Tag: Wakefield factor

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

Some folks just can’t understand why we are having so many measles outbreaks these days.

It is actually really easy to figure out and find the decline in vaccination rates if you really look for it…

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

And it is easy to understand why we are having these measles outbreaks, even though overall vaccination rates in a state might be good.

The problem is the clusters of unvaccinated people in very specific areas of each city, county, and state.

MMR vaccination rates have dropped over the years in Washington (red line) and Clark County (yellow line). Can we thank Andrew Wakefield, Jenny McCarthy, and Bob Sears, etc.?

These pockets of susceptibles put everyone at risk, especially those who are too young to be vaccinated, too young to be fully vaccinated, and those with true medical exemptions who can’t be vaccinated.

Looking at the state and county level rates of MMR vaccination by kindergarten, you can see that a lot more kids haven’t been getting vaccinated since 1990. In fact, while 97.6% of kindergarteners during the 1998-99 school year had their MMR vaccination, it quickly fell to about 90%, where it remains today. In Clark County, where we are currently seeing a large outbreak of measles, the drop was even worse.

Not surprisingly, this mirrors the vaccine exemption rates in these areas.

“What’s so important about all this data is that it destroys the false narrative. Vaccination rates haven’t gone down lately. Period. Ask any epidemiologist you know to run these numbers.”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

Speaking of false narratives, many states now publish school and county level immunization rates, so it is easy to see past anti-vaccine propaganda and see that vaccination rates truly have gone down lately in areas that are dealing with outbreaks.

Immunization rates are very low at the Portland Waldorf School.

The Oregon Health Authority actually publishes annual lists of child, adolescent, and school immunization rates.

“I wanted to make sure and corroborate that data with data from the Oregon Health Authority, which they conveniently don’t publish very often, but someone sent me their data from 2014, showing that 97.1% of 7th graders in Oregon have received an MMR vaccine! Where’s the decline?”

JB Handley on CDC, Check YOUR Data: MMR Vaccination Rates are NOT Declining

In 2017, 95.5% of teens in Oregon had received one dose of the MMR vaccine. Only 90% had received the recommended two doses. Rates in Multonah County, near the current outbreak in Washington, were actually a little better, at 96.7% (one dose) and 92% (2 doses).

Still, there are plenty of schools with much lower rates, creating the pockets of susceptibles that are causing these outbreaks.

Where’s the decline?

Have you checked the Portland Waldorf school?

While schools with higher rates help to boost the average rates for the county and state, the schools and communities with low rates are prime for outbreaks.

SchoolMMR Rates
Orchards Elementary School71.4%
Minnehaha Elementary School89.3%
Cornerstone Christian Academy?
Hearthwood Elementary School72.2%
Home Connection86.7%
Homelink River61.1%
Slavic Christian Academy?
Image Elementary School78%
Eisenhower Elementary School89%
Tukes Valley Primary and Middle School​?
Maple Grove School?
Evergreen High School?

In Washington, for example, the schools involved in the outbreak (at least the ones that report) all have immunization rates below the state and county levels.

If you are on the fence about vaccinating your kids, check where you’re getting your information from if what you are hearing is scaring you.

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

Why Are We Having Measles Outbreaks If MMR Vaccination Rates Are Not Declining?

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

How Many People Get Measles Each Year?

It used to be that measles was very common and almost everyone got measles.

A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.
A measles epidemic hit New York City in 1951, as this front page NYTimes article reports.

While it was a so-called rite of passage and a part of growing up, it wasn’t something you looked forward to, as some kids didn’t survive having measles.

How Many People Get Measles Each Year?

Fortunately, measles case counts have dropped in the post-vaccine era.

How much did they drop?

Let’s see..

