Measles—it’s no joke

A new patient came to see me a few months back. She is in her 60’s or 70’s and not in the best health. She is very nice. And simple—very simple. I spoke to her brother before the appointment. He told me that she was a normal, happy kid until the age of seven.

Then she got sick. At first it wasn’t much, just a cold. Then there was a rash. Then she got very, very sick. She had measles, and she was one of the about 1-1000 people who develop acute encephalitis as a complication of the disease.

The rest of the kids in the family are quite bright and successful. My patient came to her appointment with a caregiver who assists her in basically any function that requires thought. She’s quite nice, but she’s not happy. She is anxious, perhaps partly because she can’t understand what is going on around her. And she is completely dependent on others for all but the most basic of her physical needs.

Denialists point to all kinds of pseudo-evidence (i.e. made-up crap) when it comes to vaccination. The point they always miss, partly because they never see it in real life, is that these diseases have real consequences for real people—not just made up connections with autism and other problems. The statistics are quite clear. Vaccines save lives. People who were around in the pre-vaccine era will tell you about the fear.

I recently did an oral history with my father. During a whooping cough epidemic, his mother rented a cottage on a lake outside the city to keep her kids from getting pertussis and perhaps ending up dead or brain-damaged from hypoxia. As an intern in the 40s he remembers how summer would bring a flood of polio victims to the hospital.

The diseases that vaccines prevent are very real and much more dangerous than the vaccines designed to prevent them.

There have been recent outbreaks of measles associated with reduced vaccination rates. Parents who fail to vaccinate their kids bear a portion of responsibility for this, but it’s the noisy idiots like Jenny McCarthy and Gary Null who are more to blame.

I enjoyed meeting my new patient, but it was a sad visit. Her parents were dead, her siblings had already finished their careers and become grandparents, and she was left behind, a seven year-old in a 70 year-old’s body.


Comments

36 responses to “Measles—it’s no joke”

  1. My mother recently sent me a copy of the obnoxious anti-vax propaganda ad, with the syringes. She also wrote a quick note mentioning that we should look into this, as we just had our second in December. I called her and really went at her about it – mainly because one of my niece’s is pregnant (yikes!?!).

    So the first thing I asked her was; “Do you remember polio?” Do you remember the fear? Do you remember the kids who had serious complications, due to measles and mumps? She was responding affirmatively, so I explained that those memories, those were the real world consequences of diseases that vaccines have put a virtual halt to. That is the reality. I also explained that this bullshit connection of vaccines and autism, is not real.

    After I was done with her, I called my pregnant niece. It was heartening to discover that I needn’t have bothered. Her mother the nurse, was very keen on making sure she knew the truth and understood the importance of vaccinating our children.

  2. Does anyone know any movies that have a good portrayal of the pre-vaccination-fear? Because of the way people respond to images sometimes where an argument will fall on deaf ears an accurate visual experience might show another angle.

  3. Via the miniblog at http://www.badscience.net http://www.upi.com/NewsTrack/Top_News/2008/03/30/nigerian_officials_try_to_contain_measles/8384/

    Nigerian health officials have opened treatment centers to cope with a measles epidemic that has claimed 165 lives in the past three months.

    Officials noted the death toll from the outbreak, which infected more than 3,000 people, could rise as they fear many cases go unreported throughout the country.

    …health officials say more than 95 percent of the children infected by the disease were not immunized.

    So 165 dead, how many more permanently injured, because of an anti-vaccine campaign by Niegrian Islamists (who also scuttled the polio vaccination program in Nigeria)

  4. I’m in my sixties, and I can remember kids in elementary schools who wore braces because they’d had polio. I can also remember seeing news footage of people with polio who had to live in iron lungs because they could no longer breathe for themselves. It’s crazy not to vaccinate.

  5. You can still see what polio looks like in India. Oh Darn, that outbreak was caused by the oral polio vaccine.

    Maybe Pal can supply some pictures from this year of what it looks like when the influenza or chicken pox vaccines fail.

  6. 1. I’m in my mid-50s, and I too had schoolmates with braces following polio. I remember my own bout with mumps and am so grateful my children were spared the days of misery.

