Tag: shedding

Is the Polio Vaccine Linked to Outbreaks of Hand Foot Mouth Disease?

Wait, why would anyone think that the polio vaccine could be linked to outbreaks of hand, foot, and mouth disease?

“Scientific researchers have discovered that the infectious disease Hand,Foot and Mouth Disease is vaccine-induced and then spread to others through shedding from the Polio Vaccine. Enterovirus 71 (EV71) causes Hand, Foot, and Mouth Disease. The polio vaccine (OPV and IPV) is contaminated with EV71. It, along with EV-D68 and several other enteroviruses and coxsackie viruses are used in the manufacturing of the polio vaccines, which are given to children three times in the first year of life, and again between 4-6 years of life. Bottom line: children recently vaccinated with the polio vaccine are shedding the EV71 that causes the most serious complications of HFMD. ”

Health Freedom Idaho

Shedding…

Is the Polio Vaccine Linked to Outbreaks of Hand Foot Mouth Disease?

Health Freedom Idaho makes some very serious claims and even links to a research article, which in most cases, you would expect to support their claims.

Not surprisingly, the article, A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses, says absolutely nothing about contamination of vaccines and nothing about shedding.

“Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.”

Anna Kata Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement

What about a link between polio vaccines and hand, foot, and mouth disease?

It is sad that anti-vaccine propaganda gets shared so quickly among parenting groups.
It is sad that anti-vaccine propaganda gets shared so quickly among some parenting groups, who’s members obviously don’t read the articles when they do their research.

Well, hand, foot, and mouth disease is typically caused by the coxsackievirus A16 and EV71, which are enteroviruses. So is the polio virus. In fact, the Enterovirus genus is made up of 15 different species and 100s of different viruses. And they are all in the same Picornavirus family.

And that’s likely why researchers have found that “the most dominant epitope is highly conserved among enterovirus species, including HFMD-related coxsackieviruses, HFMD-unrelated echoviruses and polioviruses.”

Epitope?

“An epitope refers to the specific target against which an individual antibody binds.”

What is an Epitope?

So basically, this research isn’t saying that the polio vaccines are contaminated or that they cause hand, foot, mouth disease.

What it is saying, is that if you have been vaccinated with the polio vaccine, then you might have some protection against other enteroviruses!

“As shown here, poliovirus vaccination may have an impact on subsequent severity of HFMD disease. Cross-reactivity between EV71 A3 epitope and the A3v epitope of poliovirus 3 Sabin strain, may lead to the stimulation of protective, cross-reactive T cell responses, limiting the severity of subsequent HFMD.”

Wei et al. on A Dominant EV71-Specific CD4+ T Cell Epitope Is Highly Conserved among Human Enteroviruses

Yay for cross-reactivity!

“Cross-reactivity between antigens occurs when an antibody directed against one specific antigen is successful in binding with another, different antigen. The two antigens in question have similar three-dimensional structural regions, known as epitopes, which allow the antibody for one antigen to recognize a second antigen as being structurally the same antigen.”

Stephen J. Chadwick, MD

So you get antibodies from the polio vaccine and these antibodies cross react with the viruses that cause hand, foot, and mouth disease, which could lead to milder symptoms, because it is like you already have some antibodies to that virus too!

“HFMD outbreaks could occur where polio vaccination has failed, due to lack of refrigeration or other breaks in the cold chain that (might) go unreported.”

Exploring the Link between Polio Vaccination and Hand Foot Mouth Disease

In China, where outbreaks of hand, foot, and mouth disease are much more severe than they are in the United States, often leading to life-threatening disease, there has been a concern that the increased number of outbreaks could be linked to a failure of their polio vaccines, since getting vaccinated could be protective.

That’s the link the research is talking about…

I actually asked one of the researchers about what anti-vaccine folks were saying about their study and they told me:

“Well, that’s actually totally backwards. Our article suggests that FAILURE to get vaccinated with polio vaccine might set you up for Hand Food Mouth disease (EV71).”

Bottom line: polio vaccines are not contaminated and children recently vaccinated with the polio vaccine are not shedding the EV71 that causes the most serious complications of HFMD. Health Freedom Idaho made the whole thing up.

