Thursday, 5 February 2015

Revisiting The Measles Vaccine Debate, in Light of Disneyland

Apparently I need to blog about this measles vaccine business again.

It's over a year since I talked about this, when there were small outbreaks in Canada and the US. The CDC reported 102 cases of measles at the end of January, most stemming from an outbreak at Disneyland in December.

No, it's not a national emergency, although measles is "one of the leading cause of death in young children globally" (Read more here). The chances of a healthy person dying of measles in the US are fairly slim, as the majority of severe complications and deaths due to complications occur in developing countries with weak health infrastructure and children who are chronically malnourished. (Read more here). However, the chances are still a little too high for my liking: 1 or 2 infected children in 1000 will die, and up to 1 in 20 will experience measles-related complications. I know that a lot of people aren't with me on this, but I consider measles a serious disease. Read more here.

I'm fully aware that many, many Americans got measles before the vaccine was routinely administered, as the disease is extremely contagious,  and survived it with minimal discomfort and downtime. Measles just used to be a part of life.

But it hasn't been for a long time. The measles vaccine almost eradicated a disease that, for some that come in contact with it, is very dangerous. It can cause ear and chest infections, brain damage, deafness, blindness, pneumonia, and  encephalitis. Author Roald Dahl wrote about how his daughter Olivia died of measles encephalitis:
"Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything. 'Are you feeling all right?' I asked her. 'I feel all sleepy,' she said. In an hour, she was unconscious. In twelve hours she was dead."

I know a mother whose son can't have the measles vaccine because of a rare blood disorder, and she explained to me very carefully about how while the lack of a measles vaccine is always a concern, herd immunity protects people like her son. However, as fewer people vaccinate, herd immunity weakens, and puts even vaccinated people at risk, as the measles vaccination is only 95% effective.

Here's a video about herd immunity, featuring some Gummi Bears...

Herd immunity is important, And this is why, blogging about the measles vaccine this time, I'm calling the crowd out that refuses to give it to their children.

The Decision Not to Give the Measles Vaccine Doesn't Just Affect That Child

If a parent's decision not to give a child the measles vaccine affected only that child, I'd be truly more than happy to let parents decide what they want. But that's not the reality. A child who hasn't had the measles vaccination is potentially dangerous to infants, the immunosuppressed, and other people who can't have the measles vaccine for good reasons, including people undergoing cancer treatment...people who didn't ask to be affected by the actions of those who refuse to to give their children the measles vaccine, and shouldn't have to be. For people who refuse to vaccinate to insist that their right to go against the dictates of public health policy based on solid science should trump the rights of everyone else to to be in an environment that's free of the potential to catch a disease with potentially serious health consequences is just selfish.

Yes, you parents who aren't vaccinating your children against measles. You're selfish. And if no one's told you that yet, it's about time that you heard it.

"But Autism"

I've read the reasons why parents aren't choosing to get their children the measles vaccination. I've yet to hear a substantially-supported argument in favour of refusing to vaccinate, and this includes "Big pharma" and "toxins" and especially the "But autism" thing. In fact,  I'm flabbergasted at how often I'm hearing about people still refusing to vaccinate against measles because of the fear of their child getting autism.

In recent discussions on this, I've challenged on this ableist, "but autism" angle whenever I can, pointing out (as I did in my last blog post on this topic) that the studies that "linked" autism and vaccines were thoroughly debunked. I've pointed out that several times this week in discussions that making autism a "boogeyman" is a tactic of so-called "advocacy groups" with questionable ethics, such as "Autism Speaks", and that many people autistic people would tell you that they're perfectly fine with being autistic - it's society that has the problem.

A friend did on Twitter said the other day, "As an autistic, the fact that so many people would rather have a child that's dead than autistic child scares the shit out me."

"Fucking Furious"

I didn't realize until I read that, and started typing in response, "It makes me fucking furious, which is why I'm never going to stop fighting against this ableist 'I'd vacccinate, but autism' bullshit," how angry about all this I really am (and I'm not autistic, so I can only imagine how autistic people must feel). Even if there was a remote chance that the measles vaccine could cause autism (which there isn't), I'd rather take that remote chance, vaccinate, and know  that there was a 95% chance that my child would avoid the terribly contagious measles and anything more more serious that it might turn into.  I'm not a parent, but if I was, in this hypothetical world where vaccines once in a blue moon caused autism, I would without hesitation choose to do everything that I could to ensure my child stayed warm and alive in my arms, including vaccinate, rather than, God forbid, end up one of the few with a body that just cannot take the strain of fighting measles.

The Measles Vaccine - The Bottom Line

Forgive me if I cannot understand why a fear of autism prevents parents from giving children the measles vaccine, especially since it's been proven that the two. Aren't. Linked. Any children that I have will get the measles vaccine, to protect them and to protect others.