    2. Whooping cough. As you know, pertussis is a potentially deadly bacterial infection that can strike at any age, but is particularly dangerous for babies. Adults are the number one transmitter of pertussis to babies. One of the best ways to protect babies from pertussis is to make sure that anyone in close contact with them is vaccinated.

    PKIDS is a national nonprofit whose mission is to educate the public about infectious diseases. They have launched a national campaign for effective vaccination against pertussis: “Silence the Sounds of Pertussis.”

    The site is: http://www.pkids.org/pertussis

    Here are my two posts on the Silence the Sound of Pertussis campaign:

    Why Vaccinate? and PKids’ Campaign: Silence the Sound of Pertussis. I’m keeping a list of bloggers contributing to the campaign there.

    Three things to know:

    The immunity given by vaccination in infancy wanes after about 10 years. The CDC recommends that teens receive a booster, in the form of Tetanus-diphtheria-acellular pertussis vaccine (Tdap).

    A person with pertussis is contagious long before the cough develops.

    Most infants acquire pertussis from adults, who either weren’t immunized or whose immunization has worn off.

    From Pertussis.com:

    Young infants are at highest risk for pertussis-related complications, including seizures, encephalopathy (swelling of the brain), otitis media (severe ear infection), anorexia (severe restriction of food intake) and dehydration.

    Pneumonia is the most common complication and cause of infant pertussis-related deaths.

    Whooping cough can be life-threatening for infants who are not fully vaccinated. In fact, over the last decade, 80 percent of whooping cough deaths occurred in infants under 6 months of age.

    In adolescents and adults, whooping cough can cause severe coughing that can make it hard to breathe, eat, or sleep, and can result in cracked ribs, pneumonia, or hospitalization.

    Here’s an adult’s description of her recent bout with pertussis

  7. Oh, Chuckles…always worth a good laugh.

    Just because our flu vaccine didn’t save as many people as usual doens’t mean we need to abandon the whole thing.

    Come up with a better alternative…oh wait you can’t.

  8. I had those diseases they vaccinate for now (MMR and chicken pox) (I’m 57.) The pattern was that I would get a very mild form of the disease; then my younger sister would catch it from me and have a more severe form (though not life-threatening).

    So if I were to go only on my personal history, I could assume that there was no reason for all the fuss. I did not realize that encephalitis was ~1/1000; that’s scary.

    Thank you for the information.

  9. Oh yeah Chunkie. Those pesky measles are nothing to worry about….

  10. moreonthat

    So, I have a request for you:

    I’m in my mid-30’s and I almost found out the hard way that I wasn’t immune to measles. There was a local case, and so I went and had my blood tested to be sure, although I didn’t expect anything because I had had one of the early MMR vaccines when I was a child. Turned out that I wasn’t immune to measles and also that they found out later that people need two shots. I was very surprised. I was immunocompromised at the time but I made the effort to get a second vaccine dose.

    I think it would be a great public service if you, or one of the other doctors on SB, could write out a post for people, especially adults, explaining what vaccines they need. I know now about the MMR ‘gap’ for a lot of people my age, and I know about the tetanus shot every 10 years, but not much else. I think it would be great to inform people on this because many of us are pro-vaccination but have accidentally falling through the cracks.

  11. “Come up with a better alternative…oh wait you can’t”

    I have never argued that there was a better alternative. Science should come up with a better alternative…oh wait it can’t.

  12. Thank you, great links! What I mean is though, something top posted, about what adults should be vaccinating for and why. It would get more readers and might really help to educate a lot of people who didn’t know they were at risk.

  13. I’m going to think about that…thanks for the suggestion.

    Oh, and Chuck, if you are claiming that there is a fatal flaw in our current system, evidence please.

    Meanwhile, the current system is quite good, but we are always working on improvements (but you don’t read the literature, so I don’t expect you to know that). Science is already way ahead of you. Believe it or not, you haven’t come up with some huge discover that the scientific world has managed to overlook. That’s called “grandiosity”.

    You have been useful in helping point out denialist tactics, but we tire of you now.

  14. Anonymous

    Given that on average 36,000 have died every year from the flu since 2003 (That is that I can find. I am sure the 36,000 average has been used for longer then that), the current system isn’t good or bad, it is just status quo. I’m sure there probably have been some improvements, but the average given by the CDC does not reflect them. You would have to be a denialist to not admit to that.

