Half of Measles Patients Unvaccinated, Most Willingly
Half of measles cases since 2000 occurred in patients who refused vaccines. Continue reading →
Half of those who contracted measles over the past 15 years were unvaccinated, and in most of those cases the patient (or their legal guardian) refused the vaccination, reports a new study published online earlier this week by the "Journal of the American Medical Association."
The research team, led by Dr. Saad B. Omer, reviewed published reports of measles outbreaks in the United States since 2000 - the year the disease was eliminated from the population - as well as all outbreaks of whooping cough (pertussis) since 1997, when that disease was at its lowest point. The goal was to evaluate the association between vaccination and the epidemiology of these diseases, both of which are preventable.
The authors analyzed a study of national measles data reported to the CDC from 1985 through 1992, which found "unvaccinated children who had a vaccine exemption were 35 times more likely to contract measles compared with vaccinated children. The epidemic curve of measles determined that the resurgence started a year earlier among children with exemptions compared with vaccinated children."
In much of the world people are unvaccinated for the simple reason that vaccines are unavailable or cost too much money. That was not the case in the United States. In fact most of those who contracted measles were offered free or inexpensive vaccines, but they (or their parents) refused them despite having no medical reason to do so. Although vaccine prices have risen in recent years, insurance companies have been required under the Affordable Care Act to completely cover childhood vaccinations since 2011.
Reasons the researchers found for vaccine refusal included personal belief exemptions; specific cultural norms (for example in Amish communities); and religious exemptions. Less often a vaccine could not be provided because of medical or logistical reasons, including that the patient was sick at the time the medication was to be given, or the patient could not physically make it to his or her appointment.
Some parents refuse to have their children vaccinated because of false health concerns raised by anti-vaccination activists such as actress Jenny McCarthy, who in turn based their concerns largely on a since-retracted study by Dr. Andrew Wakefield which seemed to show a link between vaccines and the onset of autism in young children.
Following an investigation Dr. Fiona Godlee, editor in chief of BMJ (formerly known as the British Medical Journal) stated that Wakefield's study could not be replicated and "was based not on bad science but on a deliberate fraud." Wakefield was stripped of his medical license and recently appeared as a guest speaker on a cruise focusing on conspiracy theories, presenting alongside experts on crop circles, UFOs and government mind control theories.
There are small but real risks involved in vaccinations, as there are with any drug or medical procedure. They are not hidden, and information on them easily available from doctors or online. The risks of harmful side effects are far less dangerous than the risks of catching the disease. Measles is a highly contagious viral disease that can be very serious - and in some cases fatal - and those who refuse vaccines jeopardize not only their own health but also that of others.
Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC), told Discovery News that "2015 was a very active year for protecting Americans." Indeed, there were plenty of crises and near-crises that threatened our health. Here's a sampling of six scares from 2015. In the meantime, the World Health Organization has already
for 2016. For the second year, Ebola dominated global health issues. At the CDC, over 4,000 staff members, or 20 percent of the staff, worked on curtailing the outbreak, Frieden said. "The thing that is least well understood about Ebola is how close it became to a global catastrophe," Frieden said. "It could have been widespread in Africa for years, and it would have killed people not just from Ebola, but because health systems stop functioning." In fact, in Guinea,
, because the country's health care system was so overloaded with Ebola patients that people with other diseases couldn't get proper treatment. "Ebola is an epidemic that not only kills but undermines others," Frieden said.
Over 15,000 Americans died from
) in a single year; it causes more hospital-acquired infections than any other bacteria, according to a CDC study. Not only do people often contract it when they are on antibiotics; some strains are resistant to treatment from antibiotics, making fecal transplants the leading alternative treatment. But the scariest bacteria news of 2015 might be the recent finding that a superbug gene found in China quickly infected someone in Denmark, highlighting the risk that drug-resistant bacteria pose to most modern medicine. "I'm an infectious disease physician and I have treated many people with cancer who are getting chemotherapy and have had horrible infections held in check with antibiotics," Frieden said. "If we don't have antibiotics, then cancer and other [modern medical treatments] are hanging by a thread." Waiting for a new miracle drug is a mistake, he added; it's also essential to take "better stewardship of the antibiotics we have."
Air pollution is a silent killer, said Dr. Francesca Dominici, a professor of biostatistics at the Harvard T.H. Chan School of Public Health. But there's no escaping it. "With air, you cannot wake up one morning and say you're not going to breathe or even move somewhere with clean air," she said. "It's affecting everybody." There is an antidote, however: "If we shut down coal-fired power plants, it would save lives immediately," she said. "But it's the one thing no one is talking about." Climate change talk tends to focus on the future, what life will be like in 100 years. But there is a "health crisis happening right now," she said, and "it's crazy to think people are not doing anything about it. In a certain way, not acting on air quality and power plants is like not acting on the Ebola epidemic." When coal-fired power plants are shut down, the ambient air improves immediately, she said. Air pollution is linked to cardiovascular disease, which is the No. 1 killer in the U.S. It's also associated with lung function and cognitive issues in children.
Although it didn't cause any deaths, the measles outbreak traced to Disneyland grabbed headlines across the country and put the debate about vaccines back in the spotlight. Many of the 147 people who fell sick were not immunized against measles, either for personal beliefs or because they were too young to get the vaccine. Vaccines in the U.S. are "underused," Frieden said. Take the HPV vaccine, which is recommended for girls and boys at age 11 or 12: according to a 2014 survey, 40 percent of girls and 60 percent of boys hadn't started the 3-shot series. "We're doing less well that Rwanda at protecting our children against HPV," he said. About 25 percent of Americans are infected with HPV, which can cause several types of cancer.
Each year, more than 200,000 people die from preventable medical errors, killing more Americans than anything except for heart disease and cancer. "Considering we're all going to get sick at some point and need a hospital, it's hard to think we could suffer from error, and care that is not coordinated as it should be," Dominici said. Errors include everything from giving patients the wrong medication to giving premature babies too much oxygen.
When 180 people in one small town in Indiana were infected with HIV in less than a year, it drew national attention. In a county that typically sees fewer than five cases of HIV a year, most of the new cases were linked to partners injecting the prescription opioid oxymorphone with shared syringes. Opioid pain relievers are prescribed for reducing severe pain, but "we got the risk-benefit wrong," Frieden said. "There's a short-term benefit, but in the medium- and long-term, you could die from it." The painkillers are so addictive that 1.9 million Americans live with prescription opioid abuse or dependence, and there are thousands of overdose deaths in the U.S. per year. The 2015 Indiana State Department of Health investigation reveals additional risks, including a resurgence of HIV.