Tag: unvaccinated

What Percentage of Adults Are up to Date on Their Immunizations?

Are you up to date on your vaccines?

What about everyone else?

What Percentage of Adults Are up to Date on Their Immunizations?

Can you guess why this question comes up so often?

Yup.

There is no plan to force adults to get vaccinated...
There is no plan to force adults to get vaccinated…

It’s about herd immunity.

If most adults aren’t immune because they haven’t been vaccinated or don’t get boosters, then since we aren’t seeing that many outbreaks, herd immunity itself must be a myth.

The thing is though, adults were either born in the pre-vaccine era and likely earned their natural immunity or were born in the vaccine era and are vaccinated and immune.

It is also important to understand that herd immunity is disease specific, so when we talk about herd immunity for measles, it doesn’t matter if everyone has herd immunity levels of protection against hepatitis A or Hib.

And adults do get a few boosters and some vaccines that are only recommended for adults, including the shingles vaccine.

In addition, some vaccines, like Hib and Prevnar, have indirect effects, protecting adults even though they aren’t vaccinated, because vaccinated kids are less likely to become infectious.

But back to the original question, how many adults are up to date on their immunizations?

“While modest gains occurred in vaccination coverage for pneumococcal, Tdap, hepatitis A (persons with chronic liver conditions), herpes zoster, and HPV vaccination, coverage did not improve for other vaccinations and many adults remained unvaccinated with recommended vaccines. “

Vaccination Coverage Among Adults in the United States, National Health Interview Survey, 2016

While most adults are immune to what were once common childhood diseases, like measles and mumps, because they were either vaccinated or had the disease naturally, many could do better with newer vaccines that weren’t available when they were kids.

More on Adult Vaccination Statistics

If It’s Vaccines, Then Why Are There Autistic Kids Who Are Unvaccinated?

Although we know that vaccines aren’t associated with autism, anti-vaccine folks can’t let go of the idea.

Paul Thomas misses the one thing his data is telling him...
Paul Thomas misses the one thing his data is telling him…

So how do they explain all of the autistic kids who are unvaccinated?

If It’s Vaccines, Then Why Are There Autistic Kids Who Are Unvaccinated?

Of course, anti-vaccine folks have a ready answer – it’s vaccines, but it’s not just vaccines.

I guess that’s how they explain the fact that there are so many autistic adults too! Well, actually no. Most anti-vaccine folks are surprised when you point out that there are so many autistic adults, as it doesn’t fit in with their idea that autism is new and caused by kids getting more vaccines than they used to.

Well, I guess mostly caused by giving so many more vaccines than we used to – there are also the autistic kids who were never vaccinated.

How do they explain those kids having autism?

Like their competing theories about how vaccines are associated with autism (it’s the MMR vaccine, no it’s thimerosal, no it’s glyphosate contaminating vaccines, etc.), they have a lot of ideas about how everything else causes autism. From fluoride and chlorine to acetaminophen and aluminum-lined containers, plus mercury, arsenic, aspartame, MSG, and the vaccines your child’s great-grandmother received – they think that just about anything and everything can cause autism. Or at least anything that they think they can sell you a treatment for, such as their supplements, special diet plans, or other “cures.”

Makes you wonder why they still focus on vaccines…

But they do, even as more studies have shown that vaccines are not associated with autism. And since vaccines don’t cause autism, it shouldn’t be surprising that there are unvaccinated children with autism. The only reason there aren’t more is that most parents vaccinate their children, so, of course, most autistic children are going to be vaccinated.

Another reason is that some parents stop vaccinating their kids once they have an autistic child. But since vaccines aren’t associated with autism, which is highly genetic and inheritable, younger unvaccinated siblings born after older siblings were diagnosed often still develop autism.

Now if vaccines didn’t cause autism in these unvaccinated kids, why would anyone still think that they caused autism in their older siblings?

“I must admit that it was through conversations with a coworker that I began to suspect something might be wrong with my youngest son. It concerned me so much that I started looking for information online. I read some of the stories and they sounded similar to what I was experiencing with my son – with the symptoms, the regression and the age at which it all started to become apparent.”

Lara’s Story: Growing Up Anti-Vaccine

Unlike some other stories you might read online, Lara’s story is about her unvaccinated autistic child.