Year Cases
1920 469,924
1941 894,134
over 400 measles deaths each year
1962 503,282
1969 25,826
1970 47,351
1978 26,871
1979 13,597
1983 1,497
1986 6,282
1989 18,193
1990 27,786
1991 9,643
1992 2,200
1993 312
last record high number of measles cases
1994 963
1995 281
1996 508
1997 138
1998 100
1999 100
2000 86
2001 116
2002 44
2003 55
record low number of measles cases
2004 37
2005 66
2006 55
2007 43
2008 140
2009 71
2010 61
2011 220
2012 55
2013 187
worst year for measles since 1994, with the largest single outbreak (377 cases in Ohio) since the endemic spread of measles was eliminated
2014 667
2015 188
2016 86
2017 120
2018 372
2019 1,234+

Can you guess when the first measles vaccines were introduced?

Can you guess when we started to give kids a second dose of the MMR vaccine?

Can you guess when Wakefield became popular and Dr. Bob’s vaccine book was released?

Do you know how much it costs to contain these outbreaks?

Do you understand the consequences of a natural measles infection?

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?

A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.
A lot has changed since we got reassurance from the CDC that we were seeing an expected range of measles cases, although there were plenty of warning signs then that this was going to be one for the record books.

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.

The Rockland County measles outbreak already exceeds the total yearly case count for 11 of the past 19 years!
The Rockland County measles outbreak exceeded the total yearly case count for 11 of the past 19 years – in January!

And with several large outbreaks continuing overseas, next year doesn’t look like it will be much better, especially with reports of a measles resurgence in many regions of the world.

More on Measles and Measles Cases

Why Are You Still Worried About the MMR Vaccine?

We know why most folks got scared of the MMR vaccine.

Who's to blame for low immunization rates and continuing outbreaks?
Who’s to blame for low immunization rates and continuing outbreaks?

And most of us remember when most folks welcomed the MMR vaccine the end of endemic measles in the United States.

Why You Were Worried About the MMR Vaccine

Of course, that all changed when Andrew Wakefield spoke at the press conference for his 1998 Lancet paper and said:

“And I have to say that there is sufficient anxiety in my own mind of the safety, the long term safety of the polyvalent, that is the MMR vaccination in combination, that I think that it should be suspended in favour of the single vaccines, that is continued use of the individual measles, mumps and rubella components… there is no doubt that if you give three viruses together, three live viruses, then you potentially increase the risk of an adverse event occurring, particularly when one of those viruses influences the immune system in the way that measles does. And it may be, and studies will show this or not, that giving the measles on its own reduces the risk of this particular syndrome developing… the risk of this particular syndrome developing is related to the combined vaccine, the MMR, rather than the single vaccines…. People have been saying for some time, people on the periphery of autism, have been saying for some time that this may well be related to bowel damage.”

Although there was no evidence for any of that, vaccination rates went down and measles rates went up – the Wakefield Factor.

MMR vaccination rates had dropped below 80% by 2003, when the first measles outbreaks in the UK began. They didn't fully recover until 2012.
MMR vaccination rates had dropped below 80% by 2003, when the first measles outbreaks in the UK began. They didn’t fully recover until 2012.

But no, it wasn’t one person at a press conference that us lead down a decade of worry about the MMR vaccine.

“And then the nurse gave my son that shot. And I remember going, “Oh, God, no!” And soon thereafter I noticed a change. The soul was gone from his eyes.”

Jenny McCarthy on Oprah

Andrew Wakefield had plenty of help!

Not only from anti-vaccine celebrities, but from the media and their scare stories.

Why Are You Still Worried About the MMR Vaccine?

But that is all old news.

Over and over again, we see new studies that show that the MMR vaccine is safe and is not associated with autism.

Andrew Wakefield’s work was never replicated.

The MMR vaccine never contained thimerosal and doesn’t even contain aluminum, which I mention only because those are ingredients that some folks get scared about, not because they are harmful.

Vaccines are safe. The MMR vaccine is safe.

And more and more, as predicted, we are seeing why vaccines are necessary – more and more outbreaksOutbreaks that are proving to be deadly.

Why are you still worried about the MMR vaccine?

Because anti-vaccine folks are still scaring you away from vaccinating and protecting your kids!

Don’t listen to them!

More on MMR Vaccine Fears