  15. My step-mother’s uncle is completely deaf from measles he got when he was three.

    I am so grateful that I grew up and that I’m raising my children in a time when there is little worry of things like smallpox, measles, mumps, rubella, whooping cough and all the rest.

    My kids had all their shots by 2yrs.

  16. This is particularly a US problem because we have no organized way of taking care of the very small percentage that react badly to the vaccinations. Ideally there would be universal immunization and an agreement that the society would bear the burden of caring for those who were damaged.

  17. You’re joking? We actually have such a system. In fact if you’ve been keeping up, in the recent Hanah Poling case, a family was reimbursed from the system despite the unlikelihood of a link, because we err on the side of helping out the family.

    http://vaers.hhs.gov/

  18. A good friend of mine was deaf due to measles. She was the daughter of an Air Force Surgeon. The entire family couldn’t have been more gracious. Because of this, most of her friend, included myself learned ASL. She could read lips but sometimes when she was younger it wasn’t as easy for her. The last time I spoke with her, she had a career and a family of her own. She had nothing in life to complain about and there was nothing in her life that anyone should pity.

  19. Dear Charles Strawman,

    No one is making the argument that the unfortunate surviors are somehow worthless. The point is that while many deaf people can lead perfectly normal lives, avoiding the loss of one of our primary senses is a very important goal.

    You are a first class denialist, and a heartless asshole to boot.

    Go away.

  20. Actually we do not have such a system. NVICP will not help anyone when vaccines fail, only for adverse reactions. Check the tables.

  21. That is perhaps one of the dumbest things you’ve ever said, but it’s tough to choose. Perhaps you had measles encephalitis, but of course, that doesn’t mean you can’t live a very fulfilling life as a dolt.

  22. I presumed that I could not file for vaccine failure. If you are stating that I can file, then thank you very much for that information. At least I will be able to recoup for last year’s vaccine failure. I will let you know how it goes.

    Thanks.

    In spite of everything, I do have a good life, a roof over my head, family and friend, and a good paying job. What more do I need? I hope that you can say the same.

  23. Let me see if I can play “follow that goalpost”–there is a system to compensate people in the unlikely event of severe vaccine reactions. Now you also want people to be compensated if they catch the disease they were vaccinated against?

    If so, please try to remember that vaccination is our best prevention weapon for these diseases, but it certainly isn’t perfect, and vaccines don’t come with a guarantee…with your reasoning, I should be able to sue you if you are unvaccinated and give me pertussis. Your reasoning is quite poor.

  24. I do not deny that vaccines are necessary in today’s society. Having witnessed the pain and suffering over the years from the influenza, chicken pox, small pox, and pneumonia vaccines and what government and science will and will not do has seriously jaded my view and trust in the vaccine institution. “For the greater good” does my family no good whatsoever.

  25. Elf Eye

    For the life of me, I can’t figure out what Chuck is objecting to. Let’s say you take a group of one hundred unvaccinated individuals. Fifty contract a disease. Out of the fifty, five die and ten suffer serious longterm harm. Now let us take a group of one hundred vaccinated individuals. One suffers a bad reaction to the vaccine, for which he or she is compensated out of a federal fund. Five fail to develop complete immunity and are susceptible to the disease, as they would have been if unvaccinated. No net loss there. To me the math seems to be in favor of vaccination. As a patient contemplating the odds, I see that I stand a much better chance of benefiting from vaccination than nonvaccination and that the consequences to society of nonvaccination are much graver than the consequences of vaccination. Chuck, however, points triumphantly to the number who do not benefit, much smaller than the number that do, and concludes that there is a problem with vaccination. Chuck, can you point out a flaw in my analysis? Nota bene: It will have to be something other than an example of a patient who failed to benefit from vaccination because my analysis already allows for the fact that vaccinations are not 100 % effective. (Is anything?)

  26. Statistics are a great thing as long as they don’t adversely affect you. Multiple members of my family received an ineffective influenza vaccine in multiple seasons and one has lifelong medical problems because of it. One member received an ineffective Chicken pox vaccine, another received an ineffective pneumonia vaccine. One person has lifelong problems as an adverse reaction to small pox. No compensation was ever received because it happened before NVICP. These are not “statistical people”, they all live under the same roof, mine.

