Vaccinated person transmits measles to other vaccinated people-- MMR doesnt work?

Spoiler to apologize for click-bait title:

Yes, the MMR vaccine works just fine.

But there is a difference between 'just fine' and 'perfectly'.

A few things I would want in a 'perfect' vaccine-- Only one dose is needed, zero side-effects, 100% protective antibody or CTL mediated immunity for life, inability of the target pathogen to evolve resistance to the vaccine, dirt cheap, can be stored at room temperature (but stable at high/low ambient temperatures), doesnt need to be administered with a needle-- Im sure you and I can think of a lot more.

But we dont live in a world where 'perfect' vaccines exist. Thats because 'perfect' immunity doesnt exist. Due to the nature of our immune systems, 'perfect' vaccines are not even possible. I spoke about this at length at the first FreeOK:

Kevin has a few posts up at emmunity to help describe this too-- Our immune systems are little evolutionary systems of random mutation and natural selection. How we react to a pathogen is chance and luck with a bit of guidance (but that guidance cant see into the future to see the full implications of evolutionary 'decisions'). People do not make identical antibodies to the same vaccine/pathogen, and you cannot predict what kind of antibodies someone will make, any more than you can predict what humans will look like in 1 million years.

As much as anti-vaxers want to down-play the 'few' lives that are lost to chicken-pox or hepatitis B or influenza every year-- every time a person dies, well, thats a 'failure' of our immune systems. The 'right' mutations didnt happen, or were not selected for.

Happily, we have vaccines to help make our immune systems less likely to fail. They give our immune systems a head-start, if we are ever exposed to the dangerous pathogen. But, sometimes our immune systems can fail in regards to the vaccine, too-- either by ignoring the vaccine and not making a good response, or making a good response and then 'forgetting'.

But, if EVERYONE gets the vaccine, then the people who get the vaccine but 'fail' are still protected. As I said at FreeOK, you, me, any of us might have a 'failed' response to, say, MMR-- but we wont know it until some jerk with measles is sitting on the same bus as us. EVERYONE gets vaccinated, enough are protected to save the people who cannot get vaccinated for medical reasons, or got vaccinated and unbeknownst to the host, the immune system failed.

You will be shocked, SHOCKED, to find out that an anti-vaxer doesnt understand the basics of how our adaptive immune response works, and thinks the reemergence of eliminated diseases is totally not anti-vaxers fault:

Should You Trust 'The Daily Beast' About Vaccines?

Never heard of the guy, but hes one of Oracs BFFs (lol).

He references this paper:

Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011

And concludes:

Did you get that? A twice-vaccinated individual, from a NYC measles outbreak, was found to have transmitted measles to several of her contacts.  That's a piece of evidence that The Daily Beast and their fictitious author are falsely implying does not exist. You can't blame non-vaccinating parents in pogrom like disgust and hatred for the morbidity and mortality of infectious diseases when even the vaccinated infect others who are also vaccinated; doubly disproving their efficacy.

First, the paper. The paper is very cool. Its like nutbars have a superpower-- the ability to turn cool papers into absolute derpitude. Ugh. No, this paper is the first documented case of a vaccinated person transmitting measles to other vaccinated people, *very* cool.

Usually if you have been vaccinated, and your immune system failed, you still make *some* kind of immune response. Even if its crappy, it still gives you a head-start if you are exposed to the pathogen, limiting the symptoms/duration of the disease. So, you might get measles, instead of MEASLES. This limits the disease, and limits the ability to transmit virus to a new host.

The patient at the center of this paper did make a crappy immune response to the vaccine, but this response was not enough to prevent her from transmitting to other people... who also made a crappy immune response and/or their immune system 'forgot' its good response.

This paper is the *first time* it has been demonstrated that a vaccinated individual infected other vaccinated individuals with measles. Academically, that is cool. We have had the luxury of being able to 'ignore' people who dont respond to MMR because the percentage is so low, they were protected by herd immunity anyway. But now that we have all these anti-vax jackasses flying round the world, we have to seriously look into this issue. We have to figure out a way to protect the people who are doing everything they are supposed to do to protect themselves and other people.

Regarding the claims of Oracs BFF--

You can't blame non-vaccinating parents in pogrom like disgust and hatred for the morbidity and mortality of infectious diseases when even the vaccinated infect others who are also vaccinated...

As they plainly state in this paper, 87% of the measles infections in the US in 2011 were in unvaccinated individuals. 87% of people were at '100% vaccine failure' because they didnt get the vaccine. They exposed others to the virus. 87% unvaccianted means 9.4% of people were vaccinated, but their immune system failed, so they were infected with measles by unvaccinated hosts. And 8 people-- 3.6% of the measles infections in 2011-- were infected by a vaccinated individual... who was infected with measles by an unvaccinated individual.

Unvaccinated people were directly and indirectly responsible for all of that.

So what would happen if everyone was vaccinated with two doses of MMR when they are little? What if those unvaccinated people werent around? Well, we know what happens. When MMR uptake rates are high, then the vaccine failure group is still protected, and endemic measles is eliminated. This isnt a hypothetical. We know this would happen because measles *was* eliminated in the US. It wasnt until the MMR 'scare', when people stopped vaccinating their kids, that MAGICALLY, measles reemerged in the US.

