Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
I realize that I've thanked Jenny McCarthy and Andrew Wakefield before for giving the U.S. the gift of a measles resurgence. Originally, when I started this sarcastic little exercise, I assumed that it would be 5-10 years before we in the States caught up with the level of endemic measles that has been resurgent in the U.K. in the decade since Andrew Wakefield published his shoddy, fraudulent, pseudoscientific, litigation-driven article in The Lancet claiming that the MMR vaccine was responsible for "autistic enterocolitis," leading to an anti-MMR hysteria that drove down vaccination rates and made measles endemic again in the U.K. However, I rapidly realized that I was wrong and that measles would come roaring back in the U.S. far faster than that.
Here's yet another story about how it has done just that:
The number of measles cases in the U.S. is at its highest level since 1997, and nearly half of those involve children whose parents rejected vaccination, government health officials reported Thursday.The number of cases is still small, just 131, but that's just for the first seven months of the year and doctors are troubled by the trend. There were only 42 cases for all of last year.
"We're seeing a lot more spread. That is concerning to us," said Dr. Jane Seward, of the U.S. Centers for Disease Control and Prevention.
Pediatricians are frustrated, saying they are having to spend more time convincing parents the shot is safe.
"This year, we certainly have had parents asking more questions," said Dr. Ari Brown, an Austin, Texas, physician who is a spokeswoman for the American Academy of Pediatrics.
The CDC's review found that a number of cases involved home-schooled children not required to have the vaccines.
[...]
It is no longer endemic to the United States, but every year some Americans pick it up while traveling abroad and bring it home. Measles epidemics have exploded in Israel, Switzerland and some other countries. But high U.S. childhood vaccination rates have prevented major outbreaks here.
In a typical year, only one outbreak occurs in the United States, infecting perhaps 10 to 20 people. So far this year through July 30 the country has seen seven outbreaks, including one in Illinois with 30 cases, said Seward, deputy director of the CDC's Division of Viral Diseases.
None of the 131 patients died, but 15 were hospitalized.
The article notes that vaccination rates in the U.S. are still over 90%, still high enough for herd immunity to hold sway, but that outbreak pockets, where lower vaccination rates are the rule and herd immunity has become shaky, are forming. That's what's allowing these outbreaks to occur. Here's the kicker:
Of this year's total, 122 were unvaccinated or had unknown vaccination status. Some were unvaccinated because the children were under age 1, making them too young to get their first measles shot.In 63 of those cases _ almost all of them 19 or younger _ the patient or their parents refused vaccination, the CDC reported.
In Washington state, an outbreak was traced to a religious conference, including 16 school-aged children who were not vaccinated because of parents' beliefs. Eleven of those kids were home schooled and not subject to vaccination rules in public schools.
The Illinois outbreak _ triggered by a teenager who had traveled to Italy _ included 25 home-schooled children, according to the CDC report.
So, rejoice, Jenny McCarthy, J.B. Handley, David Kirby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, Dr. Jay Gordon, and all the other antivaccine activists (or their willing dupes who oh-so-piously claim they are really and truly "not antivaccine") spreading misinformation, pseudoscience, and fear about vaccines! You're winning. You're succeeding in casting doubt on the safety of vaccines to the point that it's causing real problems for our public health system:
The nation once routinely saw hundreds of thousands of measles cases each year, and hundreds of deaths. But immunization campaigns were credited with dramatically reducing the numbers. The last time health officials saw this many cases was 1997, when 138 were reported. Last year, there were only 42 U.S. cases.The American Academy of Pediatrics has made educating parents about the safety of vaccines one of its top priorities this year, in part because busy doctors have grown frustrated at the amount of time they've been spending answering parents' questions about things they read on the Internet or heard from TV talk shows.
In June, the CDC interviewed 33 physicians in Austin, suburban Seattle and Hollywood, Fla., about childhood vaccinations. Several complained about patient backlogs caused by parents stirred up by information of dubious scientific merit, according to the CDC report.
Yes, each and every of you anti-vaccinationists or enablers or sympathizers with antivaccinationists (but above all, Jenny McCarthy, given that you've willingly--nay, enthusiastically!--become the celebrity face of the antivaccination movement, going so far as to get all your Hollywood friends to show up at Generation Rescue charities, to organize antivaccine marches on Washington, and get professional wrestling to help you raise money for the cause), this resurgence in measles is the result of your tireless labor in scaring parents with lies and pseudoscience to the point where they fear and refuse vaccination. Now your efforts are really beginning to bear fruit, and we're catching up with the U.K., which has a decade-long head start. Measles is coming back, Who knows? If you keep it up, you could reach the golden age of pre-MMR, as described in the CDC report itself:
In the United States, measles caused 450 reported deaths and 4,000 cases of encephalitis annually before measles vaccine became available in the mid-1960s (1). Through a successful measles vaccination program, the United States eliminated endemic measles transmission (1). Sustaining elimination requires maintaining high MMR vaccine coverage rates, particularly among preschool (>90% 1-dose coverage) and school-aged children (>95% 2-dose coverage) (7). High coverage levels provide herd immunity, decreasing everyone's risk for measles exposure and affording protection to persons who cannot be vaccinated. However, herd immunity does not provide 100% protection, especially in communities with large numbers of unvaccinated persons. For the foreseeable future, measles importations into the United States will continue to occur because measles is still common in Europe and other regions of the world. Within the United States, the current national MMR vaccine coverage rate is adequate to prevent the sustained spread of measles. However, importations of measles likely will continue to cause outbreaks in communities that have sizeable clusters of unvaccinated persons.
