the smallpox vaccine, problems with shedding are really a thing.

Since the smallpox vaccine is a live virus vaccine and since it very commonly causes a skin reaction at the injection site, shedding can spread it to others. While that’s a good thing with some vaccines, like the oral polio vaccine, because it increases herd immunity, it isn’t with the smallpox vaccine.

If the weakened smallpox vaccine can cause a skin reaction on your arm where you got the shot, what is it going to do if it gets on a child’s skin that is irritated all over with eczema?

An 8-month-old boy with eczema vaccinatum.
An 8-month-old boy with eczema vaccinatum. Photo by CDC/Arthur E. Kaye

It’s a good thing that we don’t routinely have to use the smallpox vaccine anymore.

“Because persons with eczema are deferred from vaccination, only a single, accidentally transmitted case of EV has been described in the medical literature since military vaccination was resumed in the United States in 2002.”

Reed et al on Eczema vaccinatum.

And that it doesn’t happen with any other vaccines!

More on Eczema Vaccinatum

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

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

Show Me the Vaccine Insert!

Have you ever wondered why anti-vaccine folks always ask about vaccine inserts?

It will soon be obvious that anti-vaccine folks don't really read vaccine inserts...
It will soon be obvious that anti-vaccine folks don’t really read vaccine inserts…

Would they really be happy if we handed them the entire vaccine insert before every visit?

Would they read the entire vaccine insert?

Which part of the vaccine insert do anti-vaccine even read?
Which part of the vaccine insert do anti-vaccine folks even read?

Or would they continue to only believe the parts that they think justify their decisions to leave their kids unvaccinated, unprotected, and at risk for getting life-threatening diseases?

Show Me the Vaccine Insert!

Let’s see what’s really in these package inserts…

“Measles, mumps, and rubella are three common childhood diseases, caused by measles virus, mumps virus (paramyxoviruses), and rubella virus (togavirus), respectively, that may be associated with serious complications and/or death. For example, pneumonia and encephalitis are caused by measles. Mumps is associated with aseptic meningitis, deafness and orchitis; and rubella during pregnancy may cause congenital rubella syndrome in the infants of infected mothers”

MMR II Package Insert

Wait a second!

How can anti-vaccine folks say that measles is a mild disease if the vaccine insert says that it “may be associated with serious complications and/or death.”

Have they really read this thing?

“The impact of measles, mumps, and rubella vaccination on the natural history of each disease in the United States can be quantified by comparing the maximum number of measles, mumps, and rubella cases reported in a given year prior to vaccine use to the number of cases of each disease reported in 1995. For measles, 894,134 cases reported in 1941 compared to 288 cases reported in 1995 resulted in a 99.97% decrease in reported cases; for mumps, 152,209 cases reported in 1968 compared to 840 cases reported in 1995 resulted in a 99.45% decrease in reported cases; and for rubella, 57,686 cases reported in 1969 compared to 200 cases reported in 1995 resulted in a 99.65% decrease”

MMR II Package Insert

Full stop!

How can they say vaccines don’t work when the package insert provides these stats showing it does and goes on to say that “M-M-R II is highly immunogenic and generally well tolerated.”

“The recommended age for primary vaccination is 12 to 15 months.”

MMR II Package Insert

Why are some of these folks delaying or skipping their child’s MMR vaccine? The package insert says to give it at 12 to 15 months!

“Individuals first vaccinated at 12 months of age or older should be revaccinated prior to elementary school entry.”

MMR II Package Insert

That’s the part of the package insert that says to give a second dose before kids enter kindergarten.

“There are no reports of transmission of live attenuated measles or mumps viruses from vaccinees to susceptible contacts.”

MMR II Package Insert

And that’s the part that says they can stop talking about shedding.

Maybe we should make anti-vaccine folks read these inserts…

“The following adverse reactions are listed in decreasing order of severity, without regard to causality, within each body system category and have been reported during clinical trials, with use of the marketed vaccine, or with use of monovalent or bivalent vaccine containing measles, mumps, or rubella:”

MMR II Package Insert

Do anti-vaccine folks understand that some of the things that are listed in the adverse reactions section of the package insert haven’t actually been proven to be caused by the vaccine? They are listed “without regard to causality.”