Vaccinated people infecting other vaccinated people is a frustrating, but rare novelty. But unvaccinated people transmitting viruses to everyone else? Thats old news, homeboy.

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Hey, thanks for the plug :-D

I should not that the animations and graphics you linked to were made by Matt Woodruff, though he has no online presence other than at emmunity, so I'm happy to take the credit.

Also, this post in infuriating. The idea that a single counter-example DISPROVES! all of immunology research of the last 150 years would be bad enough, but the fact that that supposed counter example is actually completely consistent with 150 of research...

Ugh... I almost want to believe these people are trolling us and don't actually believe the shit they're saying, despite all evidence to the contrary. Which I now realize is a sentiment that itself demonstrates the expansive capacity of the human brain for cognitive dissonance and stupidity.

You responded fast... didn't see your comment until now...


I will almost certainly teach this paper my students next year from the angle of 'natural' (hahahahaha) boosting of immunity.

You vaccine near-as-dammit everyone. Your vaccine efficacy and length of protection is estimated in a measles-endemic/epidemic environment. Measles rates drop to zero because you campaign has been so successful. Your vaccinated population no longer gets the 'natural' boosters of being constantly - or even periodically - exposed to measles antigens. Immunity is waining faster than expected in currently vaccinated populations (who may have got their jab 5-25+ years ago, with no antigenic exposure since the final dose).

Once again, vaccines (as with parents who say "oh MY child won't get measles, that's not a first world disease!") are a victim of their own success. We may need to consider giving adults measles boosters. Front line health workers and school staff would be sensible places to start.

I loved your video. I found out a lot from it. Thanks!
Near the end, you referred to Nef gene, and about some people who got infected in Australia in the 90s. I googled it but couldn't find any information that could fit in my non-biologist brain.
I would be sooo grateful if you could expand on that case, explain in plain English, what Nef does, how and why did it disappear, to then reappear, independently, in each of the patients.

Thank you so much again!

Oh, and for future reference, there is a simple, but good simulation to help understand herd immunity:

Hi I saw the title of your blog and I was baffled as to how vaccinated people could transmit measles to other vaccinated people. I think ever since I first knew what vaccination is and its purpose, the idea of possibly being infected with chicken pocs or measles never crossed my mind because I assumed I was safe.
However based on the statement you made that "Our immune systems are little evolutionary systems of random mutation and natural selection" and that "People do not make identical antibodies to the same vaccine/pathogen, and you cannot predict what kind of antibodies someone will make", since scientists know this that people are different therefore shouldn't more than one vaccine be produced according to the type of antibodies people produce? Would it not be possible for a study to be conducted where people of different sex, race and maybe even class are tested to see what type of antibodies they produce and therefore what type of vaccines can be produced. Since humans evolve, the same meds/vaccines that were developed 20 or 30+ years ago cannot be expected to have the same effective results on the new human generation.
Is it not the responsibility of the department of health to employ specialists that will ensure that vaccines are updated according to how the human body changes over time? Also taking into account that evolution may apply to viruses as well?

By NST LUSHABA 14333938 (not verified) on 29 Apr 2014 #permalink

Well nothing in this world can be given the title "100%", the only thing to be done is to actually approximate. "Measles vaccine is usually administered as MMR, a combination vaccine that provides protection against three viral diseases: measles, mumps, and rubella. The MMR vaccine is strongly endorsed by medical and public health experts as safe and effective"( Our immune system do not work the same, one immune system might accept the MMR and the other might not. Getting vaccinated is actually the best way to prevent measles. The most unfortunate thing is that these vaccines may turn out to be very dangerous for the body. It is very vital that before a vaccine is accepted by the medical department , its side effect may be listed and known. This will ensure that more research may be done on ways that can decrease the consequences of the effects of certain vaccines. The only way a person who is vaccinated can infect the next person is as if only the next person has not yet received vaccination. People must be familiar with these vaccinations to prevent themselves from being vulnerable to the diseases

By Mamaila Manaka… (not verified) on 01 May 2014 #permalink

This is a very interesting topic and its really thwarting to discover that vaccines are nto reliable and that measles can be transmitted by a vaccinated person to a person who is not vaccinated, with such great emphasis placed on being vaccinated for measles in schools etc. worldwide. Its well likely that the immune system recognizes the vaccine as foreign material etc. it came to mind that Nanotechnology can be used to fortify or ameliorate the vaccinnes. Nanotechnology has the ability to combat infected cells in the immune systen and body system.Think about it once the infected cells are destroyed the bacteria of measles cant be transmitted and everyone will be safe and protected. it is the goverment's responsibility to ensure that vaccines are compatible to the immune system and human body.