But, hey, if you succeed, Jenny, it'll be far more than just isolated communities of unvaccinated persons. Then the measles can really go to town! After all:
Measles is one of the first diseases to reappear when vaccination coverage rates fall. Ongoing outbreaks are occurring in European countries where rates of vaccination coverage are lower than those in the United States, including Austria, Italy, and Switzerland (3,4). In June 2008, the United Kingdom's Health Protection Agency declared that, because of a drop in vaccination coverage levels (to 80%--85% among children aged 2 years), measles was again endemic in the United Kingdom (3,8), 14 years after it had been eliminated. Since April 2008, two measles-related deaths have been reported in Europe, both in children ineligible to receive MMR vaccine because of congenital immunologic compromise (4,8). Such children depend on herd immunity for protection from the disease, as do children aged <12 months, who normally are too young to receive the vaccine. Otherwise healthy children with measles also are at risk for severe complications, including encephalitis and pneumonia, which can lead to permanent disability or death.
And that was just the measles. Keep it up, Jenny and other antivaccine activists, and you could probably drive vaccination rates low enough that pertussis, polio, Haemophilus influenza b, the mumps, and a whole lot of other vaccine-preventable diseases make a similar comeback. Heck, if you work hard enough, maybe they'll all become endemic again. It'll be just like the old days! Won't that be grand? Isn't that what you want? That'll be the reward for your success.
I'm sure all the suffering, hospitalized, and dead children in the future will thank you for your tireless efforts to save them from autism now.
Medicine & Health
Comments
How comforting.
College classes are starting up next week, so we should get some real nice exposure patterns brewing in dorms across the country...
I'm teaching a medical micro lab this fall, and the first day of class is going to be dedicated to vaccination requirements. Hopefully I can get their young minds on the right track.
Posted by: MarkySparky | August 21, 2008 3:07 PM
There are few things that can turn me into a boiling cauldron of hate, Orac. The results of antivaccinationist propaganda is one of them. People were luck enough that there were no deaths during this outbreak. Do we know if the hospitalizations resulted in any lasting damage?
I'm not a violent person, in general. That doesn't keep me from harboring the desire the lavish a savage beating on those who endanger us all with this nonsense. Maybe, instead, people will start walking up to them with pictures of smiling, happy children, and say "This child, my child, is dead. Because of you."
Likely, that won't wake them up. But maybe it'll shame them. It's all a nonbeliever in the afterlife can hope for.
Posted by: Ranson | August 21, 2008 3:14 PM
Good grief. This shouldn't take long to spread throughout nursing homes and other senior care places as well, between the visiting kids and the staff who have small children.
But but but Americans Love Children So Much!!! That's why we're bringing back childhood diseases! (And going to other countries to foster and adopt, because all the children here are just loved bunches and bunches already. Not.)
Posted by: DonZilla | August 21, 2008 3:31 PM
Vaccination denialists should go to Africa to see how they have achieved a 90 per cent reduction in measles related deaths since the turn of the century thanks to vaccines. There are still around a quarter of a million deaths every year world wide. The last thing we need is unvaxed Americans carrying diseases to the rest of the world.
Posted by: mike stanton | August 21, 2008 4:17 PM
Should they get the Uranium Olympic medal, for helping to encourage a 311 percent increase over last years caseload?
(Along with all of that shiny grey they can have bonus mutations!)
Posted by: Patrick | August 21, 2008 4:38 PM
Change the label:
Jenny McCarthy, J.B. Handley, David Kirby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, Dr. Jay Gordon, and all the other antivaccine activists promoters of preventable infectious diseases.
I dearly wish that vaccine-refusers could be sued for damages when outbreaks occur.
Posted by: Liz Ditz | August 21, 2008 4:42 PM
It's disgusting what Jenny McCarthy and JB Handley, Lenny Schafer and the rest of the flaming antivaxers (even those who deny that they are antivaccine but who quote the same antivax nonsense) have done.
Why shouldn't there be a diphtheria (or polio) outbreak here if someone travels from an area where the disease is active and brings it back here? Think of all the kids in day care centers. Those places are perfect for spreading germs. Doctors aren't used to seeing these diseases because they've disappeared due to vaccines. They aren't necessarily going to jump on them with the proper treatments if they don't recognized them immediately.