She isn’t alone. You only have to look at personal stories and posts in parenting forums to see that there are many cases of autism among unvaccinated and partially vaccinated children:

  • “It is highly likely my 4-year-old son is autistic. And he is completely 100 percent vaccine-free. And I am just at a total loss.”
  • “I have unvaxxed kids on the spectrum, and my friend does as well.”
  • “A good friend’s son is autistic. He is totally non-vaxxed.”
  • “I seriously delayed vaccinating my son, so had very few vaxxes at the time he was diagnosed”
  • “We have autism in our unvaxxed children”
  • “I know two little boys who are both autistic, completely non-vaxxed”
  • “I have two unvaccinated children who are on the autism spectrum and have never vaccinated any of my children.”
  • “I am not sure what caused my son’s autism, but autistic he is. He is completely unvaxxed as we stopped vaxxing 10 years ago.”
  • “I have a 10 year old daughter with autism spectrum disorder… My daughter has never had a vaccine, a decision I made shortly after she was born, after much research.”

Unfortunately, while realizing that unvaccinated children can develop autism does help some parents move away from anti-vaccine myths and conspiracy theories, others get pushed deeper into the idea that it is just about toxins. It is not uncommon for some of these parents to blame vaccines they got while pregnant or even before they became pregnant, Rhogam shots, or mercury fillings in their teeth, etc.

Fortunately, most don’t though.

Take Juniper Russo, for example.

She “was afraid of autism, of chemicals, of pharmaceutical companies, of pills, of needles” when she had her baby. She just knew that vaccines caused autism when she first visited her pediatrician after her baby was born and knew all of the anti-vaccine talking points. She also later began to realize that her completely unvaccinated daughter had significant developmental delays. Instead of continuing to believe that vaccines cause autism, Ms. Russo understood that she “could no longer deny three things: she was developmentally different, she needed to be vaccinated, and vaccines had nothing to do with her differences.”

And she understands that her autistic child isn’t damaged, as hard as folks in the anti-vaccine movement still try to push the idea that she is.

More on Autistic Kids Who Are Unvaccinated

An Unvaccinated Child in Oregon Recently Had Tetanus

I recently wrote about how there was a case of diphtheria in Oklahoma last year.

It was a good reminder that we aren’t just seeing measles outbreaks these days.

Need another reminder?

An Unvaccinated Child in Oregon Recently Had Tetanus

An unvaccinated 6-year-old in Oregon developed tetanus.

Can an unvaccinated child really get tetanus after a toe nail injury?
In a similar case, an unvaccinated 4-year-old got severe tetanus after a minor toe nail injury. (CC BY 3.0)

“In 2017, a boy aged 6 years who had received no immunizations sustained a forehead laceration while playing outdoors on a farm; the wound was cleaned and sutured at home. Six days later, he had episodes of crying, jaw clenching, and involuntary upper extremity muscle spasms, followed by arching of the neck and back (opisthotonus) and generalized spasticity. Later that day, at the onset of breathing difficulty, the parents contacted emergency medical services, who air-transported him directly to a tertiary pediatric medical center. The boy subsequently received a diagnosis of tetanus and required approximately 8 weeks of inpatient care, followed by rehabilitation care, before he was able to resume normal activities.”

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, 2017

Many folks will recognize the “jaw clenching” from the alternative name for tetanus – lockjaw.

“Upon hospital arrival, the child had jaw muscle spasms (trismus). He was alert and requested water but was unable to open his mouth; respiratory distress caused by diaphragmatic and laryngeal spasm necessitated sedation, endotracheal intubation, and mechanical ventilation. Tetanus immune globulin (3,000 units) and diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) were administered for presumed tetanus. He was admitted to the pediatric intensive care unit and cared for in a darkened room with ear plugs and minimal stimulation (stimulation increased the intensity of his spasms). Intravenous metronidazole was initiated, and the scalp laceration was irrigated and debrided.”

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, 2017

Wait, wasn’t it too late to vaccinate him at this point?

Of course not.

Remember, tetanus vaccine doesn’t actually kill the tetanus bacteria. Or even prevent a tetanus infection, believe it or not. The tetanus shot is a toxoid vaccine directed against the toxin that the tetanus bacteria makes.

Once tetanus spores germinate, the bacteria have to grow and then produce exotoxins. The exotoxins then have to travel to different sites in your nervous system, where they act as neurotoxins.

At this point, although he was treated with antibiotics and tetanus immune globulin, there is still a chance that spores will germinate and becteria will eventually grow and produce more exotoxin. Getting the vaccine helps ensure that you will make some of your own antibody to fight them.

