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NYC skyline over a 1905 world map, syringes pointing towards the city to show vaccinations after measles outbreak.
Kate McCabe / Gavel Media

Measles, Medicine, and Misinformation

Measles was declared eliminated in the United States in 2000. According to the Centers for Disease Control and Prevention (CDC), this elimination is defined as “the absence of continuous disease transmission for 12 months or more,” making it no longer endemic, or constantly present. This could soon change, as measles looks to mount a comeback tour through the U.S. and abroad. In the first quarter of this year alone, there has already been the highest number of cases post-elimination excluding 2014, which reported 667 cases over the course of the entire year. So far 626 have been documented, most of them coming from New York, where measles stems from unvaccinated people in Orthodox Jewish communities.

Despite its elimination in the U.S., measles is still common in many countries. As such, the origin of most cases in the U.S. is almost always unvaccinated travelers coming into contact with the disease abroad and bringing it back into the U.S. This is likely what happened with Patient Zero, who had come from Israel to Brooklyn in November of last year. He would later go on to visit various ultra-Orthodox communities in the U.S. to raise money for charity, bringing measles along with him.

This follows a similar trend as other recent incidents, with the CDC reporting that three-quarters of cases in the last five years have occurred in similarly insular communities, such as the Amish in Ohio or the Somalian community of Minnesota. Although the majority of the American public is vaccinated, it is not uncommon for these tight-knit communities to be wary of vaccinating their children, as religious beliefs or distrust of government can allow for anti-vaccination misinformation to gain traction.

It isn’t just these small communities that pose a danger to public health: The anti-vaxxer movement has found growing footholds throughout the U.S. and Europe. Some claim religious beliefs motivate them to withhold vaccinations from their children. Others cling to the notion that vaccines cause autism, which has been medically proven to be an utterly false and unqualified statement. Still, others feel that forcing people to get vaccinated constitutes government coercion and violates their rights as citizens.

The sad truth is that, regardless of the reason, these communities endanger those who actually cannot receive certain vaccines, such as children who are too young to have received all their shots, immunosuppressed patients, elderly people with weakened immune systems, or individuals with severe allergies to gelatin, antibiotics, or other ingredients common in many vaccines. In refusing to get vaccinated, these individuals compromise herd immunity, a key tenant of a modern, healthy society.

The idea of herd immunity is if a substantial portion of the population is immune to a particular disease, it can protect the rest of its members who are still vulnerable. They are able to do this by greatly reducing the chances that a susceptible person comes into contact with an infected person. In this way, the disease will not be able to find receptive individuals and, therefore, will be stopped from circulating in the community. For this to work effectively, a community must reach a certain immunity threshold to properly break the chain of infection. This differs from disease to disease, but the threshold for measles, which is extremely infectious, is about 90 to 95%. This means that even if the majority of a population is vaccinated, there is still a risk of an outbreak if vaccinations are below the threshold.

One doesn’t have to search far for proof. Madagascar, whose population had a 58% vaccination rate in 2017, is now experiencing one of the worst measles outbreaks in decades, with more than 1,200 people killed and over 100,000 reported cases. Measles is particularly dangerous in less developed countries, like Madagascar, where children are often malnourished and there is less access to quality healthcare. However, it is not just Madagascar; drops in vaccinations across Europe have led to a 20-year high in measles cases, as well.

Although the U.S. is certainly not in danger of an epidemic like the one currently being battled in Madagascar, it is clear that the importance of vaccinations cannot be understated. Even with over half the population immune, measles is ravaging the country. While the majority of the U.S. is more than fine, it is critical that the value of modern medicine and science be respected. While people are certainly entitled to their own opinions, they are not entitled to their own facts. Before the measles vaccination in the 1960s, around two million people died globally, with three to four million cases of infection in the United States alone. History may be said to repeat itself, but hopefully the same will not have to be said about a preventable disease.

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