  27. elf eye

    Chuck, assuming that the vaccines had something to do with your family’s health problems and these are not cases of post hoc ergo propter hoc, these cases prove what? That vaccines are not always safe and effective for each and every patient? We already know that. That we should continue to work to improve both the safety and efficacy of vaccines? We already know that. (By the way, are you planning to avoid all medicines and medical procedures–none are 100 % safe and effective.) Is your point that it is a good idea to compensate people injured by vaccines so that the pharmaceutical industry will continue to manufacture a product that does more good than ill? Done. That we should not vaccinate? I trust that is not your point. If it is, it has been refuted. So what _is_ your point? I can’t find one other than the fact that you nurse a grievance because members of your family fall into a group that is small in size but will be with us always: those who are either injured by vaccines or who do not develop the desired immunity. You know, my daughter falls into a small group: those who are allergic to red dye. She ended up in the emergency room one night. We now exercise extreme vigilance when shopping for food and personal care products, and both of us carry epipens. Do I expect red dye and its accompanying risk to my daughter to be eliminated from all food sources and personal care products? No. Do I expect each and every food and personal care product to be 100 % safe and effective for each individual consumer? No. There are numerous food allergies out there, and any given individual may not even realize he or she is allergic until consuming a certain quantity of the allergen. (My daughter was eighteen when she began to break out into hives.) The risk for any given individual is to a large extent unpredictable. Do I feel resentful that a risk-free state of affairs will never be achieved? No. I _do_ expect careful labeling of the contents of foods and personal care products, but the risk to my daughter will never be reduced to zero. Of course, red dye is not integral to maintaining the health of the population, so the analogy, like all analogies, is not perfect–in fact, the case for vaccines is stronger because of their benefits. My point is, though, that there are many products, from vaccines to food coloring, that are valuable to numerous people while harming a small number because of allergies or for other reasons. To the best of our ability, we address the needs of those people who are susceptible to harm–think peanut-free classrooms for children allergic to peanuts. So, again, what is your point other than the fact that you seem to resent the fact that vaccines are not 100 % percent, an unrealistic goal in an imperfect, unpredictable world?

  28. Elf Eye

    The last line should have read “vaccines are not 100 % safe and effective….” See, I have just proved that we live in an imperfect world. 😉

  29. Anonymous

    Elf Eye,

    Are you willing to be criminally charged if you don’t give your child red dye in order to receive an education? Don’t give me your pointless straw man arguments unless you expect to get the same in return.

  30. False analogy—you’ve followed it too far. Failing to vaccinate your children affects MY children. What you feed your kids does not.

  31. Herd immunity cannot be scientifically achieved for influenza or pneumonia, so it is not a false analogy. Pal can herd immunity be theoretically achieved for Chicken Pox? Be honest now because I honestly do not know.

  32. Needed to have a little dinner. Yes herd immunity is possible for chicken pox. Is it the correct allocation of resources given the risks, different question.

  33. Yes, a very interesting question.

  34. Evinfuilt

    I’ve said it before, I’ll say it again. Not knowing till I was much older why my aunt walked funny was eye-opening (and now I wonder if it was what she went through that helped inspire her to become an MD.)

    I hope for many generations to come my family still remembers what Polio did and why we vaccinate.

  35. AutismHeroMom

    All this crap disguist me if vaccines work then why are people worried about the percentage of children with disorders making vaccination a contraindication infecting your children. I live with vaccine induced autism everyday 2 of my 3 beautiful children have VIA and we have the proof they have a mitochondrial disorder just as most of the others with VIA have we had the studies done. We have a case awaiting in Vaccine court. All I want is people to be educated a $400 test can save your child from being locked in a world all their own in need of constant care. By the time our children reach adulthood your tax dollars will be paying for their care in nursing homes and group homes when there is no one left to care for them and I think there will be more of them then any other diseases and disorders. They say 1 in 150 but the latest research is showing 1 in 67 the rate is continuely increasing. Make vaccines safe don’t take them off the market yes they are important but they are not a one size fits all thing.

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