I wonder how many people are actively seeking out pockets of measles infection so they can have their beloved measles parties. JB Handley's youngest hasn't been vaccinated for measles, if he's following his advice to others. Is he going to take that child to a measles party or lock her in a bubble to prevent her from getting measles?
I hope someone puts a full page ad in the NYT and USA today "thanking" these bozos and the morons in TV news (and Oprah and "The View") who have aided them in spreading their lies. They'll need to be thanked for the death, hospitalizations and maiming they will be doing if the diseases continue to spread as they are.
Posted by: Ms. Clark | August 21, 2008 4:47 PM
Ah good ol' Washington. First it was pertussis, now measles. If herd immunity keeps dropping like this, my fully vaccinated children are increasingly at risk for getting these diseases, though they probably not suffer the full effects of the disease. And my newborn nephew is hugely at risk if measles spreads to his area. Thanks a lot.
Posted by: Diane | August 21, 2008 4:52 PM
Which would be sort of ironic.
Posted by: Brian | August 21, 2008 4:53 PM
I'd like to know when it is that grotesque anti-vaccinationism becomes domestic bio-terrorism? The anti-vaccine parents have been gloating and clucking over the incident of the anthrax researcher allegedly sending anthrax in the mail, how is what they are doing any different in the outcome?
Posted by: Hmn? | August 21, 2008 5:16 PM
Jenny McCarthy, J.B. Handley, David Kirby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, Dr. Jay Gordon, et al should be required to establish a fund to compensate those children injured by vaccine preventable diseases.
Wasn't there a successful lawsuit several years ago against a paid spokeperson for some financial product?
Posted by: TheProbe | August 21, 2008 5:36 PM
And then AOA (not intentinonally?) actually says something accurate: "The tone of the articles makes it clear to the British people that measles is life-threatening and the possibility of a massive outbreak is very real. "
Hope the American people can figure that out too, at least in Hollywood.
Posted by: kristina | August 21, 2008 5:50 PM
My isurance coverage is reduced because we don't smoke, have smoke detectors, etc. Shouldn't parents who refuse to vaccinate pay higher premiums for failing to prevent the preventable?
Posted by: Ruth | August 21, 2008 5:54 PM
Has Wakefield offered his take on this?
Posted by: Socrates | August 21, 2008 5:56 PM
Read some of the comments on the AoA website about this issue. According to some, they think these diseases are safer ("more natural") than the vaccines and that getting the diseases is better because their children's immunity will be stronger from it. Some have even said straight out that they would rather their children get the diseases than receive the vaccinations.
Wow.
But don't worry! According to them there's nothing to worry about! Measles hasn't killed anybody in the U.S. this year, so there is nothing to worry about.
Posted by: RJ | August 21, 2008 6:00 PM
Mike Stanton wrote "The last thing we need is unvaxed Americans carrying diseases to the rest of the world."
That has already happened:
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3308 ..."The index case of the cluster was thought to be a 17-year-old American studying in the United Kingdom, who had visited Jewish relatives in Antwerp and was diagnosed as a clinical measles case by a Belgian GP at the time of his visit."
(okay, to be fair he did pick it up in the UK, but still he is an American!)
Posted by: HCN | August 21, 2008 6:00 PM
"Shouldn't parents who refuse to vaccinate pay higher premiums for failing to prevent the preventable?"
YES! Of course they should. Dollars for vaccines or thousands for hospitalization and future complications.
Posted by: RJ | August 21, 2008 6:04 PM
Sadly the idiocy travels and so we get this headline up in Langely BC: Mumps infection hits town. Even more annoyingly our local paper in describing the outbreak goes above and beyond the call to ignore the elephant in the room and not point out that the outbreak is because so many parents in this area don't vaccinate.(http://www.canada.com/langleyadvance/news/story.html?id=93496699-c577-4510-b4d5-831dbb6e5169)
Needless to say a detailed letter to the editor was sent...will it do any good? Doubtful!
Posted by: Blair | August 21, 2008 6:19 PM
Last year Polite Dissent reproduced a Batman cartoon that probably wouldn't make a lot of sense to generations who have had the benefit of vaccination Courtesy of your roll-call of dishonour, sadly, that cartoon may yet be easily understood by current and future generations of children and their parents.
Posted by: HolfordWatch | August 21, 2008 6:24 PM
As a 45yo graduate student, I was surprised that I was required to get childhood vaccinations again upon re-entering university. I did so willingly despite being relatively certain that I had been fully vaccinated as a child. I did have rubella in the early 70s, so it is possible that I didn't have the MMR. I remember rubella being the worst illness ever befalling me and I certainly wouldn't want to go through that as an adult. I was a bit perturbed about being asked to get re-vaccinated, but when an encephalitis outbreak occurred on my campus, I was certainly glad I did.