More on Linking the Polio Vaccine to Hand Foot Mouth Disease

What to Do If Your Child Is Exposed to Pertussis

Although things are much better than they were in the pre-vaccine era, we still have pertussis outbreaks in the United States.

How does that work?

Waning immunity and folks who are unvaccinated.

How Contagious is Pertussis?

Pertussis is very contagious, but not quite as contagious as other vaccine-preventable diseases, such as measles.

That’s why the focus on controlling pertussis outbreaks is usually looking at close contacts – those who were within about 3 feet for at least 10 hours a week or who had direct face-to-face contact with the person when they were contagious.

Have you gotten a letter from your child's school about pertussis yet?
Have you gotten a letter from your child’s school about pertussis yet?

So when you get a letter about a possible case of pertussis in your child’s school, it may be a a general warning and not that your child is at risk.

How do you get pertussis?

“Persons with pertussis are infectious from the beginning of the catarrhal stage through the third week after the onset of paroxysms or until 5 days after the start of effective antimicrobial treatment.”

Manual for the Surveillance of Vaccine-Preventable Diseases

Spread by respiratory droplets (coughing and sneezing), pertussis symptoms usually start about 5 to 10 days after being exposed to someone else who is in the early stage of their pertussis infection.

While pertussis symptoms can linger for up to 10 weeks, someone who has pertussis is most contagious during the first 2 or 3 weeks of symptoms.

Is Your Child Protected Against Pertussis?

Two pertussis vaccines, DTaP and Tdap, help protect us against pertussis.

In the Unites States, they are routinely given as a primary series (DTaP) at 2, 4, and 6, and 15 to 18 months, with a booster dose at age 4 years. And then a booster of Tdap at age 11 to 12 years. Later, Tdap is given again during each pregnancy, between 27 and 36 weeks gestation. Adults who have never had a dose of Tdap should get caught up, especially if they will be around a baby.

Protection from the pertussis vaccines wanes or wears off, so even fully vaccinated children and adults can still get pertussis. Of course, you are much more likely to get pertussis if you are unvaccinated and you will likely have more severe illness if you are unvaccinated.

Postexposure Antimicrobial Prophylaxis for Pertussis

Fortunately, as with meningitis was caused by Neisseria meningitidis and Haemophilus influenzae type b (Hib), taking antibiotics after being exposed to someone with pertussis can help prevent you from getting sick.

There are only specific situations for which this type of postexposure antimicrobial prophylaxis is recommended though, so for example, you wouldn’t usually give everyone in a school antibiotics because a few kids had pertussis.

Why not give antibiotics to everyone who might have been exposed to someone with pertussis?

“…there are no data to indicate that widespread use of PEP among contacts effectively controls or limits the scope of pertussis outbreaks.”

Postexposure Antimicrobial Prophylaxis

In addition to the fact that it likely wouldn’t stop our pertussis outbreaks, overuse of antibiotics can have consequences.

Situations in which postexposure antibiotics (azithromycin, clarithromycin, and erythromycin, or Bactrim) likely would be a good idea include:

  • household contacts of a known pertussis case
  • to help control an outbreak in a limited closed setting, like a daycare
  • contacts of a pertussis cases who are at high risk for severe pertussis, including pregnant women, infants, especially infants less than 4 months old, and people with chronic medical problems
  • contacts of a pertussis cases who are also contacts of someone who is at high risk for severe pertussis

What if you were exposed to someone with pertussis and have already gotten sick?

If your child was exposed to pertussis and is now coughing, then in addition to antibiotics, pertussis PCR testing and/or culture will also likely be done to confirm that they have pertussis. And remember that their contacts might need postexposure antibiotics.

Kids who have been exposed to pertussis and who have been coughing for more than 3 weeks won’t need antibiotics or testing, as it is too late for the antibiotics to be helpful and likely too late for testing to be accurate. Fortunately, after 3 weeks, they should no longer be contagious.

What to Do If Your Unvaccinated Child Is Exposed to Pertussis

Unvaccinated kids who are exposed to pertussis should follow the postexposure antimicrobial prophylaxis guidelines.

They should also get caught up on their immunizations, including DTaP if they are between 2 months and 6 years, or Tdap if they are older.

