Thursday, May 01, 2008

Measles outbreak a direct consequence of vaccine rejectionism

Exactly as predicted, in exactly the way predicted, there has been an outbreak of measles in the US. According to the CDC, the disease was brought into this country by travelers, and caught by children whose parents had rejected measles vaccination. Of note, almost a third of the cases were in babies who were not yet immunized. This is precisely what one would expect as a result of vaccine rejectionism: a substantial proportion of the victims are infected by exposure to children who should have been vaccinated. In other words, the decision by vaccine rejectionists to be free riders, taking the benefits of mass vaccination without partaking of the risks of individual vaccination, victimizes other people's children.

Prior to 1963 when the measles vaccine was introduced, there were 3-4 million cases of measles per year, 48,000 hospitalizations, and 400-500 deaths per year. Measles had been effectively eliminated in the US by the year 2000. Measles still exists in other countries and can easily be imported by travellers. Of course, it always could be imported by travellers, but herd immunity prevented spread of the disease. Now, as a result of vaccine rejectionism, herd immunity has been reduced and the disease can take hold and spread. Of the 64 documented cases thus far, 63 occured in individuals who had not been vaccinated.

It would be bad enough if vaccine rejectionists were harming only their own children, but a substantial proportion of the cases have occured in children who are too young to be vaccinated. The youngest members of society are protected from vaccine preventable diseases by the fact that everyone else is vaccinated. When the disease cannot take hold in the population, there is virtually no chance for a baby to be exposed to that disease. Out of the 64 documented cases of measles, 20 occured in babies and toddlers who had not yet been vaccinated.

Where did the exposures take place? Evidently vaccine rejectionists took their ill children to pediatricians' offices where they infected babies who were there for well baby visits. Think about that for a moment: babies whose parents were doing everything possible to keep them healthy caught a life threatening disease because of the ignorance of parents who don't understand immunology, don't understand statistics and don't understand risk.

To date, 14 of the 64 patients have been hospitalized, most with pneumonia. Fortunately, there have been no deaths yet. In addition to the 64 reported cases, 8 unvaccinated siblings in one family have contracted measles within the past week, and 3 appear to have pneumonia.

Vaccine rejectionism is dangerous. It harms the children who are not vaccinated, and it harms unrelated children who are too young to be vaccinated. Make no mistake about it, vaccine rejectionism is unethical as well as the result of scientific ignorance. Parents who reject vaccines implicitly rely on other people being vaccinated. They are willing to accept the benefits, without partaking of the risk. They expose their own children to life threatening illness, and they expose other people's children to life threatening illness. The government should act to restrict vaccine waivers to only those with medical indications for forgoing vaccination. The right to indulge one's philosophical beliefs ends at the point where it threatens the life and health of other people's children.


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