It's as simple as that.

I'm sorry that I can't be as diplomatic as I was last time. Discussions this past week have shown me that subtlety doesn't get the point across with this particular issue.


  1. I could not agree with you more, Sarah. So much anti-vax positioning is based on discredited science, anecdote, and plain false information. Some kids get sick after a vaccination, there maybe some removed correlation but no science for causation. The people who choose not to vaccinate put other lives at risk...plain and simple. People may not die from measles itself, but from the complications of measles. People should remember that even a simple cold or flu for their child often results in PICU or ICU for our compromised children.

    I saw with amazement a piece of lunacy in the form of a book on amazon called "Melanie's Marvelous Measles." predicated upon junk science and outright fabrication


    Right, I am going to pen a book called: Melanie's Marvelous Hemorrhoids or perhaps Melanie's Marvelous Zits, or .... I think the world is coming to an end. I am happy you tackled this topic.

  2. PS... For good measure I'm also going to call out all the chicken pox vaccinaters on being seflish. Just so that you don't have to miss a week of work to take care of your kids (read the arguments in favor of introducing universal chickenpox vaccine early/mid-90s) now even healthy people are at risk of shingles. Used to be we wouldn't get shingles as long as our immune system was functioning reasonably well because the virus would always be suppressed by a steady exposure to wild chicken pox. Now, because of the vaccine, otherwise perfectly healthy people are dealing with shingles (extremely unpleasant to debilitating) or are forced to get a vaccine and subject themselves to the risks there-in (see insert and VAERS). But hey - you could keep sending your kid to daycare and we didn't loose "productivity".

  3. Hello Jennifer

    First, my condolences on losing your son. I am not a parent, but can't even begin to imagine that nightmare.

    Second, thank you for writing the best piece that I've seen so far on the choice not to vaccinate children. It's obvious that you've done your homework on this and given it a great deal of thought and are approaching it with a great deal of personal integrity.

    I've worked with autistic people that behave as you described, when I was working in the developmental services sector. I've seen how difficult it can be, given the current availability of funding for respite, supports, and educational placements, how difficult it can be to raise a child whose autism manifests in these ways, and I could emphasize with the trepidation around exposing a child to the risk of autism by vaccinating them - if that link was there. If it was, it would certainly not be something to be minimized. But studies of hundreds of thousands of children over several continents have shown that it's not, and this is where I don't understand the concern.

    I've also heard the concerns on whether herd immunity can really exist. You provided me with some things that I hadn't heard, and I thank you for the information.

    I do admire the strength of your convictions on this, because I absolutely don't doubt that there are things in vaccines that I'd rather my child not have injected into them. I'd just be so frightened of losing my child to a preventable disease if I didn't.

    I think that our rhetoric gets angry because we are scared. But you're right - it's no reason to treat all parents who choose not to vaccinate like they haven't done their own research and thinking on this.

  4. Until I started looking into the Disneyland story, I didn't even know that there was a chicken pox vaccine, and I was very surprised. But I do hear more adults talking about getting shingles than I used to..

  5. As a part of the crowd that has put time and research into vaccination, we have elected not vaccinate at this time.
    It is not fear of autism (although I do have knowledge of people who have had vaccines reactions, and as a result their children were diagnosed with autism. Can I say it was the vaccine itself, a pre-existing condition, or something that the child had before they vaccinated - no I cannot. I just know that they went to the doctor with a normally developing child, went for a routine vaccine, and their child had bad reaction.
    I also know that my husband's daughter had a bad reaction to a vaccine, for which they feared they might lose her.
    Vaccine (injectable viruses/ bacteria and other chemicals designed to ignite the immune system) do not come without potential for reaction, just as the diseases they are aimed to minimize. It is, really a risk of the unknown.
    We have decided that we may give some - my research as lead me (based on manufacturer's inserts and labeling), to recognize that some side effects are minimized as one is older (just as in some of the diseases). That being said, because certain illnesses have lesser consequences as one ages (for example, whooping cough for a baby is extremely dangerous - whooping cough, while not pleasant, is perhaps a little less of a danger as one ages).
    Other diseases are much more troublesome for an already compromised immune system, or much more dangerous as one ages (such as chicken pox).
    The other issue that I looked into was the number of vaccine. A pattern that I have noticed in those whose children have bad reactions is that sometimes they are receiving multiple shots in one visit. Thus, I will never give my child more than one vaccine at a time.
    I have read some of the research that is available regarding the autism link, and it is inconclusive by design. Based on the fact that parents still claim that their children have reactions which lead to an autism diagnosis, I am not convinced that there is no link. However, I am also not convinced that there might be other triggers or that perhaps there isn't some sort of genetic predisposition to a vaccine reaction.
    However, as the vaccine inserts clearly state to the potential side effects of vaccines: There are no reliable studies that could determine for sure if the reported side effects are in fact due to the vaccines.
    Regarding effectiveness - this past year's flu shot was only 25 % effective. To be forced into a product that has a terrible track record for safety (one has only to look at the lawsuits and vaccine injury reports); and an effectiveness that can only be guessed as best, my personal opinion is there needs to be a better way - we need to make informed choices, have alternatives, be educated as to other ways to prevent and lessen the effects of disease (sanitation, nutrition, hygiene, etc.), as well as choices that do not force people into taking injection that may potentially involve unknown risk.

