Dear parents, let’s talk about measles

Vaccine superhero
Thanks to vaccines, L. is protecting other kids in her community. And by avoiding illnesses, she has more time for important stuff, like being a superhero. Photo by Colin McRoberts

Dear parents,

Livia, with permission of her mother
This is Livia. An unvaccinated child with measles potentially exposed her the disease, so she spent one of her first six months in quarantine. Photo courtesy of Jennifer Simon

You’re probably aware that measles has been in the news a lot lately. We need to talk about it again, even if you feel like it’s old news, because of Livia, Rhett, and Cami.

The disease that was virtually eradicated 15 years ago in the United States is spreading in pockets around the country with over 84 infected individuals in 14 states so far this year.

Unlike Ebola, measles is very easy to catch. It can infect a child if he or she breathes in a room where a sick person coughed or sneezed within the last two hours. And because people are contagious four days before they have any sign of a rash, it’s often spread by people who have no idea that they (or their kids) are infected. 90%  of unvaccinated children will become infected if they’re exposed to someone with measles. (You can find more information here).

This means that the disease can spread rapidly once it has a foothold in the population. Last year, for example, an outbreak among an Amish community infected 383 people. This year, most of the infections so far are linked to exposure at Disneyland, and there is concern that the number of outbreaks may continue to rise.

And measles is a very serious disease. 30% of people infected—particularly children under the age of 5 and adults over the age of 20—will develop complications.  One or two children out of every 1,000 who contract measles will die from it, and about the same number will develop encephalitis that can cause seizures or mental retardation (See the CDC’s list of complications here).  It’s very telling that older people, who have lived in a time before modern vaccines were developed, who remember what it was like to have outbreaks of diseases like measles and polio, overwhelmingly support vaccination.

(Some people, arguing from ideology rather than an understanding of the facts, will tell you that measles is no big deal to claim their fifteen minutes of fame. They can’t acknowledge how harmful measles can be without also acknowledging how dangerous their advice is. That gives them a very heavy bias to believe that measles is just one of those things kids have to suffer through to grow up. The facts are clear, and measles can kill.)

A.M., who is not actually a doctor yet, used by permission of her parents.
Doctor A.M. knows how important it is for babies and puppies to be protected from dangerous pathogens. Photo by Colin McRoberts

But you know this, and you’re trying to do the right thing. You feed your children healthy food, encourage them to exercise, and like the huge majority of parents in America today, you get your children vaccinated as part of their healthy lifestyles.

Unfortunately, some people are choosing not to vaccinate their children. As a consequence there are little pockets of unvaccinated children throughout the country.

You know this is a problem, because they could potentially infect children too young to receive vaccines.

Like Livia

They could potentially infect children and adults with weakened immune systems who can’t receive the vaccine.

Like Rhett.

They could potentially infect children and adults for whom the vaccine doesn’t work quite right for various reasons.

Like Cami.

If you’re angry about this, you’re justified in feeling that way. Goodness knows that there are enough dangers in the world that you can’t protect your child from. Measles (and mumpsrubellaHPVinfluenzapertussischickenpoxtetanushepatitis a and bis something we can protect our children from. And it may make you angry that some parents refuse to do what they should to prevent them in their children, thereby putting the population at risk.

But however much it might make you feel better to post angry comments online about this, it’s counterproductive. That’s the most frustrating thing of all—no amount of scientific information will convince them otherwise, and people who are sitting on the fence with this debate may join up with the anti-vaxxers if they identify with them.

So what can you do?

Talk to other parents.

Parents don’t vaccinate their children for many different reasons. For some, it’s lack of access to good healthcare, and healthcare information. For others, it’s a part of a lifestyle. A few parents won’t change their minds no matter what.  They have been lied to, and they’ve bought into those lies. They’ve even found a few unscrupulous doctors happy to profit by bolstering their opinions. These parents won’t change their minds, because that would mean that they’ve been wrong about their understanding of how the world works, and that they’ve actually been harming their children through their beliefs when they meant to protect them. If you put yourself in their shoes, I’m sure you can understand how difficult changing your mind under these circumstances would be. However wrong they are, it’s counterproductive to keep arguing with them or call them stupid—because they aren’t!—and it’s a waste of your time.