“His opisthotonus worsened, and he developed autonomic instability (hypertension, tachycardia, and body temperatures of 97.0°F–104.9°F [36.1°C–40.5°C]). He was treated with multiple continuous intravenous medication infusions to control his pain and blood pressure, and with neuromuscular blockade to manage his muscle spasms. A tracheostomy was placed on hospital day 5 for prolonged ventilator support. Starting on hospital day 35, the patient tolerated a 5-day wean from neuromuscular blockade. On day 44, his ventilator support was discontinued, and he tolerated sips of clear liquids. On day 47, he was transferred to the intermediate care unit. Three days later, he walked 20 feet with assistance. On day 54, his tracheostomy was removed, and 3 days later, he was transferred to a rehabilitation center for 17 days.”

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, 2017

And since you don’t develop natural immunity to tetanus, getting vaccinated helps protect you from future exposures.

After an episode like this, you wouldn’t want to risk your child getting this sick again, would you?

“The boy required 57 days of inpatient acute care, including 47 days in the intensive care unit. The inpatient charges totaled $811,929 (excluding air transportation, inpatient rehabilitation, and ambulatory follow-up costs). One month after inpatient rehabilitation, he returned to all normal activities, including running and bicycling. Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations.”

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, 2017

Well, most of us wouldn’t…

Hopefully other parents learn a lesson though.

Remember, you can wait too long to vaccinate your kids. You can skip or delay a vaccine long enough that they end up getting measles, tetanus, diphtheria, or meningococcemia, etc., before you get caught up.

More on Tetanus In An Unvaccinated Child in Oregon

What is the Natural Immunity Model?

It’s becoming a little clearer why some folks think it is safe to not vaccinate their kids, leaving them at risk to get vaccine-preventable diseases.

Who's calling the measles outbreaks a national emergency?
Who’s calling the measles outbreaks a national emergency?

Their idea of a natural immunity model of getting disease simply involves hiding in the herd and any outbreaks they trigger magically stopping.

What is the Natural Immunity Model?

Bob Sears thinks he has exposed some big news, that not everyone who gets measles dies.

Fortunately, that’s very true and something folks have always known.

With a death rate of about 1 in 1000 cases, you wouldn’t expect to have had any deaths after just 50 or 60 cases. But you never know. It’s not like every 1000th case dies. It could be the second case, the 562nd, or the 3043rd.

The hospitalization rates work the same way. They are statistical averages of what typically happens when people get measles.

That’s why measles was once called a “harmless killer.” It is often harmless, if you call having a high fever and feeling miserable for a week harmless, but it is sometimes a killer.

So is what we are seeing in Washington “what an outbreak looks like with the natural immunity model,” when no one is vaccinated and protected?

Of course not!

In a natural immunity model, up to 90% of the people who are exposed to someone with measles get sick!

In the pre-vaccine era, everyone got measles. That's the natural immunity model.
In the pre-vaccine era, everyone got measles. That’s the natural immunity model.

In a natural immunity model, everyone gets measles.

Not everyone survives having measles though.

Remember, the last measles death in the United States was during a 2015 outbreak in Washington. A immunocompromised women got caught up in an outbreak of mostly unvaccinated people, got measles, and died.

That’s the natural immunity model.

This family didn't have a choice about their son getting sick - he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.
This family didn’t have a choice about their son getting sick – he was too young to be vaccinated when he was exposed to an unvaccinated child with measles.

Not having a choice about getting measles.

That’s the natural immunity model.

Worry about your child with leukemia after an exposure to measles…

That’s the natural immunity model.

“Well, what does this mean? Much like the outbreak in 2014 in a large Amish community (around 400 cases), and the recent NY outbreak in an orthodox Jewish community (around 100 cases), these types of outbreaks are centralized and self-limiting—which means they don’t spread like wildfire. These cases are also almost exclusively in communities who are CHOOSING not to be vaccinated. In other words, they are not random people “victimized” by measles. #dontfeelsorryforthem”

Melissa Floyd

Do anti-vaccine folks really think that these outbreaks are self-limiting? That they just stop on their own?

Do they not understand that the only thing that keeps them from “spreading like wildfire” is the intensive work of the local and state health departments, efforts to get folks vaccinated, and quarantines?

The Disneyland measles outbreak, for example, was hardly centralized or self-limited. It spread to Arizona, Nebraska, Utah, Colorado, Washington, Oregon, Mexico, and Canada.

