Why Measles? Why Now? - Mothering Forums

Why Measles? Why Now?

Turquesa's Avatar Turquesa (TS)
07:26 PM Liked: 53755
#1 of 26
06-28-2014 | Posts: 4,161
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There are two narratives that I'm hearing to explain the recent measles outbreaks in the United States, and neither of them fully make sense.

The first is that they are caused by "growing numbers" of parents refusing to vaccinate. But here in the U.S., there are no "growing numbers."
http://www.culturalcognition.net/blog/2014/1/28/the-logic-of-reciprocity-and-the-illogic-of-empirically-unin.html

The second is that unvaccinated people are traveling to countries where measles is endemic and then bringing it home to the U.S.

It sounds plausible on the surface. But hasn't there been international travel for quite awhile? I have found no evidence to support the notion, for example, that there has been a dramatic increase in international travel since, say, 1999, when we didn't see measles outbreaks to the extent that we see them today. Are more unvaccinated people traveling since that time? Are more people traveling to measles-endemic countries? And can anybody provide evidence either way?

A third explanation that I've heard that may make a little more sense is that we simply need a new measles vaccine. http://www.edwardjennersociety.org/wp-content/uploads/The-re-emergence-of-measles1.pdf

What are your thoughts?
kathymuggle's Avatar kathymuggle
08:36 AM Liked: 180750
#2 of 26
06-29-2014 | Posts: 4,363
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Hmmm….#2 or 3?

There are outbreaks in Europe and the Phillipines. The outbreaks there are said to be due to low vaccination rates - but really, we would need to confirm this with figures. We would also need to know if the outbreaks are new. If there have always been outbreaks, then travel does not explain it away.

In any event, I do think it is plausible that travellers bring measles back from wherever they go. Measles is not endemic in N. America, and aside from the rather unlikely possibility of shedding causing the disease, travel is the most likely reason for the importation. The disease taking hold here is another thing. I suspect the vaccine is not working as well as most would like, and IMHO, that is really where the focus needs to be. Non-vaxxers do not really owe you anything - not a vaccine and not to curtail travel. The vaccine manufacturers and promoters owes you immunity at the advertised efficacy rate - and I do not think MMR is delivering.

Do we have any good data on attack rates in vaccinated verus unvaccinated in any of the current outbreaks?
samaxtics's Avatar samaxtics
09:48 AM Liked: 2095
#3 of 26
06-29-2014 | Posts: 783
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-Perhaps it is because the group with natural immunity, i.e. those born after 1970 here in Canada and I think the year used in the States is 1957, is getting smaller.

- It could be that these cases really aren't measles but one of the several other viruses that present like measles.

-Or they are looking to start adult doses of the vaccine.
teacozy's Avatar teacozy
11:13 AM Liked: 5294
#4 of 26
06-29-2014 | Posts: 1,657
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Quote:
Originally Posted by Turquesa View Post
There are two narratives that I'm hearing to explain the recent measles outbreaks in the United States, and neither of them fully make sense.

The first is that they are caused by "growing numbers" of parents refusing to vaccinate. But here in the U.S., there are no "growing numbers."
http://www.culturalcognition.net/blog/2014/1/28/the-logic-of-reciprocity-and-the-illogic-of-empirically-unin.html
The problem with looking at overall rates it that vaccine exemptions tend to cluster in certain communities. If the exemptions were evenly spread throughout the US, the numbers wouldn't be a huge problem.

See this link on the states with the best and worst coverage. Colorado, for example, is at 85% for MMR in kindergarteners. While the "best" states are at 98-99 percent, bringing the overall average up.

http://www.advisory.com/daily-briefi...ccine-coverage

They conclude on that link : "High vaccination coverage levels at the national and state levels might mask clustering of unvaccinated children at local levels where vaccine-preventable diseases might be transmitted," CDC researchers wrote, adding that health departments and schools can use the data "to identify schools with low vaccination coverage and high exemption levels"

Basically, a nationwide statistic like that doesn't mean as much in terms of outbreaks. Outbreaks tend to occur where there are pockets of people who do not vaccinate. The nationwide stat is I believe around 92% for the MMR. But there are large pockets and areas in the US where the rate is well below the threshold needed for herd immunity, which is 95% for MMR if I remember correctly.

If 90% of the country vaccinated, and the 10% that don't were widely and evenly spread across the country, it is less likely that a disease with a single entry point will hit many people. But if 92% of the country vaccinated, with some areas reaching 99% and others reaching 85%, the areas with only an 85% rate are extremely vulnerable to outbreaks, both as compared to the areas with 99% and even the areas with 92%.