But most of the anti-vaccine rhetoric is coming from only a tiny group of people. They don’t speak for you. Most parents vaccinate on-time, just like you do and just like pediatricians do. It’s very important that you make your decision to do so public and visible, and your reasons for doing so clear.  In that way, you may reach parents who are sitting on the fence; they have some concerns about vaccines, but they’re not totally committed to the anti-vaccine movement.

Understand that you do have the power to change these parents’ minds if you talk to them with patience and understanding.  Let them know that you vaccinate yourselves and your children not only to protect your family, but to protect other families. Listen to their fears without shouting at them. Let them know that you understand their fears, but share with them the huge amount of scientific research–done by physicians and scientists who are also parents– that has tested vaccine safety and has shown you that vaccines are safe and effective.

A healthy, happy, fully-vaccinated aunt and niece and nephew. Photo by Colin McRoberts

Believe it or not, you have a great deal of power to bring about change. These playground conversations and shared stories are the most effective way of improving parents’ understanding of the benefits of vaccines.

Do it for your kids, and theirs, and Livia and Rhett and Cami.

22 thoughts on “Dear parents, let’s talk about measles

  1. Kathleen Burke January 31, 2015 / 6:12 pm

    I completely agree. I am so glad I vaccinated my children!!

  2. Paul K. Strode January 31, 2015 / 7:05 pm

    Reblogged this on Mr. Dr. Science Teacher and commented:

    “A few parents won’t change their minds no matter what. They have been lied to, and they’ve bought into those lies. They’ve even found a few unscrupulous doctors happy to profit by bolstering their opinions. These parents won’t change their minds, because that would mean that they’ve been wrong about their understanding of how the world works, and that they’ve actually been harming their children through their beliefs when they meant to protect them.”

    • Patrick February 8, 2015 / 1:45 pm

      “Vaccines are safe and effective.”

      If this is true why are vaccine manufactures given immunity from being sued. If a child is vaccine injured they must go to federal vaccine court for a monetary award.

      Why don’t you lobby the vaccine makers and scientist to change the law and allow patents the right to sue the vaccine maker directly if they believe their child had been injured by a vaccine?

      Vaccine makers threatened to stop making vaccines unless the were protected from lawsuits. And the Supreme Court recently ruled vaccine makers can not be sued if they know of a safer way to make a vaccine but choose not to due to being protected from lawsuits.

      This is fact not lies.

      • reissd February 8, 2015 / 2:22 pm

        During the 1980s, a TV show raised the idea that the DTP vaccine causes brain damage to the national awareness. Later studies showed that’s not the case. But many lawsuits were brought, and some won, even when the evidence was shaky. So manufacturers were leaving the market.

        Concerned about the vaccine supply and diseases coming back, Congress stepped in. The act that resulted had two goals:
        A. Protect manufacturers from liability.
        B. Give petitioners an easier process than the courts.

        It’s inaccurate to say manufacturers cannot be sued, though. Under Bruesewitz v. Wyeth they cannot be sued for design defects, but they can be sued for other kinds of claims – like manufacturing and warning defects.
        And the program offers petitioners an easier forum with lower standards of proof and appeal to the federal courts.

        Why would I oppose abolishing NVICP and going back to the courts?

        I. The profits from vaccines aren’t high enough that manufacturers will stay in the market with the threat of liability through our uncertain judicial process – and I want children protected from disease, because I care about children.
        II. Going to the court will make it harder for those with real vaccine injuries to be compensated. Because they will have to meet much higher requirements, and not get lawyer fees covered. That’s unfair.

        In other words, it’s a bad idea all around – except for the few who cannot prove the vaccine caused their injuries, who think they may be able to get to a judge who does not know enough to reject the claim (unlikely) and lawyers, who would be able to collect a larger share.

        • Jennifer Raff February 8, 2015 / 2:24 pm

          Thank you, Professor Reiss, for your historical and legal contextualization of the issues.

      • Chris February 8, 2015 / 5:39 pm

        “This is fact not lies.”