And like many other large outbreaks, it cost millions of dollars to contain.

“Measles outbreaks can be very costly to communities, a new report suggests. For example, the 2013 measles outbreak in New York City cost the city’s health department nearly $395,000 and more than 10,000 personnel hours, according to a report in JAMA Pediatrics. And there were other non-monetary costs, including the loss of a pregnancy, researchers reported.”

Measles outbreaks come with serious consequences

That hardly sounds like something that is harmless or self-limited.

“Now, the ACIP is preparing to add a 3rd dose for all college-age students to try to stop adults from getting and spreading measles—THAT’S how common adults cases are. Yet in Washington, there were only three??”

Melissa Floyd

Not only is there no call for a third dose of MMR to help stop the spread of measles, the CDC actually says a third dose isn’t necessary.

“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.”

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

Any talk about a third dose of MMR has to do with outbreaks of mumps…

“Is this all a coincidence my friends? Is the panic generated because of motive rather than data? In other words, could the media actually be encouraged to shift public beliefs on an issue to help pass legislation with a vested interest? #HerdImmunityDoesntApplyToVaccines”

Melissa Floyd

It’s not a coincidence that we are seeing so much anti-vaccine measles panic and propaganda these days. Outbreaks always bring it out.

Why?

It becomes harder to justify your decision to leave your kids unvaccinated and unprotected when you actually start to see that intentionally unvaccinated kids are getting sick.

More on the Natural Immunity Model

Vaccinated vs Unvaccinated – Measles Outbreak Edition

There are two big reasons that we are still having to talk about how it’s mainly unvaccinated folks that get sick in measles outbreaks.

Some folks keep spreading misinformation about measles, such as how most of the people who got sick in the Disney outbreak were vaccinated!?!

And other folks believe them!

Vaccinated vs Unvaccinated – Measles Outbreak Edition

Fortunately, misinformation about the number of vaccinated vs unvaccinated in an outbreak is among the easiest things to fact check.

Although folks will try to misrepresent this slide, as you can easily see, most of the folks in the Disneyland outbreak were unvaccinated.

That’s not how any of this works…

For example, if you wanted to assume that the 20 people who said that they were vaccinated really were, then you have to assume that the rest of those folks weren’t. And you also have to raise the number of folks who had their immunization status verified.

But you really shouldn’t make assumptions. All you can really say for sure from this data is that 15 (13 + 2) of the people, out of the 131 cases, were fully vaccinated.

What about the New York outbreak in 2011? Was it really started by someone who was fully vaccinated?

Surprisingly, it was!

“This is the first report of measles transmission from a twice-vaccinated individual with documented secondary vaccine failure. The clinical presentation and laboratory data of the index patient were typical of measles in a naive individual. Secondary patients had robust anamnestic antibody responses. No tertiary cases occurred despite numerous contacts.”

Rosen et al on Outbreak of measles among persons with prior evidence of immunity, New York City, 2011.

And it was a very big deal because it was the first time it had ever been reported as happening!

“During 2011, a provisional total of 222 measles cases were reported from 31 states. The median age of the patients was 14 years (range: 3 months to 84 years); 27 (14%) were aged <12 months, 51 (26%) were aged 1–4 years, 42 (21%) were aged 5–19 years, and 76 (39%) were aged ≥20 years. Most patients were unvaccinated (65%) or had unknown vaccination status (21%).”

Measles — United States, 2011

That’s in contrast to all of the other measles cases that year. Remember, there were a total of 222 measles cases in the United States in 2011. Few were vaccinated.

What about other measles outbreaks?

Only 4% of people in the Rockland County measles outbreak have been fully vaccinated.
Only 4% of people in the Rockland County measles outbreak have been fully vaccinated.

As much as folks try and report that most of the people in recent outbreaks are vaccinated, they aren’t.

Only one person, out of 53 cases of measles, is known to have had a dose of MMR in the Clark County measles outbreak.

What about other measles outbreaks?

OutbreaksYearVaccinatedUnvaccinatedUnknown
California – 24 cases201724
Minnesota – 75 cases20175682
Tennessee – 7 cases201616
Ohio – 383 cases2014534038
California – 58 cases2014112518
Texas – 21 cases2013165
Florida – 5 cases20135
Brooklyn – 58 cases201358
North Carolina – 23 cases20132183
Minnesota – 21 cases2011183
San Diego – 12 cases200812

We don’t even have to do the math.