Posted by: Liz S | August 21, 2008 6:26 PM
I think it's actually due to the Hannah Poling case. This had a measurable impact greater than the publicity generated by Jenny McCarthy's initial appearances in the media. Prior to this, 2002 was the heyday of the antivaccination movement, some time after Wakefield, a bit after the thimerosal hypothesis was proposed. We have yet to see if the Hannah Poling case is bigger than Wakefield historically. It seems though that these bouts of publicity don't last very long, so there's no need to panic yet. I hope I'm right about this.
Posted by: Joseph | August 21, 2008 6:32 PM
I hope you're right about this, too, but I think this time feels different. There's a lot more celebrity, money (celebrity fundraisers and WWE events), and marketing savvy in pushing the anti-vaccine propaganda. More people than I can ever recall seem to be falling for it, and the antivax movement is getting its message out far more effectively than I can remember before, at least in this country. I really do fear that this time it's different. I really do fear that this time there will be long-lasting damage to public health.
Posted by: Orac | August 21, 2008 7:13 PM
Orac, you might be proud of NBC Nightly News. They did story about the measles outbreaks and placed the blame squarely on those parents that do not vaccinate. They did not try to keep the story balanced. They showed one set of parents where all they got to say was that they thought vaccines may do more harm then good. No mention of Autism. Major points raised were:
1. Young parents do not remember the devastation the disease caused in the past (150 deaths per year) so that they think it is no big deal.
2. Misinformation from the internet and other sources misinforming parents (no they did not mention Jenny McCarthy by name).
3. Measle is largely being brought into the country by unvaccinated American traveling overseas or foreigners coming into the country.
But the news story squarely placed the blame on parents that do not vaccinate because they believe the misinformation given them. I not sure who the woman was who they interviewed. I am currently watching CBS to see if they have a similar story. Actually CBS has a commercial break and that will be there next story.
Posted by: Dan | August 21, 2008 7:17 PM
Surely there's a way to enforce accountability. Or, will be once this gets as bad as it is going to get.
Posted by: Liesl | August 21, 2008 7:23 PM
CBS news live blogging. Main points made:
1. Measles making a come back and doctors are worried.
2. This is due to parents not getting children vaccinated.
3. In past 500 deaths a year caused be measles.
4. Interview one mother who makes the link between vaccines and Autism.
5. There is no link between vaccines and Autism.
6. Same women, looking like the doctor, interviewed as with NBC. I guest she works for the CDC.
I thought the NBC reporting was better as they never mentioned Autism. Anyways, that we my attempt to write while listening and I may have missed some points.
Posted by: Dan | August 21, 2008 7:24 PM
I know what my anti-vaccination friend would say upon reading this
"...nearly half of those involve children whose parents rejected vaccination."
This must mean that slightly more than half involved children whose parents didn't reject vaccination, so the vaccines don't work. (Of course for a numerate, rational person that might strengthen the argument for vaccination, to get overall levels of immunity up and protect the few who aren't immune. But anti-vaccination people aren't especially rational or numerate, in my experience.)
Posted by: Mark | August 21, 2008 7:26 PM
One last comment, should Jenny ever read this:
Jenny, you ignorant slut, when actual deaths occur will you still be able to look yourself in the mirror?
Posted by: Dan | August 21, 2008 7:27 PM
Sorry, my previous comment was a bit silly. The cases that don't involve "children whose parents rejected vaccination" might well involve adults and I think there was a mention in the article of people picking measles up overseas. But I'm curious: is the vaccination 100% effective in giving immunity and, if not, what are the implications of this?
Posted by: Mark | August 21, 2008 7:33 PM
Pertussis:
To be fair, herd immunity isn't much of a factor for pertussis since the immunity isn't lifelong and adults can be (relatively) asymptomatic carriers.
Posted by: D. C. Sessions | August 21, 2008 7:53 PM
"Read some of the comments on the AoA website about this issue. According to some, they think these diseases are safer ("more natural") than the vaccines and that getting the diseases is better because their children's immunity will be stronger from it. Some have even said straight out that they would rather their children get the diseases than receive the vaccinations."
Also, back in the late 90s, Mothering magazine (letters? features?) wrote that children who had experienced measles, etc, "spiritually grew": that weeks of being sick profoundly changed the child for the better. All I can say is...wtf?
Posted by: Diane | August 21, 2008 8:13 PM
wtf! is right. If you are such a lousy parent and giving your child such a spiritually impoverished lifestyle that your child grows spiritually (again, wtf!) by coming down with measles, you should stop at one.
Posted by: daedalus2u | August 21, 2008 8:40 PM
"children who had experienced measles, etc, "spiritually grew": that weeks of being sick profoundly changed the child for the better."
I had a severe case of chicken pox as a child. You could argue that I spiritually grew from it; now, when things look bad, I can think "it's not as bad as having chicken pox in the vagina."