        It is a partial fact. Try rounding it out with more data. For instance tell us the ratio of MMR doses and compensated claims between 2006 and 2014.

        The provide us the PubMed indexed studies by reputable qualified researchers that the MMR vaccine that has been used in the USA since 1971 (but modified with a better rubella component in 1978) causes more harm than measles.

        Also, provide us the relative costs of allowing the manufacturer of the American MMR to be sued out of business, which would stop all kids from getting the vaccine. Show us it is cheaper to treat the one out of ten with measles who end up in the hospital, than to keep preventing measles. Use this as your guide:

        J Infect Dis. 2004 May 1;189 Suppl 1:S131-45.
        An economic analysis of the current universal 2-dose measles-mumps-rubella vaccination program in the United States.

        • Chris February 8, 2015 / 5:46 pm

          Oh, great. Due to a router issue this comment took three hours to post. Le sigh.

  3. reissd January 31, 2015 / 8:18 pm

    Or talk to your legislators. Say you want better protections in place for children like Rhett, Livia and others who depend on herd immunity, as well as for your own children, who may suffer vaccine failure.

  4. thefairybug February 2, 2015 / 1:12 pm

    I have never believed in seatbelts being required by law. In the unfortunate event that a wreck occurs, you should have the good sense to be wearing a seatbelt. If you didn’t, then your own lack of common sense is your own fault. People’s lives are their own responsibility, not the law’s. But Measles is something that can kill the people around you, not just you. If you want to risk your own life, that’s fine; I don’t care. But nobody — and I mean NOBODY — has the right to risk the lives of other people around them for the sake of their own personal stupidity. If not vaccinating only posed a threat to the stupid people refusing to do it, I wouldn’t care. But this is risking innocent lives that are doing their best to be responsible, and are still helpless against the dangers non-vaxxers pose.

    • Chris February 2, 2015 / 1:29 pm

      What about securing children into proper car seats? Do you think it should be up to the parent to not hold a child on their lap in a car?

      • thefairybug February 2, 2015 / 1:53 pm

        Yes — parents, as the child’s guardians, are responsible for the child’s safety. Children, though not stupid by any means, simply don’t understand WHY somethings are dangerous, and have to have safety enforced for them sometimes until they learn why it needs to be done. That’s why we remove children from unsafe or abusive homes: because the parent is failing to do their job. Honestly, I believe parents who refuse to vaccinate are just as abusive as a parent who beats their child. They’re just letting the disease do the beating for them.

        • Chris February 2, 2015 / 2:02 pm

          I don’t understand. Are you saying that the law should not force parents to use carseats, but it is okay to remove the children when parents show ignorance on how to keep their children safe?

          • thefairybug February 2, 2015 / 3:21 pm

            I’m sorry if I’m not being very clear — what I’m saying is that people should not be required by law to protect their own lives, because that’s their own business. But they should be required by law to not endanger the lives of others with their actions or inactions. The law absolutely should require that children be kept safe by their legal guardians — children don’t always know how best to keep themselves safe, so it falls to their parents. When I said ‘seatbelts’, I was referring to adults too stupid to take care of their lives even though they should know better. And yes, I do believe children should be taken away from parents who, through action or inaction, fail to keep their children safe. Accidents are one thing, but deliberately failing to do something that’s good for your child is another. This is especially true when failing to do something that overwhelming evidence says is not only good for your child, but good for the people your child encounters.

  5. Mary Joan Koch February 3, 2015 / 2:12 pm

    All states require public school students to be immunized. The problem is there are exemptions for religious and philosophical reasons as well as valid medical ones. Mississippi and West Virginia are the only states who don’t permit the religious and philosophical exemptions. Mississippi has the highest child vaccination rate in the country. State legislatures need to be persuaded to follow Mississippi’s and West Virginia’s lead.

  6. Sarah February 4, 2015 / 8:14 am

    This whole thing breaks my heart. I live in an area where I meet a lot of people who don’t vaccinate or who “vaccinate slow” and they come from all walks of life, different educational backgrounds, different political opinions, religions. I wish there were a way to communicate risk, to help people to really understand the literature. They’re all making these choices thinking they’re doing the best thing for their children. If anything they’re not neglecting their kids, they’re being hyper vigilant against a risk that doesn’t exist and at the same time putting other people, like the kids in this article, in danger.