By Pearl Booysen … (not verified) on 01 May 2014 #permalink

Scientists say that ethnicity plays a role in how likely a vaccine is to work but surely the distinction between ethnicities is becoming less defined due to more cultural interaction. Hopefully this will make the development of effective vaccines easier in the future.
Communication between countries has become far easy thanks to modern technology. Perhaps scientists from different backgrounds and continent could find a way to work together to produce an internationally effective vaccine. This might decrease the likelihood that people who travel a lot will spread a different strain of the disease. Removing yet another of the obstacles to the production of effective vaccines.
Do scientists consistently test vaccines to ensure that they are still effective against a disease? I know that diseases evolve so the vaccine probably has to too, right?

By Michelle Magli… (not verified) on 01 May 2014 #permalink

The fact that 87% of measles infections in the U.S. in 2011 occurred in unvaccinated people speaks for itself. In developing countries measles are one of the top four causes of death in children. Five out of a hundred children who contract measles will probably die, and survivors are often left with disabilities such as blindness, deafness and brain damage. Before the measles vaccine, 90% of children developed measles before the age of 15.In first world countries death because of measles are very rare. Allegations that vaccines cause autism could never be proofed. The fact is the vaccine does not give a 100% protection but it sure is the best option we have by far.

By Marike Naude (not verified) on 01 May 2014 #permalink

This is a very interesting and informative topic especially since everyone should know and understand this concept. I agree with the writer that the best thing we can do for our future is to all get vaccines for all and every disease possible, considering all our bodies react differently to different vaccines. But it can also be quite scary knowing that the same vaccine that you get might not be as effective as the one your neighbour received. I agree with a previous post that the evolution of viruses and vaccines must seriously be monitored if we want to eliminate these life-threatening diseases. Not only with all this research provide new jobs for people but it might also help cure some aliments for which cures have not been discovered yet. But if scientists knew that everyone is different and their bodies will react differently in different situations then why was only one type of vaccine approved that was said to be effective in everyone?

By Natalie Loffle… (not verified) on 01 May 2014 #permalink

Did some South African class get instructed to all go post a comment on this blog?

I always follow the slogan which says "IF YOU NOT RACKING YOUR MIND OUT SURELY YOU WOULD NEVER BE A SCIENTIST'. Thanks to them as they always bring about new things in life that at times help us with our daily living to being in good state of health.
vaccination is just the best way one could use to prevent a certain outbreak of a disease, I believe so why because I've twice vaccinated for flue every time winter season is approaching just to be on the safer side in health.
Though the above article has brought it to my attention that some vaccines cannot be reliable I think it is bearable because yes we different being with different immune systems; some being weak and some being strong. But what I may suggest is that viruses announced to be pandemic should be clearly researched about so that the vaccine is also monitored to prevent spread of diseases even if you have vaccinated as the vaccine may not be the one deserving to be used in your body.

By 14232032 nonto… (not verified) on 01 May 2014 #permalink

I personally found this article very informative considering the fact that ive gone my hole life thinking im immune to some diseases just because ive had my shot. Being vaccinated obviously has a downside because of the fact that people are so different. I think because people are so different scientists should maybe start looking into personal medication, like creating a vaccine for a specific tipe of person so that the vaccine can work more accurately and give the person a better chance at dodging an infection.

By Charissa Hickman (not verified) on 02 May 2014 #permalink

This goes to show that nothing in life works perfectly and even our vaccinated selves are still vulnerable to the disease even though we are vaccinated. I thought being vaccinated against measles made sure that you are perfectly safe from the disease, clearly not! What happens if you are given a double dose of the vaccine? Does the chances of getting the disease decrease or do they remain the same?

By Kwando (14125651) (not verified) on 03 May 2014 #permalink

I agree that we will never find a perfectly working vaccine because vaccines cannot cure all diseases and it will take a lot o research for us to have a very affordable easy to use vaccine. Researchers are surely working on developing vaccination intakes. It baffled me that vaccinated people can still transmit the deceases they have. This fact shows that our current vaccinations clearly isn't reliable and that serious research should be going into improving the vaccinations because it is a very big problem for humanity if the transmission of vaccinated diseases can still be a threat to us.

By Anton Venter (… (not verified) on 03 May 2014 #permalink

It's hard to believe that there are people out there who dislike Vaccinations so much that they attempt to fight against decades of empirical reasearch into vaccines. I sincerely believe that they just read to the point where it's said that a weakend virus is used and then they shoot up and scream; "THEY ARE TRYING TO KILL US ALL!!! DON"T BELIEVE THEIR LIES!".
Some may have legitimate problems with vaccination (freedom of choice and all that) but i believe most are mostly uninformed about the extent the vaccine helps and how much it cannot kill you.

It must be hard living life as a paranoid germaphobe

By Sid Offit (not verified) on 08 Jun 2014 #permalink

Spoiler: the measles is a mild illnesses

By Sid Offit (not verified) on 08 Jun 2014 #permalink

It must be hard living life as a paranoid germaphobe

Not as hard as being a pretend publisher with a habit of lying about having published books on child rearing, Bob.

Oh, and being reduced to necromancing six-week-old posts solely for the sake of making an ass of yourself.

@Sid "slimeball" Offit:

Spoiler: the measles is a mild illnesses.

You should tell that to Olivia Dahl. Oh wait, you can't. Measles killed her.

By Julian Frost (not verified) on 09 Jun 2014 #permalink