Thanks again, antivaccine activists. Thanks for the measles. Again:
Last year was the worst year for measles in the U.S. in 15 years, health officials said Thursday.
There were 222 cases of measles, a large jump from the 60 or so seen in a typical year. Most of the cases last year were imported — either by foreign visitors or by U.S. residents who picked up the virus overseas.
U.S. children have been getting vaccinated against the measles for about 50 years. But low vaccination rates in Europe and other places resulted in large outbreaks overseas last year.
One notes that this appears to be a disturbing trend over the last few years.
And, yes, Virginia, it was the unvaccinated who were mostly responsible for this uptick in measles cases last year:
Generally, the Americans who got measles last year were not vaccinated. At least two-thirds of the U.S. cases fell into that category, including 50 children whose parents got philosophical, religious or medical exemptions to skip the school vaccinations required by most states, CDC officials said.
In 2000, the United States achieved measles elimination (defined as interruption of year-round endemic measles transmission) (1). However, importations of measles into the United States continue to occur, posing risks for measles outbreaks and sustained measles transmission. During 2011, a total of 222 measles cases (incidence rate: 0.7 per 1 million population) and 17 measles outbreaks (defined as three or more cases linked in time or place) were reported to CDC, compared with a median of 60 (range: 37-140) cases and four (range: 2-10) outbreaks reported annually during 2001-2010. This report updates an earlier report on measles in the United States during the first 5 months of 2011 (2). Of the 222 cases, 112 (50%) were associated with 17 outbreaks, and 200 (90%) were associated with importations from other countries, including 52 (26%) cases in U.S. residents returning from abroad and 20 (10%) cases in foreign visitors. Other cases associated with importations included 67 (34%) linked epidemiologically to importations, 39 (20%) with virologic evidence suggesting recent importation, and 22 (11%) linked to cases with virologic evidence of recent importation. Most patients (86%) were unvaccinated or had unknown vaccination status. The increased numbers of outbreaks and measles importations into the United States underscore the ongoing risk for measles among unvaccinated persons and the importance of vaccination against measles (3).
We’ve been fortunate thus far in the U.S. in that we haven’t had any really huge outbreaks. Yet. Europe, however, has not been so lucky. In 2011, more than 30,000 cases were reported in Europe, 90% of of which occurred in France, Italy, Romania, Spain, and Germany.
Antivaccinationists will frequently ask why they should vaccinate their children with the MMR vaccine when measles is currently uncommon in the U.S. Of course, the primary reason that measles is so uncommon in the U.S. is because over the last few decades we have been able to maintain a generally high level of vaccine coverage. I would remind them that the U.K. had also achieved measles elimination back in the 1990s. Then Andrew Wakefield came along. With the willing help of sensationalistic British tabloids, he spread the myth that the MMR vaccine causes autism. Within less than a decade, measles came roaring back in the U.K.. It’s now endemic again in the U.K., thanks to plummeting MMR uptake rates. They’ll also ask why it matters to those whose children are vaccinated if they don’t vaccinate their kids. It’s true that vaccination against measles is very good, but it’s not 100% effective. That means that, because measles is such a contagious disease, even a certain percentage of the vaccinated are put at risk by the unvaccinated. Then there are children too young to be vaccinated or who have a medical condition that precludes vaccination. They rely on herd immunity for protection.
Another thing that antivaccine zealots frequently forget is that, like it or not, we live in a global society with a highly mobile population. A highly infectious disease like measles is only a plane ride away, and, in fact, that’s a common way that outbreaks in the U.S. get started. The oceans that we used to look to to isolate us from the rest of the world are no longer any protection against infectious diseases, and, unfortunately, Europe and other areas where antivaccinationists have succeeded in frightening parents to refuse vaccination for their children are now helping to spread the disease globally, including to the U.S. Is Europe a warning for the U.S. regarding measles? It could be. I worry that the U.S. is on the same path as the U.K. and Europe, just five to ten years behind them. If we allow vaccination rates to fall too much, in 2020 it’s not too far-fetched to imagine 30,000 cases a year in North America.
So, once again in light of this sort of news, I have to repeat a sentiment I’ve repeated a few times in the past: Rejoice, Jenny McCarthy, J.B. Handley, Jake Crosby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, Dr. Jay Gordon, Dr. Bob Sears, 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 appear to be 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 every time an unvaccinated person travels. And let’s not forget antivaccinationists in other countries, such as John Stone and Jackie Fletcher in the U.K. and Meryl Dorey in Australia. Because this is a global economy and society, it takes a global effort to degrade herd immunity in multiple countries around the world to make sure that measles.
Unfortunately for children, that’s just what we have.