An immunocompromised person or baby in a community with only a 60% MMR vaccine uptake isn't going to care what the national rate is if someone carrying the measles virus comes through.
kathymuggle's Avatar kathymuggle
12:03 PM Liked: 180750
#5 of 26
06-29-2014 | Posts: 4,363
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But tea, there have always been non-vaccine clusters. "Why measles and why now" is a good question.
Turquesa's Avatar Turquesa (TS)
01:59 PM Liked: 53755
#6 of 26
06-29-2014 | Posts: 4,161
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Yes! And following the data that we have, those clusters were probably even bigger years ago.

The cluster argument also doesn't explain why we're seeing outbreaks in non-cluster areas, like New York City.

Of course, if all 50 states had philosophical exemptions, we'd see fewer clusters because parents who don't vaccinate on schedule would have more options of where to live and be able to spread out more.
Deborah's Avatar Deborah
06:08 PM Liked: 2643
#7 of 26
06-29-2014 | Posts: 6,741
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Yes, the harassment of people who don't want to vaccinate actually creates the clusters.

The vaccination rates are actually at the highest they have ever been. The CDC keeps raising the bar. And then complaining because people are not complying with their demands.
rachelsmama's Avatar rachelsmama
06:10 AM Liked: 31382
#8 of 26
06-30-2014 | Posts: 1,583
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Quote:
Originally Posted by samaxtics View Post
-Perhaps it is because the group with natural immunity, i.e. those born after 1970 here in Canada and I think the year used in the States is 1957, is getting smaller.

- It could be that these cases really aren't measles but one of the several other viruses that present like measles.

-Or they are looking to start adult doses of the vaccine.

I'd like to add to the first point by saying that the only reason the vaccine seemed to work as well as it appeared in the past was because so much of the population had natural immunity. As the naturally immune portion gets smaller, the shortcomings of the vaccine are becoming clearer.

Also, the media coverage is designed to make outbreaks seem as bad as possible.
Deborah's Avatar Deborah
09:19 AM Liked: 2643
#9 of 26
06-30-2014 | Posts: 6,741
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Adult vaccines are the next opportunity to expand the market, and hence income, with vaccines. So it would make sense that making a huge noise about measles works well on several levels.

Intimidate parents who don't comply.

Rile up the "good" parents who vax and get them to harass parents who don't comply.

Get adults to go and get vaccines.
seewithgrace
11:02 PM Liked: 4
#10 of 26
01-25-2015 | Posts: 2
Joined: Jan 2015
Quote:
Originally Posted by teacozy View Post
The problem with looking at overall rates it that vaccine exemptions tend to cluster in certain communities. If the exemptions were evenly spread throughout the US, the numbers wouldn't be a huge problem.

See this link on the states with the best and worst coverage. Colorado, for example, is at 85% for MMR in kindergarteners. While the "best" states are at 98-99 percent, bringing the overall average up.

http://www.advisory.com/daily-briefi...ccine-coverage

They conclude on that link : "High vaccination coverage levels at the national and state levels might mask clustering of unvaccinated children at local levels where vaccine-preventable diseases might be transmitted," CDC researchers wrote, adding that health departments and schools can use the data "to identify schools with low vaccination coverage and high exemption levels"

Basically, a nationwide statistic like that doesn't mean as much in terms of outbreaks. Outbreaks tend to occur where there are pockets of people who do not vaccinate. The nationwide stat is I believe around 92% for the MMR. But there are large pockets and areas in the US where the rate is well below the threshold needed for herd immunity, which is 95% for MMR if I remember correctly.

If 90% of the country vaccinated, and the 10% that don't were widely and evenly spread across the country, it is less likely that a disease with a single entry point will hit many people. But if 92% of the country vaccinated, with some areas reaching 99% and others reaching 85%, the areas with only an 85% rate are extremely vulnerable to outbreaks, both as compared to the areas with 99% and even the areas with 92%.

An immunocompromised person or baby in a community with only a 60% MMR vaccine uptake isn't going to care what the national rate is if someone carrying the measles virus comes through.
The concept of vaccine-produced herd immunity has never been scientifically established. In fact, there is significant evidence to the contrary.

http://www.greenmedinfo.com/blog/her...yth-or-reality
Turquesa's Avatar Turquesa (TS)
10:33 AM Liked: 53755
#11 of 26
01-26-2015 | Posts: 4,161
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Thank you for the timely bumping of my thread. I hope that this discussion resumes a little in light of the Disney outbreak. The Diane Rehm Show this morning was alarmingly simplistic about this issue, although I appreciate Dr. Jay Gordon's insights.
serenbat's Avatar serenbat
08:13 AM Liked: 106507
#12 of 26
01-27-2015 | Posts: 4,680
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Quote:
Originally Posted by Turquesa View Post
Thank you for the timely bumping of my thread. I hope that this discussion resumes a little in light of the Disney outbreak. The Diane Rehm Show this morning was alarmingly simplistic about this issue, although I appreciate Dr. Jay Gordon's insights.
I love here show!!