What to Do If Your Vaccinated Child Is Exposed to Pertussis

Since protection from the pertussis vaccines wanes, even kids who are fully vaccinated should follow the postexposure antimicrobial prophylaxis guidelines if they are exposed to pertussis.

Then why get vaccinated?

Again, being vaccinated, your child will be much less likely to get pertussis than someone who is unvaccinated. Even though the pertussis vaccine isn’t perfect, it has been shown that children who had never received any doses of DTaP (unvaccinated children) faced odds of having pertussis at least eight times higher than children who received all five doses.

What to Know About Getting Exposed to Pertussis

Talk to your pediatrician if your child gets exposed to pertussis to make sure he doesn’t need post-exposure prophylaxis to keep him from getting sick, even if you think he is up-to-date on his vaccines.

More on Getting Exposed to Pertussis

How Can the Unvaccinated Spread Diseases They Don’t Have?

Folks who are intentionally unvaccinated often have a hard time understanding why the rest of us might be a little leery of being around them.

That’s especially true if we have a new baby in the house, younger kids who aren’t fully vaccinated and protected, or anyone with a chronic medical condition who can’t be vaccinated.

Why? Of course, it is because we don’t want them to catch measles, pertussis, or other vaccine-preventable diseases.

“How can you spread a disease that you don’t even have?”

It’s true, you can’t spread a disease that you don’t have.

But infectious diseases don’t magically appear inside our bodies – we catch them from other people. And if you have skipped or delayed a vaccine, then you have a much higher chance of getting a vaccine-preventable disease than someone who is vaccinated and protected.

So, just avoid other people when you are sick, right?

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

That works great in theory, but since you are often contagious before you show signs and symptoms and know that you are sick, you can very easily spread a disease that you don’t even know that you have.

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
Children with measles are contagious 4 days before through 4 days after their rash appears, but you often don’t recognize that it is measles until they get the rash! Photo by Jim Goodson, M.P.H.

There’s the trouble:

  1. being unvaccinated, you or your child are at higher risk to get sick
  2. when you get sick, you can be contagious several days before you have obvious symptoms
  3. you can spread the disease to others before you ever know that you are sick, or at least before you know that you have a vaccine preventable disease

This makes intentionally unvaccinated folks a risk to those who are too young to be vaccinated, are too young to be fully vaccinated, have a true medical exemption to getting vaccinated, or when their vaccine simply didn’t work.

measles-santa-clara-county
Folks with measles often expose a lot of other people because they don’t yet know that they have measles and aren’t showing signs and symptoms yet.

In fact, this is how most outbreaks start. Tragically, kids too young to be vaccinated get caught up in these outbreaks.

Keep in mind that these parents didn’t have a choice about getting them protected yet. Someone who decided to skip their own vaccines made that choice for them.

And remember that while you can’t spread a disease that you don’t even have, you can certainly spread a disease that you don’t realize that you have.

What to Know About The Unvaccinated Spreading Disease

If you aren’t going to get vaccinated or vaccinate your kids, understand the risks and responsibilities, so that you don’t spread a vaccine-preventable diseases to others that you might not even know that you have yet.

More on the Unvaccinated Spreading Disease

What Are the Demands and Goals of the Anti-Vaccine Movement?

So what exactly do anti-vaccine folks want?

What are they trying to do?

Are they trying to scare parents away from getting vaccinating and protecting their kids, hoping to drag us back to the pre-vaccine era?

What Are the Demands and Goals of the Anti-Vaccine Movement?

Of course, some of the folks who are anti-vaccine don’t actually like to be called anti-vaccine. Instead, they prefer to say that they are pro-safe vaccines. So for them, it is rather obvious – they want safer vaccines without toxins.

Now, since vaccines are already safe and don’t contain any toxic ingredients, it would seem like their work is done already, right?

Another goal is having fewer vaccines on the immunization schedule. Jenny McCarthy often pushes the Turn Back the Clock immunization plan, wanting kids to only get vaccines that were on the 1983 immunization schedule, back when kids still died of meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease, which are now vaccine preventable.

Other members of the anti-vaccine movement talk about vaccine choice. They want to be able to choose whether or not they should have to vaccinate their kids.