Posted by: Melissa (oddharmonic) | August 21, 2008 8:50 PM
@Mark: No. It's not. No vaccine is. Which makes it all the more imperative that everyone get vaccinated, to raise the herd immunity level as high as possible.
Posted by: The Ridger | August 21, 2008 8:53 PM
This must mean that slightly more than half involved children whose parents didn't reject vaccination, so the vaccines don't work.
Or occurred in children too young to be vaccinated or in adults from overseas who have not yet been vaccinated or in people who are immunosuppressed and either can not receive the vaccine or have lowered efficacy due to the immunosuppression or in people with true severe adverse reactions (i.e. allergy to one of the components) who therefore can not be vaccinated, etc. It is perfectly true that the vaccine is not 100% effective and that is one reason why herd immunity is important. However, that is not the only issue involved.
Posted by: Dianne | August 21, 2008 8:57 PM
Interesting that your anti-vax trolls haven't shown up yet. What's the matter y'all, having trouble figuring out how to spin a huge increase in measles cases to your advantage? Nope, they'll stay far away from this one.
Posted by: Carlie | August 21, 2008 9:29 PM
*sigh*
Ever get the feeling that the human race is doomed due to its own "re-emergent stupidity"*?
* Anti-vax craziness, AIDS denialism, climate change rejection-ism, assorted Alt.Reality superstition, fundamentalist religion etc etc.
Apologies for the gloom - reading these anti-vax stories get me depressed and angry. Plus the wide exposure this sh*t gets, especially via celebrities and wingnut commentators, reminds me what a bunch of morons our celebrity-obsessed media culture rams down our throats every day.
Posted by: Dr Aust | August 21, 2008 9:44 PM
Do any of you actually think that this could partially be the fault of the Pharma industries and the Medical community?
Pharma has knowingly lied about the safety of their products. They hired doctors to sign off on falsified safety studies (Vioxx, Paxil). They knowingly sell HIV tainted drugs to foreign countries (Bayer). And as Orac wrote about in another blog, Doctors are used to push across quasi-legal seeded trials for drug companies.
Could it be that the faith of the public has waned because they perceive (this is just my observation, mind you) that the Medical Community (and many of the public lump the Pharma Industry in with the Medical Community) is more interested in profits than in the health and well being of their patients? I'm not saying this to argue, but I think this is a valid point that should be thought about very carefully.
Anyway, just thought I'd chime in. Peace everyone.
Posted by: Just my 2 cents | August 21, 2008 9:49 PM
Here are the numbers on vaccination status from the MMWR paper:
So only 11 of the 123 patients were known to have received 1 or 2 doses of the vaccine, whereas 63 were unvaccinated because of philosophical or religious beliefs.
Posted by: franklin | August 21, 2008 9:58 PM
Just my 2 cents, yes that is most certainly a factor. Anti-vaccination wingnuttery is almost always associated with a general distrust of the medical profession, or at least of the large corporations within it. There are elements of conspiracy theory as well, especially among the more strident of the anti-vaxxers. As Orac discussed in the article you mentioned (a brilliant one, IMHO), one of the more pernicious effects of such shameful misbehavior as a seeding trial is to further weaken the trust patients have in the industry, making them even more prone to believe nonsense. It's easy to suspect Merck (for instance) of faking data about vaccinations when they've been caught red-handed covering up data about Vioxx, and from that suspicion, it's not a very far walk to start doubting vaccinations in general, especially since vaccinations are an unpleasant experience that most parents dread.
So yes, the misdeeds of the pharmaceutical giants certainly do feed this paranoia. And that is very unfortunate.
Posted by: Calli Arcale | August 21, 2008 10:21 PM
As a skeptical observation, the CDC has issued health advisories with regard to Measles. Every health care agency in the Western hemisphere is actively looking to isolate and identify measles cases.
Receiving a measles vaccine induces shedding in the recipient for up to 6 weeks. I'm quite certain that when people receive MV that they don't stay "away from society" after doing so. They could just as easily expose *anyone*. If that someone, felt slightly ill but never presented some of the more classic measles symptoms like Koplik spots, isn't it possible that this exposure goes unnoticed? I find that to be a bit of a double standard.
When Hedrich wrote about measles and the effect of herd immunity in 1933, it was in absence of a measles vaccine.
Are we convinced this is all associated with importation? I apologize if this was addressed in the surveillance report and I missed it. They noted two genotypes.
Respectfully,
AA
Posted by: anonymous antivaccinationist | August 21, 2008 10:27 PM
Add AA to the list of trolls who are unable to use Occam's Razor because they are not allowed to have sharp objects.
Posted by: Militant Agnostic | August 21, 2008 10:31 PM
They would rather their children get Polio than the vaccine because it makes for a stronger immunity? I've seen polio; baring immediate and extreme intervention, you don't live through it, and if you do manage to avoid dying a horrible protracted death you're disabled for the rest of your life, carrying around what amounts to at least one dead limb with you forever. Yeah, that's some immunity you get there, damn disease-worshiping fools.
