February 18, 2019

Measles outbreaks highlight the importance of vaccines

Most parents of school-age kids are way too young to recall how prevalent measles was in its heyday.

A very serious, highly contagious respiratory disease that affects the lungs and respiratory tract, measles affected 3 to 4 million people in the United States each year before vaccination began in 1963. Back then, measles — which can be passed on through a cough or sneeze — put 48,000 people in the hospital and killed 500 people annually.

With vaccinations routinely given to children for the past 55 years, it's easy to assume that measles has been totally wiped out. Unfortunately, as more children in school show up without being vaccinated, measles outbreaks have popped up more frequently. Just this year, more than 100 cases have been confirmed in 21 states — especially in Washington and Oregon — with most cases diagnosed in children who have not had the routine MMR (measles, mumps and rubella) vaccine.

In Wisconsin, more than 92 percent of students are meeting the minimum state vaccination requirement — a number that sounds impressive but is still lower than ideal. Wisconsin parents who do not allow their child to be immunized may do so for one of three reasons:

  • Medical reasons

  • Religious belief

  • Personal conviction

More students not being vaccinated

By far, "personal conviction" is the most popular reason cited for not vaccinating, and this number is clearly increasing. In 2017-18, 4.9 percent of students were exempt from at least one vaccine, compared with only 1.6 percent 20 years earlier, according to the Wisconsin Department of Health Services.

"Vaccines are not just about your child. They are about the health of everyone your child encounters at school, at friends' homes or at family gatherings. That is why vaccines work best when virtually everyone gets them," said UW Health infectious disease specialist Joseph McBride, MD. "This is what we call 'herd immunity.' Looking at it another way, as vaccination compliance falls below 90 to 95 percent, the risk of disease outbreaks increases dramatically."

Having said that, Dr. McBride said it's important for physicians not to judge parents who are skeptical about vaccination.

"Parents who choose not to vaccinate clearly believe they have their child's interests at heart," said Dr. McBride. "As physicians, however, we have a responsibility to point out that the overwhelming weight of science demonstrates that vaccination prevents outbreaks of very serious diseases and has saved countless numbers of lives over several generations."

From well-known actors and actresses to numerous websites and social media posts, there are many common myths and misconceptions about vaccines that leave parents feeling uncertain and even a bit scared about their safety.

Part of the challenge is trying to sort out fact from fiction. To help, Dr. McBride breaks down some of the more popular myths:

Myth #1: Vaccines cause autism

This myth has been well debunked, but it is still important to understand where it came from. In 1997, a medical journal article by a British surgeon suggested that the MMR (measles, mumps and rubella) vaccine may have caused autism in some British children.

The article was totally discredited because of serious procedural errors, financial conflicts of interest and ethical violations. The paper was retracted by the medical journal and its author lost his medical license. Several later studies found absolutely no link between vaccines and autism. This episode, understandably, created a lot of doubt among parents. By now, very few people — even vaccine skeptics — believe the autism myth.

Myth #2: Vaccines contain unsafe toxins

While it is true that formaldehyde, mercury and aluminum — which are used in FDA-approved vaccines — can be toxic to the body if ingested at certain levels, vaccines contain an extremely low, unharmful amount of these elements. This is something I get asked about frequently. What I typically tell parents is that these ingredients are used in tiny amounts, but still play a key role in the safety and effectiveness of the vaccine.

Myth #3: Infant immune systems can't handle so many vaccines

One of the most remarkable features of the human body is how many pathogens (things that cause disease) bombard us every moment and are consequently fought off by the immune system. Putting vaccines in this context demonstrates how accepting a baby or child's body is to immunization.

Myth #4: Natural immunity is better than vaccine-acquired immunity

Natural immunity is wonderful. The problem is that when someone gets an infection, we have no way of knowing if that infection will quietly resolve or become more serious and infect others along the way. Without being able to predict which path an infection will take, vaccines provide a much safer and certain road to immunity.

Myth #5: Vaccines aren't worth the risk

It's important to define risk. With the MMR vaccine or the flu vaccine, some people get a sore arm or slight fever for a day or two. For most of us, the risk of a mild side effect is worth the benefit of keeping us free of measles or reducing the chance of getting the flu.

Myth #6: The flu shot can give you the flu

Anyone who gets the flu shot injection is receiving a dead flu virus, which makes it impossible for the shot to give you the flu. (One alternative to the injection is the nasal spray vaccine, which uses a live flu virus. This option, which can result in mild, short-lived, flu-like side effects, is only approved for non-pregnant people between the ages of 2 to 49.)

Because the flu shot does not protect you from other respiratory diseases, someone can get a cough, sore throat or flu-like body aches after picking up another virus or infection. Moreover, even if you get the flu during the season, you probably won't get as sick as someone who did not get vaccinated.