Again, done. No one is forcing parents to vaccinate their kids. We may not have a choice on whether or not your unvaccinated child gets sick and puts someone else at risk for getting a vaccine-preventable disease because they were too young to be vaccinated, had a medical exemption, or their vaccine didn’t work, but you can certainly make the choice to skip or delay any vaccines you want.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

What are other goals of the anti-vaccine movement?

Johns Hopkins Medicine, which includes the Johns Hopkins University School of Medicine and the The Johns Hopkins Hospital and Health System went out of their way to correct this anti-vaccine misinformation.
Johns Hopkins Medicine went out of their way to correct this anti-vaccine misinformation about shedding.

Have you heard about the anti-vaccine folks who want to quarantine all kids who have recently been vaccinated for at least six weeks? Why quarantine kids who have been vaccinated? They are worried about shedding…

Would anyone go so far as wanting to ban vaccinations? Yup. So much for vaccine choice.

Some others want to rescind the 1986 National Childhood Vaccine Injury Act, which they think will help make it easier to sue vaccine manufacturers. That’s one of Andrew Wakefield‘s demands in his movie VAXXED. He and others never mention that if you are suing in civil court, then you must meet a higher burden of proof for vaccine injury than you do in Vaccine Court.

Remember when Robert F. Kennedy, Jr. thought he would be appointed to some special Trump commission on vaccines?

“We want safe vaccines, robust transparent science and an honest and independent regulatory agency focused narrowly on public health rather than industry profit.”

Robert F. Kennedy, Jr. on Mercury, Vaccines and the CDC’s Worst Nightmare

Kennedy’s vaccine commission never happened, but that hasn’t stopped him from pushing for an independent regulatory agency.

I’m not sure who would run or be a part of Kennedy’s independent regulatory agency though, as he believes that “Congress, the regulatory agencies, FDA and CDC, the IOM, the NIH, the AAP, the science journals, the university science departments and the press” have all been compromised by Pharma.

Kennedy also wants thimerosal out of vaccines, which, as most people know, is already out of all vaccines on the immunization schedule, including about 100 million doses of flu shots this past year. But like others, he seems to be moving on to aluminum as his new target.

What else?

Fortunately, it is easy to see why the demands and goals of the modern anti-vaccine movement are dangerous, unethical, and unnecessary, and like parents who decide to skip or delay vaccines, will simply put us all at risk for more outbreaks of vaccine-preventable disease.

What to Know About the Demands and Goals of the Anti-Vaccine Movement

Whatever their demands and goals of the anti-vaccine movement, the effect is that they are scaring parents away from vaccinating and protecting their kids from life-threatening vaccine-preventable diseases for no good reason.

More on the Demands and Goals of the Anti-Vaccine Movement

Can MMR Shedding Start a Measles Outbreak?

Have you ever noticed that any time that there is a new outbreak of measles, folks tend to ask the same basic questions.

How did the outbreak start?

Why weren’t they vaccinated?

Was it from shedding?

Wait, what?

Shedding??? Really?

Can MMR Shedding Start a Measles Outbreak?

It seems that the idea that the MMR vaccine sheds and can lead to measles outbreaks is one of those anti-vaccine myths that just won’t go away.

It comes back with each new measles outbreak.

The myth that MMR shedding leads to measles outbreaks is commonly spread on Facebook, like this discussion on a recent outbreak at a Kansas City daycare center.
The myth that MMR shedding leads to measles outbreaks is commonly spread on Facebook, like this discussion on a recent outbreak at a Kansas City daycare center.

While the oral polio vaccine is indeed associated with shedding and vaccine associated disease, that doesn’t happen with MMR. Experts don’t even recommend any restrictions for use of the MMR vaccine for household contacts of people who are immunosuppressed. And yes, your kids can even visit a cancer patient if they just had their MMR, as long as they don’t have RSV, the flu, or some other contagious disease.

What about the fact that a study once found measles virus RNA in the urine of of kids who had recently been vaccinated? Doesn’t that mean that they were shedding the vaccine virus?

No. It doesn’t.

To be considered shedding, those measles virus RNA particles in their urine would have to be contagious. Now, measles is spread by respiratory secretions. So how are measles virus RNA particles in urine going to become airborne and get someone else sick?

They don’t.

Another Facebook post about MMR and shedding.
Most measles outbreaks in daycare centers have been started by an unvaccinated child or worker who traveled out of the country.