Posted by: Julian | August 21, 2008 10:38 PM
I think the blame, unfortunately, has to fall on the internet. With the ease at which people have access to whatever quack theory that's out there, I think people mistakenly feel empowered by this. In the past, parents would have to go to the bookstore, pick out a book and spend money to gain access to the "data-free opinion" of the day. Now all it takes is typing a few keywords, doing a Google search and earning their University of Google degree. The rest of us have to go through grueling years of academic training all to have it thrown back in our faces as Pharma shills, etc. While I can't discount the fact that, overall, the internet has been a force of good in terms of dissemination of informaiton, I think the current situation is an example of the "dark side" of the internet.
By the way, isn't it funny that laypeople fail to realize how big these measles outbreaks would be were it not for vaccination. Think of the network of kids these infected kids come in contact. There is no doubt in my mind that these episodes prove the power of vaccination.
Posted by: ozzy | August 21, 2008 10:47 PM
Militant Agnostic,
I'm confused as to why you think this kind of childish banter is useful or furthers your point. My observations are clearly demonstrated, in not only the circular, but also here:
http://www.ncbi.nlm.nih.gov/pubmed/11858860?dopt=AbstractPlus
Occam's razor makes a lot more sense in the 14th century, before man started to inject disease into human beings. We've been administering disease (attenuated, weakened, whatever) in a way that would never happen in nature. Any person with a glimmer of evolutionary understanding realizes that we've only been experimenting for a very short time and the ecological consequence is unknown.
I'll get back to lurking. If my posts here have constituted trolling, then it's clear this effort is in vain.
Cheers,
AA
Posted by: anonymous antivaccinationist | August 21, 2008 10:48 PM
Yahoo! Cheers for measles making a comeback....maybe now it will shift back to the "normal" age group that it once was - instead of inflicting exposed adults who were previously vaccinated in childhood. Oh, I forgot the solution is to inject EVERYONE every 10 years, right?? What about the number of children who have "mysteriously" regressed into autism after the MMR, or the children who now suffer from diabetes due to the live-virus mumps vaccine that makes up the MMR, or how about just the sheer number of deaths that have occurred due to this one damn vaccine? Oops...forgot again. They don't count. Yahoo, McCarthy and Wakefield!!
Posted by: Dawn | August 21, 2008 11:18 PM
Orac, this post is truly not worthy of you. Seriously. The measles outbreak of 2008 will probably be comprised of an extra 150 cases over the usual annual 45. In a population of 350,000,000 Americans, you and any other scientist would have deemed this "statistically insignificant" if it suited your purposes.
D.C. Sessions writes: "To be fair, herd immunity isn't much of a factor for pertussis since the immunity isn't lifelong and adults can be (relatively) asymptomatic carriers."
Well said, sir.
Best,
Jay
Posted by: Jay Gordon | August 21, 2008 11:22 PM
A Wisconsin newspaper had an article in May 2008 about their outbreak. See here. It mentioned:
What's the deal with Switzerland and Israel? Can we do anything about foreigners entering the US or simply ensure we are all vaccinated? My state allows school children to opt out for religious reasons, but not personal reasons. Other states allow personal reasons. There's nothing to prevent states from making it mandatory with no exclusions. My university also required proof of vaccinations plus a current tetanus shot. Not sure what to do with the home-schooled children. If pregnant women are also vulnerable, it's a public health threat. Cripes, if people make a big deal about second-hand smoke and public smoking, surely they should be concerned about this as well.
Just My Two Cents, it's not like vaccines are anything new as opposed to new drugs. I think people have been led to be unnecessarily paranoid because of the autism claims.
Well, this is just maddening.
Posted by: Measles Free | August 21, 2008 11:23 PM
Dan, if you're still around, who reported the CBS story? They aired that execrable piece by Sharyl Attkisson a few weeks ago. One would hope they learned a little something from the feedback that followed it.
Posted by: isles | August 21, 2008 11:25 PM
It is time for the state to recognize that breeding is not synonymous with good parenting and act accordingly.
Posted by: I am so wise | August 21, 2008 11:31 PM
Measles free stated: "...In the latest outbreak, health officials have determined that nearly all confirmed cases were linked to people traveling abroad".
That is BULLSHIT! A Racine, Wisconsin (totally vaccinated) 5th grader started the outbreak! Don't believe me?? Check with Tom Murray, Katie DeLong, and Lauren Leamanczyk about the story from TMJ4 News. They covered it and spoke with the child's doctor.
I am so sick and tired of these lies that are spread by people like you.
How many people have died from the MMR vaccine alone? I forgot - they don't count. Total bullshit! You people literally make me sick.
Posted by: Dawn | August 21, 2008 11:53 PM
Liz Ditz stated: "I dearly wish that vaccine-refusers could be sued for damages when outbreaks occur".
