Disneyland is in the news, and not because it is the most magical place on earth. It also is the origin of the most recent rubeola measles outbreak, now spread to seven states and Mexico with over eighty cases diagnosed so far. Unvaccinated children are being kept home from school in some California districts and vaccination requirements once again have become a battleground between public health agencies and the “right to not vaccinate” community.
It’s been almost sixty years since vaccinations became routine for the childhood killers like polio, measles, mumps and whooping cough. People my age and older had no choice but to suffer through childhood infectious diseases given how effectively and quickly they spread through a community. Yes, most of us survived, subsequently blessed with life long natural immunity. A significant number did not survive or suffered life-long complications from the effects of those diseases.
People living in wealthy and privileged first world countries have forgotten that harsh reality, and many have turned their backs on vaccinations, considering them “too risky” for themselves and their children when these diseases become less common in a mostly vaccinated society. In contrast, millions of people without easy and affordable access to vaccines in third world countries have not forgotten what the devastation of these infections and gladly walk miles to get their children vaccinated to give them a better chance at a long life.
When measles or mumps or pertussis reemerges within our borders, we act surprised when it becomes a major media event — but we shouldn’t be. Diseases that were almost nonexistent are occurring with greater frequency again in modern societies due to misguided and misinformed anti-vaccination campaigns.
As a college health physician, I help enforce vaccination requirements for a state university. A week doesn’t go by without my having a discussion with a prospective student (or more likely the student’s parent) about the necessity for our requirement for proof of mumps, measles, rubella vaccination immunity. I have been accused of being a pawn of the pharmaceutical industry because I happen to believe in the evidence of the efficacy of modern vaccines to help keep a community free of infectious disease outbreaks that will kill people. I also helped coordinate a public health response at our university in 1995 when we had a rubeola outbreak of eleven confirmed cases over a three week period, necessitating the mass vaccinations of over 8,000 students and staff within a 3-day period in order to keep our institution open and safe. I’ve experienced first hand what it takes to respond to a potentially lethal contagious disease outbreak. Never again, if I can do whatever I must to prevent that from happening again.
We have forgotten these vaccine-preventable bacterial and viral illnesses are honest to goodness killers of healthy human beings. I’ve had caring, loving parents of faith request a religious exemption as God will provide the needed immunity if their child gets sick so taking the risk of a vaccine is unnecessary. I’ve had caring loving parents with no religious objection but who refuse vaccine on a personal basis, considering it a foreign substance that they do not want injected into their child and would rather “take their chances” by eating a healthy diet and other alternative prevention measures.
They are banking that everyone else will be vaccinated. The problem is: Guess again. There are now too many deciding that they are the ones who can remain vaccine-free, so scenarios like Disneyland will happen again and again. We’ve seen repeated pertussis outbreaks tragically causing infant deaths in several states over recent years.
I tell the doubting anti-vaccination families that indeed there is an alternate way to immunity — after suffering from a potentially lethal infection that threatens others who are unfortunately exposed. I prefer the modern option of immunity in the form of a vial of vaccine, a needle and syringe. I don’t think any one of these parents would deny the life saving miracle of injectable insulin for their child diagnosed with diabetes, nor would they fail to strap their child into a car seat for the rare but real possibility of a life-threatening collision on even the shortest car ride.
Vaccines are miracles and instruments of prevention too, but the rub is that we have to give them to healthy youngsters in order to keep them healthy.
I’m an old enough physician to have seen deaths from these diseases, as well as the ravages of post-polio paralysis, the sterility from mumps and deafness from congenital rubella. My father nearly died from the mumps that I brought home from school when I was eight, and he was in his early forties. My sister-in-law almost didn’t pull through when she was an infant and contracted pertussis. I’ve seen healthy people develop encephalitis and pneumonia from chicken pox. I’ve seen a healthy college student die of influenza within a week of getting ill despite everything modern medicine could offer him.
There is an epidemic of fear in our society that is unwarranted: as Seth Mnookin, a journalist covering science topics wrote in his book The Panic Virus:
“If only there were a shot for irrational fears.” When I’ve written about my stance on vaccinations in various on-line forums, I’m astonished at the vehemence of the many responses from individuals who have no trust whatsoever in the advances of modern medicine in preventing the killers that have devastated mankind for centuries.
Sure, I wish vaccines were perfect with no side effects and conferring 100 percent immunity but as yet they aren’t. I wish medications that are developed for treatment of some of these illnesses were perfect, but we can’t depend on a 100 percent guarantee of cure once sickened. I wish our immune systems were perfectly able to respond to infectious diseases, but they too fail and people do die.
There will always be a new plague — history has demonstrated that over and over with the appearance of HIV, SARS, Avian flu, Ebola or multidrug-resistant tuberculosis. There is plenty to keep our immune systems at the ready because we don’t yet or may never have effective vaccines widely available.
But there is simply no good reason to invite the old plagues back into our homes, our schools, our blood streams, and onto our death certificates. They deserve to be considered the killers of yesteryear that are now overcome by modern medicine and resigned to be merely a footnote in the epidemiology history books.
Emily Gibson is a family physician who blogs at Barnstorming.
