When we travel in cars, most of us buckle up because we know seat belts save lives. Who among us, seeing a child unrestrained in a proper safety seat or with a seat belt, doesn’t cringe and worry?
Like seat belts, vaccines also save lives. Take the combination measles-mumps-rubella (MMR) vaccination, for instance. Since 2000, the vaccine has prevented 21.1 million deaths worldwide.
But a troubling trend has emerged: Measles cases are increasing despite the availability of a safe and affordable vaccine.
In the United States, more than 1,100 cases of measles have been confirmed in 30 states this year, says epidemiologist Dr. Ashraf Khan, Lee Health system director of Hospital Epidemiology and Infection Prevention. And it’s only July.
“This is double the number of cases reported in 1994, the previous highest year and the greatest number of cases since measles was declared eliminated in 2000,” Dr. Khan says. “We are sitting at the epicenter of outbreak.”
Worldwide, the number of measles cases has surged 30 percent, WHO reports. In 2016, 89,800 people died from measles. In 2017, the number jumped to 110,000 deaths globally, mostly among children under the age of 5. Measles is so contagious that nine in 10 people who are not immune will become infected if they’re exposed to it.
Measles symptoms can progress quickly and cause serious complications in children and adults, including deafness, pneumonia, and inflammation of the brain. The potentially deadly infection remains a leading cause of vaccine-preventable infant mortality.
“If you’re vaccinated against the disease, you won’t get it or spread it to others who aren’t immune,” says Dr. Khan, who is a former director with the World Health Organization Infection Control & Microbial Resistance Collaborating Center. “The more people who are vaccinated, the fewer opportunities a disease has to spread,” he adds.
It’s important to remember that in the United States, the measles vaccine has reduced the number of disease cases by 99 percent compared with the pre-vaccine era. “Two doses of MMR vaccine are 97 percent effective at protecting against measles and 88 percent against mumps,” Dr. Khan says. “The vaccine protects you and people who are unable to be vaccinated because they are too young or have weakened immune systems.”
Health authorities cite “vaccine hesitancy” for the recent spike in measles cases. The WHO defines vaccine hesitancy as the delay in acceptance or refusal of vaccines despite availability of vaccination service. Because of its potentially lethal consequences (places like New York City and Washington state have declared health emergencies), vaccine hesitancy has been labeled a top 10 threat to global health by WHO.
Dr. Khan says measles is spreading and causing outbreaks in U.S. communities among groups of people who refuse vaccinations.
“Some communities are against vaccinations for philosophical or religious reasons,” he explains. ”Or, they’re not educated about the proven efficacy of vaccines. Also, access to care presents a challenge. Some people may live too far away or find it too difficult to travel.”
Dr. Khan stresses that vaccines not only protect immunized people, but can also reduce disease among unimmunized individuals in the community through the concept of “herd immunity.” When you get vaccinated, you’re protecting yourself and your community.
“When enough people in a community get vaccinated against a certain disease, the virus can’t travel as easily from person to person,” Dr. Khan says. “The entire community is less likely to become infected. Even people who can’t get vaccinated will have some protection against the disease. It also means if someone gets sick, the chances of an outbreak are much lower because it’s harder for the disease to spread.”
A safe vaccination rate can significantly reduce the spread of infectious disease. For measles, the community vaccination rate should be at least 95 percent, but only 91.1 percent of U.S. children between the ages of 19 and 35 months received the MMR vaccine in 2017. That number dips even lower in some parts of the country because of vaccination hesitancy.
“Promoting measles vaccination is a societal responsibility, with the ultimate goal of global elimination and eradication,” Dr. Khan says. “Continuing education outreach efforts and improving access to care can increase community vaccination rates.”
Until more people start vaccinating themselves and their children, the number of vaccine-preventable disease cases will continue to climb, Dr. Khan explains.
Before a vaccine is licensed in the United States, the Food and Drug Administration (FDA) reviews all aspects of development, including where and how the vaccine is made and the studies that have been conducted in people who received the vaccine. The FDA will not license a vaccine unless it meets standards for effectiveness (how well the vaccine works) and safety.
Results of studies get reviewed again by the Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, and the American Academy of Family Physicians before a licensed vaccine is officially recommended to be given to children.
Every lot of vaccine is tested to ensure quality (including safety) before the vaccine reaches the public. In addition, FDA regularly inspects places where vaccines are made.
According to the CDC, vaccinating children to protect them against life-threatening diseases can cause mild, short-term side effects, such as redness and swelling at the injection site, fever, and rash. But the most serious risks, such as severe allergic reactions, are far rarer than the diseases vaccines protect against.
The CDC estimates that the risk of a serious allergic reaction from any vaccine is one in 1 million doses.
Since 2003, the CDC and WHO have conducted several studies and have found no link between thimerosal (a vaccine preservative that prevents contamination of multi-dose vials of vaccines) and autism. Also, no link between the MMR vaccine and autism in children has been found.
The CDC recommends that adults born after 1956 should receive at least one MMR vaccination.
Dr. Khan says that if you are unsure of your immunization status, a simple blood test can be conducted to check. Consult with your primary care or family physician to learn more about vaccinations and which ones are right for you and your family.
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