The need for needles: Vaccines and rising infection rates
Measles was once a rite of passage during childhood. Nearly every American kid was infected by age 15, according to the Centers for Disease Control and Prevention. And each year, on average, 48,000 children were hospitalized, 7,000 experienced seizures, 1,000 suffered permanent brain damage or deafness and 450 to 500 children died.
These numbers dropped precipitously, virtually disappearing, after the first effective measles vaccine debuted in the early 1960s. In the United States, a routine and required vaccine regimen has almost eradicated the infectious disease.
But not entirely. Indeed, measles are making something of a comeback, in no small part, say health experts, due to declining vaccination rates. Last year, for example, the National Committee on Quality Assurance, said the number of children in private health plans who were properly immunized declined by as much as 3.5 percent. The phenomenon is not unique to measles. It’s happening too with other infectious childhood diseases, such as whooping cough and mumps.
Mark Sawyer, MD, is a professor of clinical pediatrics at UC San Diego School of Medicine and Rady Children’s Hospital-San Diego. We asked what’s happening, why and what happens next.
Question: It seems significant numbers of people these days are refusing or avoiding vaccinations that were, in the past, routine and commonplace. From your perspective, what’s the explanation?
Answer: This is a complex phenomenon that boils down to people getting partial, and in some cases, inaccurate information about vaccines and the diseases they prevent. Much of the misinformation is found on the Internet, where it can be difficult to separate accurate from inaccurate information.
In all cases, the risk of being exposed to and developing a disease – even among conditions that are now rare – is much greater than the potential health risks of the vaccine designed to prevent that disease. When people are given accurate information, they choose to get immunized. People should find a provider they trust to discuss their concerns and help them sift through whatever information they have heard.
Q: One complaint among parents is the concentration and number of vaccinations mandated during their children’s first years of life. What are the prospects for effectively spreading vaccinations over a longer period or reducing the number of shots required?
A: I don’t see that happening because the basic approach to the recommendations for when vaccines are given is to protect children as soon as they can be protected. By spreading out vaccines, you leave children unprotected. Why would we want to do that? There is no evidence that giving vaccines together the way we do causes any ill effects. In fact, some argue that by spreading out shots so that every time a child comes to their doctor they get another shot is more traumatic than giving them all at once.
Q: What are the consequences of diminishing numbers of people getting vaccinated?
A: The short answer is simple: We are seeing more disease. Measles cases are increasing. Pertussis is increasing. Other diseases will increase. All of the infections we immunize to prevent are still around, and they know no borders.
The protective value of vaccinations lies in part in a concept called “herd immunity,” which means that when a significant percentage of a population is vaccinated – the herd, so to speak – it provides a measure of protection for individuals who have not developed immunity. In other words, chains of infection are disrupted because large segments of the population are immune. The greater the number of people vaccinated, the less likely someone without immunity will come into contact with an infectious individual.
Conversely, if the number of individuals vaccinated declines, the chance of an infection spreading in the herd rises.
Q: Do you think the rising numbers of cases of measles, whooping cough and other diseases routinely prevent through vaccination is evidence that we’re approaching some sort of tipping point?
A: Yes. Just look at the countries of Europe who have major measles epidemics because they let their level of vaccination drop. The US will be there soon.