  6. Sarah,
    I have read some of the studies, and I think that, while it is confusing as to the link, it is also a bit more complex than people realize (Temple Grandin touches on this somewhat in one of her books).
    The legal position (Hannah Poling case) is that it is not the vaccine in and of itself - rather a pre-existing condition which led to a brain injury. In some cases that was an autism diagnosis. However, because studies cannot conclusively determine the autism link, one cannot say that a vaccine directly causes autism (basically, correlation does not equal causation). Those who try to file a claim for a vaccine causing autism would probably not win that case (see another legal precedent case where the family attempted the vaccine causes autism lost). Those who, as Hannah Poling's family did, filed a pre-existing condition for which the vaccine triggered a reaction which led to a brain injury/autism diagnosis, won the case). It is really a bit more complicated than people recognize, and perhaps very emotional for many of the families involved. To determine the autism link (or any other link to any other adverse reaction) is also much more complicated than people might recognize. For example, the mercury in vaccines was once considered a link. However, that has been removed. There is other ongoing research with other vaccine ingredients (including the way vaccines are cultured - in the 90s they began culturing vaccines in human DNA tissue from a line of embryonic stem cells) and components. To prove a link is really quite difficult and a process that involves years of analysis, genetic study, long and short term study (there are short term studies, but one type of study that is lacking is effects of build up of vaccine in the system), ruling out other factors, etc., for which even vaccine inserts clearly state that there really are not any reliable studies that could determine if the vaccines did or did not cause the reaction. I have read Dr. Andrew Wakefield's post research book, just to educate myself as to what all the hype was - he really has been mislabeled in the hype - he is really not anti-vaccine - he supports vaccinating - but he also supports choices within the vaccination program for parents, such as limited vaccines, single dose vaccines and knowledge. His studies also were not so much on the autism, but rather on the best way to treat the autism that also came with gut/bowel disease, and if treating the bowel disease would improve the autism. Because the parents in the study had a claim that their autism was caused by the vaccine, he could not do the research without that link. Thus his research was more about the bowel disease and its connection to autism, which I found rather interesting. So, if the reaction to the vaccine is not autism, but bowel disease which leads to complications of autism, wouldn't a parent want to know that? I would think so Which is why I think much of this is a bit more of a complex web than a simple statement of, "There is no link; no safety concerns; and complete effectiveness."

  7. Hi Radial...nice to see you!

    Vaccines aren't without risk, you're right. From what I've read, the risk level is low and the danger of the of the "vaccination causes autism" messaging has been to assume that correlation implies causation. And I agree with your whooping cough argument - a guy that I used to date had it in childhood, and he got through it fine. But he might have passed it along to someone that had a lot harder time with it. I realize that you can make that argument about the common cold, that you can't be responsible if you pass it along to someone who consequently develops pneumonia if their immune system is weak...but measles is going to develop into, well, measles, and if you're not vaccinated and you're exposed to it, chances are that you're going to get it - and there's a higher rate of residual damage from measles than from a vaccine, if what I've read is correct.

    The annual flu vaccine is a different animal, I think. I don't get the flu vaccine, and haven't for some years, because of its low effectiveness. But if I still worked in social services or in schools, I'd get it (I'd have to anyway), or had consistent contact with someone with a compromised immune system, I'd get it - for their sake, some protection on my part is better than none. But you're right - education about the alternatives for flu prevention needs better promotion, especially since the vaccination isn't mandatory in my province except if an employer makes it so.

    I do appreciate that more parents are at least doing research into vaccines before at making a decision one way or the other, before just jumping to a conclusion out of fear, but re: the autism issue, I still see a lot of people citing Wakefield.

    Thanks for commenting. :)

  8. I cite Wakefield, but not out of ignorance or because I believe everything he did was correct. I refer to him more because I've read his documents and am reading his book, and more to be informed. I think most people only listen to the media hype about him, not read what he actually did and what his research was about. In his own words, it was incomplete. He was not the first person to link vaccines to Autism (there plenty of lawsuits pre-Wakefield, as well as numerous other researchers who continue to look for clues and answers). And, his research was not about the Autism/vaccine link. It was about bowel disease/ Autism and treatment. I would say that, (again, I would not cite his research), but if people want to know the whole story, they should at least read his papers and his books, not base their information on what is said about him.