Well, health insurances companies and vaccine manufacturers refuse to pay for recognized vaccine damage. So, I guess fair is fair, isn't it?? I'm sure that the parents of Autistic children would like some payback too. After all, if the dimwit doctor doesn't record everything properly in the medical records - odds are the case will lose in the Vaccine Injury Court of Claims.
Now, why the heck is insurance nearly unaffordable for most Americans? Vaccines.....after all, it is all of YOUR children that are on all of the medication - thanks pro-vaccine community for nearly eliminating healthcare in this country due to higher premiums to cover your drug dependent children!! Oh, I forgot - GO OBAMA and his national healthcare plan!!
Posted by: Dawn | August 22, 2008 12:31 AM
Julian stated: "They would rather their children get Polio than the vaccine because it makes for a stronger immunity? I've seen polio; baring immediate and extreme intervention, you don't live through it, and if you do manage to avoid dying a horrible protracted death you're disabled for the rest of your life, carrying around what amounts to at least one dead limb with you forever. Yeah, that's some immunity you get there, damn disease-worshiping fools".
Well Julian, was this before or after the mass "herd" was injected with Saulk's polio vaccine? He infected tens of thousands with the crap - including himself and child.
People are bound to make repeat mistakes. Vaccines and history are proof of that nonsense.
Posted by: Dawn | August 22, 2008 12:39 AM
Please read Dr. Jay Gordon's post at 11:22 p.m. Read it and weep you fools.
Posted by: Dawn | August 22, 2008 12:45 AM
2cents:
What do you mean "HIV-tainted" drugs. How can a drug be HIV-tainted?
Posted by: Undergraduate-gal | August 22, 2008 12:54 AM
Measles Free, I'm going to have to disagree with you on that one. I understand what you're saying, but you have to look at it from a parent's perspective. Calli Arcale summed it up nicely. Vaccination is a scary business for many parents. They go into the pediatricians office thinking, "What if my child has a reaction? What if all those antivaccination people are right?" And then, they see all of this stuff about Merck and Co. lying about safety studies, and they think to themselves, "If they lied about something like that, could they also be lying about vaccines?"
Calli did a good job of stating that it isn't a huge leap from doubting drug companies to doubting vaccines made by drug companies. It's an interesting conundrum. How do we rebuild the trust of the public? How can we get them to trust drug companies and vaccines? I agree with Orac and his previous article 100%. The medical community and scientists need to step up and put firmer guidelines and stipulations on the marketing engines within the pharmaceutical industries. Right now, the public perception is that money is running the show, and I firmly believe that science should be running the show.
Posted by: Just My 2 Cents | August 22, 2008 1:00 AM
Undergraduate-gal, here's the article.
http://www.cbsnews.com/stories/2003/05/22/health/main555154.shtml
Posted by: Just My 2 Cents | August 22, 2008 1:02 AM
Dawn,
Please provide a link to a published source for your information.
According to the State of Wisconsin (pdf), the first case in 2008, occurred in a 37 year old man with no documented immunization for measles.
The CDC has sequenced two isolates from Wisconsin and they are genotype H1, which is the endemic measles genotype in China.
Posted by: franklin | August 22, 2008 1:16 AM
Ah...another vicotry.
A victory for idicoy over intelligence.
A victory for irrationality over evidence.
A victory for the smug, failed ideas of the few over the good will of the many.
A victory for ignorance over knowledge.
I suppose that it should have been expected. Mass vaccinations have done so much good in the world, prevented so many deaths, that it really was over due for someone coming in an stuffing the whole thing up.
Posted by: ChrisC | August 22, 2008 1:18 AM
Ah...another vicotry.
A victory for idicoy over intelligence.
A victory for irrationality over evidence.
A victory for the smug, failed ideas of the few over the good will of the many.
A victory for ignorance over knowledge.
I suppose that it should have been expected. Mass vaccinations have done so much good in the world, prevented so many deaths, that it really was over due for someone coming in an stuffing the whole thing up.
By the way Dawn, if you are going to attempt to make a point, please stop for a moment and think about how you are going to express it. For example:
"Well Julian, was this before or after the mass "herd" was injected with Saulk's polio vaccine? He infected tens of thousands with the crap - including himself and child.
People are bound to make repeat mistakes. Vaccines and history are proof of that nonsense."
doesn't actually make any sense... even in the context of you responding to Julian. People might take you a little more seriously if you... well... you know... approach the topic with a little thought and logical, and a bit less ... well... nonsense.
Posted by: ChrisC | August 22, 2008 1:22 AM
Crap...triple post...my apologies everyone!
Posted by: ChrisC | August 22, 2008 1:27 AM
Dawn,
In addition to Jay Gordon's post: Measles, especially milder cases, is notoriously difficult to diagnose absent a blod test. Considering the size of these "outbreaks", it doesnt take a lot of misdiagnoses to inflate the numbers significantly. The doc. will be more likely to diagnose you with measles if you're unvaccinated or partially vaccinated. This from an official provax infomercial:
In non-epidemic circumstances measles is difficult
to diagnose accurately. Therefore, mild viral illnesses causing a rash may be labelled as measles.