When you see them talk about SIDS and autism and package inserts, this is what they are talking about.

What about all of the “hidden” ingredients that are listed in the package insert?

Vaccine ingredients are not hard to find.

The ingredients that are so well hidden, they are listed right in the vaccine’s insert? Where does it mention all of the toxins that anti-vaccine folks are always talking about?

“…M-M-R II is highly immunogenic and generally well tolerated.”

MMR II Package Insert

The MMR vaccine works and it is safe.

It says so in the package insert.

Vaccinate your kids.

More on Vaccine Inserts

Is a Vaccine Strain Causing The Latest Measles Outbreak?

What’s the first question anti-vaccine folks start asking whenever we see a large outbreak of measles?

No, it’s not how can I get my kids vaccinated and protected so that they don’t get measles…

It is whether or not it a vaccine strain of measles started the outbreak.

That’s not how any of this works…

Where do folks get all of this stuff about genotypes and vaccine strains? I wonder…

Dr. Bob had no facts, but still posted that a vaccine strain of measles could have killed a woman who got caught up in the last measles outbreak in Washington.

Yup.

The usual suspects.

Is a Vaccine Strain Causing The Latest Measles Outbreak?

Why do folks who intentionally don’t vaccinate their kids desperately want these measles outbreaks to be caused by a vaccine strain?

Because then it isn’t their fault that their kids are at risk of getting a life-threatening disease!

It’s never a vaccine strain though.

Remember the Disneyland measles outbreak. A lot of folks were talking about vaccine strains when it first started.

“…California patients were genotyped; all were measles genotype B3, which has caused a large outbreak recently in the Philippines…”

Measles Outbreak — California, Dec 2014–Feb 2015

It wasn’t a vaccine strain.

OutbreaksYearGenotype
Minnesota2017B3
Tennessee2016B3
California2015B3
Florida2013D8
California2014B3, D8
Brooklyn2013D8
North Carolina2013D8
Minnesota2011B3
Washington, Illinois2008D5, D4

For example, during 2011, 222 cases of measles and 17 outbreaks were reported in the United States, with most cases originating from just five countries (France, Italy, Romania, Spain, and Germany). Six different genotypes were identified, including B3, D4, G3, D8, H1, and D9. No vaccine strains…

And no, it doesn’t matter that the vaccine strain of measles, genotype A, differs from all of the wild strains of measles we see in the outbreaks.

“Vaccine induced immunity protects against all virus strains. Measles is considered a monotypic virus despite the genetic variations.”

Factsheet about measles

Unlike the flu, HPV, and pneumococcal bacteria, in which vaccines only protect against different serotypes, in the case of measles, the genotype simply helps us figure out where the measles case came from.

And no, the latest outbreak, wherever it is, wasn’t caused by shedding from a vaccine.

But if it isn’t the vaccine strain, then why do they that is it important to rapidly identify wild strains vs vaccine strains?

“During measles outbreaks, it is important to be able to rapidly distinguish between measles cases and vaccine reactions to avoid unnecessary outbreak response measures such as case isolation and contact investigations.”

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

That’s easy to answer.

Outbreaks typically trigger a lot of folks to get vaccinated. While that’s great, one possible problem is that some of those folks might develop a fever and/or rash after their MMR vaccine. So it is important to quickly figure out whether they are part of the outbreak and have a wild strain (maybe they were exposed before their vaccine could start to work) or are having a common, mild vaccine reaction.

But couldn’t they have vaccine-associated measles if they have a rash and fever and a vaccine strain? Theoretically, but then they would likely have true measles symptoms. And even in these rare case reports, the children didn’t spread the measles to anyone else.

So why are you waiting to know the genotype of the measles strain causing the outbreak in your area? Hopefully, it isn’t to help you decide whether or not to vaccinate and protect your kids. While it is interesting to know where the outbreak originated, you can bet that it isn’t a vaccine strain.

More on Vaccine Strains Causing Measles Outbreaks

The Pacific Northwest Measles Outbreak of 2019

Breaking News – There are 2 new cases in Clark County (70 cases), bringing the total case count to 75 cases.

It started with a confirmed case of measles in a child in late December.