and still more - perhaps the heart of the problem - I would think this should concern vaccers - http://www.latimes.com/local/califor...127-story.html (one would think applejuice wrote this! ) - again back to what many have said countless times, is this outbreak "new" vs how much is missed with improper diagnosis?
Turquesa's Avatar Turquesa (TS)
08:32 AM Liked: 53755
#13 of 26
01-27-2015 | Posts: 4,161
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Thanks, but overall I wasn't super impressed with the show yesterday. See what you think. http://thedianerehmshow.org/shows/20...their_children
serenbat's Avatar serenbat
08:47 AM Liked: 106507
#14 of 26
01-27-2015 | Posts: 4,680
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Quote:
Originally Posted by Turquesa View Post
Thanks, but overall I wasn't super impressed with the show yesterday. See what you think. http://thedianerehmshow.org/shows/20...their_children

I know what you mean!!

compared to what else it out there - but what could be - that is the difference! sadly
applejuice's Avatar applejuice
06:32 PM Liked: 87312
#15 of 26
01-27-2015 | Posts: 18,632
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Why measles? Why now?

The fact of the matter is that doctors are NOT taught to look for a disease that has a vaccine developed for it, so who knows? Ten babies too young for their two month vaccines died in CA from pertussis because the doctors did not know what the presenting symptoms meant and did NOT order the proper tests to confirm the diagnosis.

The fact that no measles cases were reported in 2000 may be the result of clueless young paediatricians not knowing what they are looking at. I witnessed this in my own experience and I have told the story ad nauseum here.

Doctors simply do not know what a grandmother of the 1940s, 50s and 60s knew. So go ask a granny.
Anne Jividen
09:12 PM Liked: 40
#16 of 26
01-27-2015 | Posts: 46
Joined: Oct 2014
Modern day health care is not designed to do what is in the interest of human health, it is designed to generate profit, that is what "for-profit" health care is. It applies to all aspects of modern day American care.
EMRguy's Avatar EMRguy
07:58 AM Liked: 574
#17 of 26
01-28-2015 | Posts: 404
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Quote:
Originally Posted by Anne Jividen View Post
Modern day health care is not designed to do what is in the interest of human health, it is designed to generate profit, that is what "for-profit" health care is. It applies to all aspects of modern day American care.
Being around all types of specialties, I can tell you there is a big difference between them on what the bottom line is.
Must acute doctors are good, they do care about patients and they are well paid.
An Ortho doctor makes an average $700.000+ per year, when a urgent care/ family doc starts of at $120+k
The PED, FC, OBGYN docs, are mostly caring for chronic condition patients, insurance companies expect a standard of care to keep working with those doctors and vaccines are a part of that care.
samaxtics's Avatar samaxtics
08:19 AM Liked: 2095
#18 of 26
01-28-2015 | Posts: 783
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Quote:
Originally Posted by applejuice View Post
Why measles? Why now?

The fact of the matter is that doctors are NOT taught to look for a disease that has a vaccine developed for it, so who knows? Ten babies too young for their two month vaccines died in CA from pertussis because the doctors did not know what the presenting symptoms meant and did NOT order the proper tests to confirm the diagnosis.

The fact that no measles cases were reported in 2000 may be the result of clueless young paediatricians not knowing what they are looking at. I witnessed this in my own experience and I have told the story ad nauseum here.

Doctors simply do not know what a grandmother of the 1940s, 50s and 60s knew. So go ask a granny.
Yes indeed. This is why it is so amusing when some provaxxers ask if all the doctors are in on the conspiracy. We know a doctor socially. If you don't follow what their medical association has laid out in terms of practices you will be denied membership and then you are hooped. Acting like these doctors are investigating each and every disease and drug is laughable. They are following protocol. They are trusting that the information they receive is accurate and factual. Doctors have family lives too; there aren't enough hours in the day to independently research every disease their patients (which number in the hundreds or thousands) could have. And the younger ones have a mountain of student debt. They aren't going to be rocking the boat with ideas that are contrary to the guidelines.