A lot of cases of mild poisoning involve a rash,
I think you can guess why measles suddenly become easier to diagnose when its epidemic. The numbers supposedly decrease the statistical risk of clinical misdiagnosis.
.
Posted by: Undergraduate-gal | August 22, 2008 1:29 AM
Undergraduate-gal,
Please provide a citation for your source.
Posted by: franklin | August 22, 2008 1:39 AM
2cents: Thanks
Franklin: I chose this particular source because it included the part about (non-)epidemics. But I can't imagine the info would come as a surprise to you. There are dozens of similar references if you google measles and diagnosis. It should be even easier for seasoned pubmed. jockeys
http://72.14.235.104/search?q=cache:4usMWvWpLwcJ:www.sehb.ie/search/publications/mmr/mmr_q1.pdf+Measles+difficult+to+diagnose&hl=en&ct=clnk&cd=3&gl=uk
Posted by: Undergraduate-gal | August 22, 2008 1:54 AM
Oops that was the general URL. Here's teh specific reference:
http://www.sehb.ie/search/publications/mmr/mmr_q1.pdf
Posted by: Undergraduate-gal | August 22, 2008 2:00 AM
2 Cents:
From your link there simply is no evidence to conclude what you concluded in your second post. Even concluding that the decision was unethical cannot be determined.
AA:
Groups of intelligent people have done just as--if not more--seemingly dangerous things that aren't when Occam's Razor is applied. We've risked sending people to the moon using the Razor--asserting the most likely explanation of data to draw conclusions that led to the Apollo missions. Your argument is therefore weak and unpersuasive.
Posted by: your_homework | August 22, 2008 2:17 AM
To Jay (sorry,coming a bit late):
"The measles outbreak of 2008 will probably be comprised of an extra 150 cases over the usual annual 45. In a population of 350,000,000 Americans, you and any other scientist would have deemed this "statistically insignificant" if it suited your purposes."
Obviously, you misunderstand what statistically significant means:
You observe a variable (number of measles) over some time and plot the distribution of this variable. You fit it with an appropriate curve (often a Bell curve). You determine a standard deviation. If you encounter another data point lying more than 3 (that's not necessarily the factor, but a frequently used ne) times the standard deviation away, you consider the result significant. It does not matter how small the absolute number is. Otherwise I could say "Why bother about 9/11? 3000 death in a world population of 7 billion is not statistically significant."
Posted by: Martin | August 22, 2008 2:30 AM
You forgot "unethical".
Posted by: Dunc | August 22, 2008 5:33 AM
UGG, in the UK at least, suspected measles diagnoses are confirmed, usually with a combination of an antibody and PCR test for the virus. So it isn't just a case of looking for a rash. The increase in cases we have seen over here, is, sadly, all too real.
In the UK there has been an increase in cases - the possibility of an epidemic in Hackney, East London has resulted in a lot of publicity about the negative effects of the disease. Vaccine uptake rates have recovered, but at around 85% immunisation rate nationally over here, things are not looking great.
The other thing about herd immunity is that it protects those who, for whatever reason are unable (not unwilling) to have the vaccination. So in addition to exercising a choice not to vaccinate your child, you are putting people at risk who don't have any choice...
Posted by: Dee | August 22, 2008 6:27 AM
"The measles outbreak of 2008 will probably be comprised of an extra 150 cases over the usual annual 45"
And what about the measles outbreak of 2009, 2010, 2011 etc....unless you believe that these things happen in isolation of course?
Who would you blame for the fact that vaccine preventable disease is once again hospitalising and killing children?
Posted by: Kev | August 22, 2008 6:27 AM
With all due respect, Dr. Gordon, I decide what is and is not "worthy" of me on this blog. But thanks for your concern.
Martin pretty much demolished your "rationale"; so I don't see the need to add much. However, yes, a quadrupling in one year of the number of measles cases is definitely of major concern, especially when the outbreaks are occurring in regions with low vaccine uptake. Moreover, when taken together as a confluence of events including decreased vaccine uptake allowing isolated outbreaks to become more common and numerous, antivaccine propaganda being copiously pumped out by Jenny McCarthy (who's gearing up for another round of antivaccine propaganda this month with her book), J.B. Handley, and like-minded conspiracy theorists, coupled with the clear concern among pediatricians who are having to refute pseudoscientific antivaccine nonsense being promulgated on the Internet, and I really do think that this is just the beginning. I'd really really love to be wrong about this. Public health and healthy children matter far more to me than a little egg on my face for being Chicken Little. But right now I don't think I am wrong--unfortunately. The U.K., after all, led the way and showed us what can happen. Measles went from being eradicated 14 years ago to being endemic again, all because