Several news outlets today are reviewing the measles outbreak in Wales, citing public health experts who lay the blame for the burst in cases squarely at the feet of Andrew Wakefield’s bogus MMR vaccine scare in 1998 and the subsequent media coverage. The Wall Street Journal has a particularly in-depth story [hits paywall if you click the link here, butclicking from Google News seems to give full access], “Fifteen Years After Autism Panic, a Plague of Measles Erupts,” that digs into the roles of both in the Wales outbreak, that left 1219 people infected with measles and one in ten hospitalized. Most were hospitalized with pneumonia or dehydration, and most fell into the age range of children who should have been vaccinated around the time of the Wakefield scare.
One of the most common refrains people repeat in arguing against vaccinating their children is that diseases like measles simply aren’t their problem. That virus, they say, is a “third world” or “developing world” problem, something to worry about in places where water isn’t clean and nutrition is poor. Of course, that kind of insouciance about being a fortunate first-worlder is in itself misplaced; children in developed nations have died from measles. But the Wall Street Journal story makes an important point–one that yes, has been made ad nauseum but bears repeating: In this global society, there are no “first” and “third” worlds. A well-fed child with measles can take that infection anywhere, including to more resource-poor parts of the world where children live unprotected by vaccines. As Jeanne Whalen and Betsy McKay write in their WSJ piece:
The outbreak matters to the rest of the world because measles can quickly cross oceans, setting back progress elsewhere in stopping it. By 2000, the U.S. had effectively eliminated new home-grown cases of measles, though small outbreaks persist as travelers bring the virus into the country. New York City health officials this spring traced a Brooklyn outbreak to someone they believe was infected in London.
From London to Brooklyn or Wales to … anywhere. Terrible that unwarranted anxiety–flogged into a froth of vaccine resistance by the news media and opportunists looking for a buck–leads some parents to leave their children unvaccinated. Even worse if the result is an outbreak in places where children might not be lucky enough to access hospitals to treat their measles-related pneumonia or where they join the 1 in 1000 who die from measles infection.
As the WSJ article points out and many others have frequently noted, measles is an extremely contagious respiratory illness spread by coughing and sneezing. Most people do recover from it, but it can cause deafness and pneumonia, and it can be fatal. The prevention is simple, extremely low risk, and so effective that back when vaccine uptake was high, both the US and the UK categorized it as “eliminated” because it basically had ceased to circulate in populations in either country.
Health officials in these nations are naturally baffled and upset by the disease’s resurgence. Their passion for ensuring that people take advantage of a lifesaving preventive measure is likely just as powerful as the passion of the small but still vocal community of people who argue that vaccines cause autism. Indeed, the article quotes one such official, Paul Cosford, as describing the resurgence of measles as “galling.” Cosford is the medical director of Public Health England, the UK’s public health agency.
Another public health official, James Goodson, the “lead measles expert” at the US Centers for Disease Control, makes another important point about the rise in measles cases among the unvaccinated. This increase in a rapidly spread, highly contagious virus is simply the warning bell, he says in the article. People who forego measles vaccination likely forego other vaccinations as well, including immunization against slower-moving but even deadlier diseases like diptheria and pertussis. In other words, measles outbreaks might simply be the beginning of something even more serious.
In addition to laying blame at the feet of Andrew Wakefield and at supporters of his debunked ideas, including Jenny McCarthy, the WSJ article also singles out its own: the news media. In Wales, for example, the South Wales Evening Post seems almost to have gone out of its way to drum up vaccine fears and resistance. Indeed, the article says that health experts cite the Post as responsible for Wales becoming the epicenter of the UK outbreak:
Health experts in Wales say the Post’s coverage was probably the main reason vaccination rates fell further here than elsewhere. By the third quarter of 1998, uptake of the vaccine in 2-year-olds fell by 14% in the newspaper’s distribution area, compared with a 2.4% drop in the rest of Wales, according to a report in the Journal of Epidemiology & Community Health.
Parents are naturally concerned and put off by the idea of jabbing needles into little infant thighs and injecting what to many people seems like a mix of appallingly named chemicals. I sympathize: I cringed when each of my children received their vaccinations. Add to that the half dozen pages we receive at each visit explaining in detail what the potential side effects of vaccines are and the warning signs of a reaction, and it’s no wonder that parents are primed to make huge leaps in anxiety and concern. As the Wales outbreak demonstrates, though, it takes more than parents. It also takes people–scientists and journalists–willing to use sensationalism to drum up readership and attention and money and to sideline public health in the process. And unfortunately, we have yet to develop a vaccine against simple human venality.
Emily Willingham, Contributor