When we were still trying to get my child diagnosed, I asked a developmental paediatrician if we should continue to vaccinate our son. (it was hard for me to let go of the indoctrination ) He said I can't tell you that. So I asked him, "if this were your child, would you continue to vaccinate?" And he shook his head no. He had been practicing medicine for over 30 years and had the experience of both disease and their vaccines.
KSLaura's Avatar KSLaura
10:00 AM Liked: 231
#19 of 26
01-28-2015 | Posts: 533
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I think the combination of low-vaccination rates and frequent international travel (possibly more families traveling than several decades ago) has contributed to outbreaks. Really, it comes down to an infected person coming into contact with a person who has no immunity. The virus can stick around for a while on surfaces and in the air. People are likely contagious before they know they have the measles.


http://www.theatlantic.com/health/ar...easles/384738/


'In reality, measles never went away.
At the petri-dish level, the virus—one of the most stable, unchanging strains there is—looks just the way it did in the pre-vaccination era. Measles remains one of the most infectious illnesses on the planet. The virus stays active and contagious in the air for up to two hours, and can be transmitted from an infected person for up to four days before and after a rash appears.
The stability of the measles virus is also what makes its vaccine so effective. "Oftentimes viruses mutate a lot, like the influenza virus, but this virus is very stable," said Cody Meissner, a professor of pediatrics at Tufts University School of Medicine. "There's really only one strain of the measles virus."'
EMRguy's Avatar EMRguy
10:39 AM Liked: 574
#20 of 26
01-28-2015 | Posts: 404
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Quote:
Originally Posted by KSLaura View Post
I think the combination of low-vaccination rates and frequent international travel (possibly more families traveling than several decades ago) has contributed to outbreaks.
Really? what are your thoughts on the Baltimore case? http://www.inquisitr.com/1789056/bal...measles-virus/

99% vaccination rate.
Not travel
No mickey
MyFillingQuiver's Avatar MyFillingQuiver
11:27 AM Liked: 721
#21 of 26
01-28-2015 | Posts: 1,161
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Very interesting perspective. Often, the outbreaks are blamed on the unvaccinated in "poor areas". Unfortunately, the myth continues, that those who do not vaccinate don't do so because they can't afford it and therefore don't have access..when in my research (albeit humble and not scientifically controlled) I have found the poor have excellent access and plenty of pressure to vaccinate and are quite vaccine compliant.

When there is a whooping cough outbreak or a measles issue, it's automatically blamed on the unvaxed around this area, and where I am there are a lot of home-bound folks, who are not likely world travelers.
beckybird's Avatar beckybird
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#22 of 26
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If millions of kids are vaccinated, and only a tiny percentage are not, isn't there a slight chance the recently vaccinated could be shedding ? We are told it is almost certainly not possible, but even a 1% chance of shedding would be something, considering the amount of kids who get the MMR.
It's easy to blame the unvaccinated, but could the shedders be to blame as well? The modern-day witch hunt continues.
fayebond's Avatar fayebond
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Posting something because I want to get notifications.
kathymuggle's Avatar kathymuggle
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http://www.ncbi.nlm.nih.gov/pubmed/19324753

For infectious diseases where immunization can offer lifelong protection, a variety of simple models can be used to explain the utility of vaccination as a control method. However, for many diseases, immunity wanes over time and is subsequently enhanced (boosted) by asymptomatic encounters with the infection. The study of this type of epidemiological process requires a model formulation that can capture both the within-host dynamics of the pathogen and immune system as well as the associated population-level transmission dynamics. Here, we parametrize such a model for measles and show how vaccination can have a range of unexpected consequences as it reduces the natural boosting of immunity as well as reducing the number of naive susceptibles. In particular, we show that moderate waning times (40-80 years) and high levels of vaccination (greater than 70%) can induce large-scale oscillations with substantial numbers of symptomatic cases being generated at the peak. In addition, we predict that, after a long disease-free period, the introduction of infection will lead to far larger epidemics than that predicted by standard models. These results have clear implications for the long-term success of any vaccination campaign and highlight the need for a sound understanding of the immunological mechanisms of immunity and vaccination.

http://www.ncbi.nlm.nih.gov/pubmed/6741921

Little is known about how an intensive measles elimination program changes the overall immune status of the population. A computer model was created to study the effect of the measles elimination program in the United States on the number of susceptibles in the population. The simulation reveals that in the prevaccine era, approximately 10.6% of the population was susceptible to measles, most of whom were children less than 10 years of age. With the institution of the measles immunization program, the proportion of susceptibles in the population fell to 3.1% from 1978 through 1981, but then began to rise by approximately 0.1% per year to reach about 10.9% in the year 2050. The susceptibles at this time were distributed evenly throughout all age groups. The model did not consider the potential effect of waning immunity. The results of this study suggest that measles elimination in the United States has been achieved by an effective immunization program aimed at young susceptibles combined with a highly, naturally immunized adult population. However, despite short-term success in eliminating the disease, long-range projections demonstrate that the proportion of susceptibles in the year 2050 may be greater than in the prevaccine era. Present vaccine technology and public health policy must be altered to deal with this eventuality.
MyFillingQuiver's Avatar MyFillingQuiver
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Wonderful synopsis. Thank you!
serenbat's Avatar serenbat
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Thanks Kathy!
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