The Pacific Northwest measles outbreak on 2019 started when a child exposed others in the area in late December.

There were soon reports of more cases.

The Clark County measles outbreak quickly grew.

And more cases.

The Pacific Northwest Measles Outbreak of 2019

But the measles cases didn’t stay in Clark County.

Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.
Two of the unvaccinated kids from Clark County traveled to Hawaii while they were contagious.

As with other recent large measles outbreaks, cases soon spread to neighboring counties.

As of late January, there are now measles cases linked to this ongoing outbreak in Clark County and King County (Washington) and Multnomah County (Oregon).

The rapid growth of the outbreak led Clark County to declare a local public health emergency and Washington’ governor to declare a State of Emergency in all counties in the state of Washington.

“The measles outbreak and its effects impact the life and health of our people, as well as the economy of Washington State, and is a public disaster that affects life, health, property or the public peace.”

Governor Jay Inslee on proclaiming a State of Emergency

Why so much concern?

Are you familiar with the immunization rates in this part of the country? About the only good thing you can say about Washington’s immunization rates are that they are better than Oregon‘s…

Washington has one of the highest rates of exemptions in the United States.

That’s right.

High non-medical vaccine exemption rates and low vaccination rates. A recipe for very large outbreaks of vaccine-preventable diseases, especially measles which is so highly contagious.

Immunization rates by county in Washington.

And a recipe for disaster. These outbreaks are getting harder to control, are lasting longer, and are getting bigger and bigger.

Also remember that the last measles death in the United States, in 2015, was a woman who got caught up in a measles outbreak in Clallam County. Why didn’t that trigger folks in the area to get Vaccinated?

Pacific Northwest Measles Outbreak of 2019
Clark County (WA)70 cases
King County (WA)1 case
Multonomah County (OR)4 case
 75 cases

How many of them are vaccinated? Anti-vaccine folks are pushing hard to convince folks that everyone in the outbreaks are vaccinated. Don’t believe them!

As in most outbreaks, almost all of the people in this outbreak are unvaccinated.

How many people will get sick in the Pacific Northwest Measles Outbreak of 2019 before it ends?

You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.
You will have to make an extra appointment if you followed his immunization plan and left your kids unvaccinated and at risk during this outbreak.

Are parents going to keep listening to anti-vaccine folks who push the idea that measles isn’t that bad and make you think that it is riskier to get vaccinated?

Are they going to realize that unless they are malnourished or have a vitamin deficiency, that taking extra vitamin A that you order from someone’s online store will not reduce their risk of severe complications if their unvaccinated child gets measles?

“Please contact your pediatrician or doctor if your child is scary sick, struggling to breathe or unable to eat or very lethargic or otherwise seriously ill. Let them know you are worried they may have measles so they can arrange not to contaminate the waiting room or the whole office.”

Paul Thomas, Integrative Pediatrician

Getting vaccinated can help keep your kids from getting “scary sick” from measles…

“The above recommendations are informational only. Please consult with your doctor before implementing anything you might learn here.”

Paul Thomas, Integrative Pediatrician

The only good advice he gives.

Anti-vaccine misinformation has gotten us to the place where these outbreaks are becoming more common. Vaccinate your kids so they don’t get measles and don’t expose anyone else.

And for the anti-vaccine folks who are asking:

  • it isn’t going to be shedding or a vaccine strain that caused the outbreak
  • everyone or almost everyone in the outbreak is going to be unvaccinated
  • the measles vaccine does work against all the different genotypes of measles
  • more people don’t die from getting the MMR or any other vaccine than from the diseases they protect us against
  • whether the death rate of measles is 1 in 1000 or 1 in 10,000 cases, remember that just before the measles vaccine came out, in the early 1960s, nearly 500 people would die of measles each year. And it isn’t that a person dies after 1,000 or 10,000 cases. With more cases, there is just a higher chance that someone will eventually die.

And you are still worried about the MMR vaccine because anti-folks are still scaring you away from vaccinating and protecting your kids.

Vaccines are safe and necessary with few risks. There is no good reason that we should still have outbreaks like this.

More on The Pacific Northwest Measles Outbreak of 2019

Updated March 3, 2019