But what about that case in Canada? Anti-vaccine folks like to bring this up when they talk about shedding. In 2013, there was a case of vaccine-associated measles. That proves that the vaccine sheds, right?

Absolutely not!

“Of note, only one case report of transmission from vaccine-associated measles has been identified.”

Murti et al. on Case of vaccine-associated measles five weeks post-immunisation, British Columbia, Canada, October 2013

That child got measles about 5 weeks after she was vaccinated in the middle of a measles outbreak. Because she had no links to the other cases and she tested positive for vaccine-strain measles, it is thought that she had MMR vaccine-associated measles, which is extremely rare.

Shedding Light on Measles Outbreaks in Daycare

MMR shedding is not causing outbreaks of measles – or rubella and mumps, for that matter.

If shedding from the MMR, by any method, got kids sick, then why aren’t there even more cases of measles?

Daycare centers everywhere have a mix of infants and toddlers, including some who are intentionally unvaccinated, those who are too young to get their first MMR, and those who are just getting vaccinated.

When a case of measles does pop up though, it isn’t because of shedding, it is typically because someone who wasn’t vaccinated traveled out of the country, got measles, and brought it back home, exposing others.

What to Know About MMR and Shedding

Measles outbreaks are not caused by shedding from the MMR vaccine.

More on the MMR and Shedding

Answers To Frequently Asked Questions About Immunizations

Have questions about your child’s immunizations?

We probably have the answers.

Answers To Frequently Asked Questions About Immunizations

Not surprisingly, many parents have the same questions about immunizations and they want answers to reassure themselves that they are doing the right thing for their kids by getting them vaccinated and protected.

Still have questions?

Rotavirus vaccines are associated with a very small risk of intussusception, but that is not a good reason to miss the benefits of this vaccine.
Like most pediatricians, my kids are vaccinated and protected. Photo by Vincent Iannelli, MD

With so much misinformation out there scaring folks about vaccines, that’s not surprising.

Just keep in mind that every anti-vaccine talking point and myth they push has an easy answer, even as folks continue to move the goalposts in search of new arguments against vaccines.

Yesterday it was mercury. Today it’s aluminum. Tomorrow it will be something else, while they continue to use vaccine scare videos to make you think that vaccines aren’t safe.

Parents who do their research understand that the real threat to their kids isn’t vaccines, it is the anti-vaccine experts that continue to push propaganda about vaccines.

What to Know About Answers To Frequently Asked Questions About Immunizations

The most basic answers to your questions about vaccines are that while vaccines aren’t perfect, they are safe and necessary and they do work well to protect us from vaccine-preventable disease.

More on Frequently Asked Questions About Immunizations

Do More Vaccinated or Unvaccinated Kids Get Sick in Outbreaks?

Some anti-vaccine folks continue to claim that vaccines don’t work and that most outbreaks of vaccine-preventable diseases are actually caused by kids who have been vaccinated.

They also push the myth that more vaccinated than unvaccinated kids get sick in most outbreaks.

Vaccinated vs Unvaccinated in an Outbreak

So are outbreaks usually caused by kids who have been vaccinated?

No, of course not.

Do we sometimes see more vaccinated than unvaccinated kids in some of these outbreaks?

Yes, sometimes we do.

Vaccine Epidemiology

Wait, what?

Yes, we sometimes see more vaccinated than unvaccinated kids in an outbreak.

How can that be if vaccines work?

It is actually very easy to understand once you learn a little math and a little more epidemiology.

Basically, it is because while vaccines work, they don’t work 100% of the time, and more importantly, there are way more vaccinated kids around than unvaccinated kids.

The Mathematics of Disease Outbreaks

That means that you need to understand that more than the absolute number of vaccinated and unvaccinated people that got sick in an outbreak, you really want to know the percentages of vaccinated vs unvaccinated kids who got sick.

For example, in a school with 1,000 kids, you might be very surprised if six kids got a vaccine preventable disease, and three of them were vaccinated, leaving three unvaccinated.

Does that really mean that equal amounts of vaccinated and unvaccinated kids got sick?