  7. zaclem01 March 25, 2015 / 9:18 pm

    I fully intend on vaccinating my child when he or she is born. I still can’t believe anyone would do otherwise.

  8. Olivia April 16, 2015 / 9:43 pm

    I plan on vaccinating my children when I have them, but I have friends and family that have decided not to. Can you, Dr. Raff and other commenters weigh in on some of the arguments I’ve heard from these friends? What are your thoughts on vaccine safety experiments/tests being done with other vaccines as placebos instead of saline solution? And what do you think about the argument that diseases were already on the decline before vaccines were introduced? links shown to me illustrating the decline of disease:
    http://www.vaclib.org/sites/debate/web1.html and http://www.healthsentinel.com/joomla/index.php?option=com_content&view=article&id=2654:united-states-disease-death-rates&catid=55:united-states-deaths-from-diseases&Itemid=55

    • Chris April 16, 2015 / 11:23 pm

      First look up the Belmont Report.

      Death rates are not valid statistics to measure decline of the actual diseases. Decline in deaths from measles, pertussis only indicate improvements in medical care, like the use of ventilators and antibiotics.

      Seriously, look at the following census data and tell when measles rates went down and stayed down before 1963:

      From http://www.census.gov/prod/99pubs/99statab/sec31.pdf
      Year…. Rate per 100000 of measles
      1912 . . . 310.0
      1920 . . . 480.5
      1925 . . . 194.3
      1930 . . . 340.8
      1935 . . . 584.6
      1940 . . . 220.7
      1945 . . . 110.2
      1950 . . . 210.1
      1955 . . . 337.9
      1960 . . . 245.4
      1965 . . . 135.1
      1970 . . . . 23.2
      1975 . . . . 11.3
      1980 . . . . . 5.9
      1985 . . . . . 1.2
      1990 . . . . .11.2
      1991 . . . . . .3.8
      1992 . . . . . .0.9
      1993 . . . . . .0.1
      1994 . . . . . .0.4
      1995 . . . . . .0.1
      1996 . . . . . .0.2
      1997 . . . . . . 0.1

    • Chris April 16, 2015 / 11:41 pm

      Here is measles incidence and death rates from the CDC Pink Book Appendix G. So when did measles cases decline and stay down before 1963?

      Disease: Measles in the USA
      Year__Cases____Deaths
      1950__319,124__468
      1951__530,118__683
      1952__683,077__618
      1953__449,146__462
      1954__682,720__518
      1955__555,156__345
      1956__611,936__530
      1957__486,799__389
      1958__763,094__552
      1959__406,162__385
      1960__441,703__380
      1961__423,919__434
      1962__481,530__408
      1963__385,156__364
      (^^ first vaccine licensed)
      1964__458,083__421
      1965__261,905__276
      1966__204,136__261
      1967___62,705___81
      1968___22,231___24
      1969___25,826___41
      1970___47,351___89

  9. Ummu Syifa April 21, 2016 / 5:19 am

    My daughter got Measles the day after she had Measles vaccines (on 9 months old). What’s wrong?

    I am moslem. As a moslem, I concern about halal too, not just about the chemical ingredients, that some people concerned with.

    Some vaccines still use porcine trypsin on the manufacture process. Later, I found that the DNA from porcine trypsin present in the end product of Rotavirus vaccine.

    That’s why, some moslem people decided not to vaccinate their kids. Because in my religion, it is prohibited to use some drugs (and also vaccine for prevention), that contain non halal stuff, for example like porcine.

    • Jennifer Raff April 21, 2016 / 6:32 am

      Hi, there are some good responses to this same comment of yours on the other post, explaining why your daughter couldn’t have gotten measles from the vaccine (measles takes longer to incubate than a day), and also gave you some information about the halal status of the vaccine. I hope those answers were helpful! Maybe if you share this information with your neighbors, they may feel better about vaccinating once they know that it doesn’t go against their religious obligations.
      (And I’m so very sorry about your daughter, that’s awful. I hope she is okay).

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