“The majority of people who got measles were unvaccinated.”

Measles Cases and Outbreaks

It is easy to see that most folks in these outbreaks are unvaccinated!

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

More on Vaccinated vs Unvaccinated – Measles Outbreak Edition

Remembering Measles

I don’t remember treating any kids with measles in medical school or residency.

We certainly saw a lot of other now vaccine-preventable diseases when I was in training, from rotavirus and pneumococcal disease to meningococcal disease.

“When I graduated from medical school, many of the current vaccines were either not yet invented or just beginning to be widely used. I still remember what health care was like in the pre-vaccine era, and I remember that there seemed to be at least one child in each neighborhood who spent much of her life in an iron lung because of polio. As a young resident in pediatrics, I heard, on the whooping-cough ward, the coughing and choking of children with pneumonia. I remember the brain damage from encephalitis caused by measles, and the birth defects of babies whose mothers had had German measles during pregnancy. In my first years in pediatric practice, I remember making hospital rounds every morning and treating children with meningitis, and complications of chicken pox and other illnesses that have been either eliminated or lessened in severity by the widespread use of vaccines. Also, I remember more than a decade ago when Great Britain temporarily stopped the routine use of the DTP vaccine because of a reaction scare (which later turned out to be a false alarm) and consequently suffered a resurgence of whooping cough. Because of my “historical” perspective, I have grown to appreciate the value of vaccines as a necessary public-health measure. Currently in our pediatric practice, we follow the vaccine schedule recommended by the American Academy of Pediatrics.”

Dr. William Sears on Ask Dr. Sears: Vaccination/Immunization Concerns

But I trained in the post-elimination era for measles.

Remembering Measles

Although some folks only seem to have the Brady Bunch to use as a guide, fortunately there are many other ways to discover what measles used to be like.

I asked some of my old instructors…

“Typical case of measles – a couple days of high fever, with a sick (miserable) looking kid with running nose, bad cough, and red eyes. You can see Koplik’s spots if you know to look for them on the buccal mucosa (I describe them as grains of salts on red tablecloth). Fever gets higher and rash appears at peak of fever (day 3-4). The rash disappears with a brawny hyperpigmented appearance. The child frequently gets diagnosed with an ear infection. If no complications (ear infection or pneumonia), recovery is quick once the fever resolves, but these kids look really sick, miserable, and sad during the acute phase. They have a measly look.”

Jeed Gan, MD

After reading that account, I’m glad my kids are all vaccinated and protected and hopefully won’t ever get measles, as it sounds horrible.

Although I have never seen it, I can certainly imagine that measly look…

A child with measles and four days of the classic measles rash.
A child with measles and four days of the classic measles rash. Photo by CDC/NIP/ Barbara Rice

What else can you imagine?

“I’ve often called measles ‘the harmless killer’ because, although most youngsters recover uneventfully, the disease a certain amount of really serious damage.”

Dr. Joseph Molner

Can you imagine intentionally leaving your kids unvaccinated and at risk of a harmless killer disease?

In this 1959 article in the Madera Tribune, Dr. Bundesen warns parents to take measles seriously.
In this 1959 article in the Madera Tribune, Dr. Bundesen warns parents to take measles seriously.

It is important to note that even a “mild” attack included a fever that could hit 104F or higher and, altogether the symptoms could last up to 12 days, as the cough often lingers after the rash has cleared up.

Measles is definitely contagious.
Measles is definitely contagious.

And in the pre-vaccine era, everyone ended up having measles, as it was so contagious.

Not everyone survived having measles though.

Even after improved sanitation and hygiene dropped mortality rates for measles and other diseases in the early part of the 20th Century, a lot of kids still died with measles.
Even after improved sanitation and hygiene dropped mortality rates for measles and other diseases in the early part of the 20th Century, a lot of kids still died with measles.

It was once well known that measles was not always so easy on kids.

1953 medical advice column
1953 medical advice column

Why have so many folks forgotten that fact?

Do you think that a 106F fever comes with a mild disease?
Do you think that a 106F fever comes with a mild disease?

Is it because vaccines work so well that we don’t see or hear about measles that much anymore?

Kids with measles feel awful.

At least we don’t hear about them until immunization rates drop and we start having more and more outbreaks.

Is that what it’s going to take to get you to vaccinate your kids? An outbreak in your city? Your child’s school? Or are you going to wait until your kids get sick?

More on Remembering Measles

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?