I guess technically, but in the practical sense, it only would if half of the kids in the school were unvaccinated. Now unless they go to a Waldorf school, it is much more likely that over 90 to 95% of the kids were vaccinated, in which case, a much higher percentage of unvaccinated kids got sick.

Before we use a real world example, some terms to understand include:

  • attack rate – how many people will get sick when exposed to a disease
  • basic reproductive number or Ro – different for each disease, Ro basically tells you  just how contagious a disease is and ranges from about 1.5 for flu, 8 for chicken pox, and 15 for measles
  • vaccine coverage – how many people are vaccinated
  • vaccine efficacy – how well a vaccine works

You also need to know some formulas:

  • attack rate = new cases/total in group
  • vaccine coverage rate = number of people who are fully vaccinated / number of people who are eligible to be vaccinated
  • vaccine effectiveness = (attack rate in unvaccinated group – attack rate in vaccinated group) / attack rate in unvaccinated group x 100

Unfortunately, it is often hard to use these formulas in most outbreaks.

Why?

For one thing, it is hard to get accurate information on the vaccination status of all of the people in the outbreak. In addition to those who are confirmed to be vaccinated or unvaccinated, there is often a large number who’s vaccination status is unknown. And even if you know the vaccination status of everyone in the outbreak, it can be even harder to get the vaccine coverage rate or a neighborhood or city.

Outbreaks of Vaccine Preventable Diseases

Reports of measles outbreaks among highly vaccinated populations are from before we started doing a second dose in 1994.
Reports of measles outbreaks among highly vaccinated populations are from before we started doing a second dose of MMR… way back in 1994.

We know what starts most outbreaks.

And no, it’s not shedding…

For example, with measles, it is typically an unvaccinated person who travels out of the country, returns home after they have been exposed but are still in their incubation period, and then exposes others once they get sick. And the great majority of folks in these measles outbreaks are unvaccinated.

Some examples of these outbreaks include:

  • the 2014 Ohio measles outbreak that started with two unvaccinated Amish men getting measles in the Philippines while on a missionary trip and ended up with at least 388 cases before it was over, almost all unvaccinated
  • a 2013 North Carolina measles outbreak with 22 cases started after an unvaccinated traveler had returned from India
  • an outbreak of measles in New York, in 2013, with at least 58 cases, tarted with an intentionally unvaccinated teen returning from a trip to London
  • a 2011 outbreak of measles in Minnesota, when an unvaccinated child traveled out of the country, developed measles, and returned to his undervaccinated community, causing the state’s largest measles outbreak in 20 years

But what about mumps and pertussis?

Those outbreaks are all among vaccinated kids, right?

Nope.

In one of the biggest mumps outbreak, in Arkansas, only 71% of people were up-to-date on their vaccines!

And keep in mind that while we do know that there are issues with waning immunity with some vaccines, you are still much more likely to become infected and get others sick if you are not vaccinated. And you will likely have a much more severe disease.

A 2013 pertussis outbreak in Florida is a good example that even with all the bad press it gets, the DTaP and Tdap vaccines work too. This outbreak was started by an unvaccinated child at a charter school with high rates of unvaccinated kids. About 30% of unvaccinated kids got sick, while there was only one case “in a person who reported having received any vaccination against pertussis.”

In another 2013 pertussis outbreak in Florida, this time in a preschool, although most of the kids were vaccinated, the outbreak started with “a 1-year-old vaccine-exempt preschool student.” And the classroom with the highest attack rate, was “one in which a teacher with a laboratory-confirmed case of pertussis who had not received a Tdap booster vaccination, worked throughout her illness.”

In outbreak after outbreak, we see the same thing, sometimes with deadly consequences – an unvaccinated child or adult triggers an outbreak and then a lot of unvaccinated folks get sick. Unfortunately, others get caught up in these outbreaks too, including those too young to be vaccinated, those who can’t be vaccinated because of true medical exemptions, and those whose vaccines may not have worked as well as we would have liked.

Get educated.

Vaccines are safe. Vaccines are necessary. Vaccines work.

What to Know About Vaccinated vs Unvaccinated in Outbreaks

Most outbreaks are started by someone who is unvaccinated, often after a trip out of the country, and the resulting outbreak will likely get many more unvaccinated than vaccinated folks sick.

More About Vaccinated vs Unvaccinated in Outbreaks