Recently documented cases of measles in New Jersey and Washington State have caught the attention of the healthcare community, especially pediatricians.  The last outbreak occurred in New York City in 2018 among orthodox Jews.  The common denominator in these outbreaks was the lack of vaccination against this highly contagious virus.

Measles on the Run

Due to the absence of any cases of measles in the US in 2000, the US public health officials declared that measles had been eliminated in this country.  Due to low use of the MMR (measles, mumps, and rubella) vaccines in other countries, however, importation of cases of measles still occurs.  This would not be much of a problem if our population adhered to guidelines for the MMR vaccine (one shot between the ages of 12 to15 months of age, and a booster between the ages of 4 and 6 years).  Individuals who are not vaccinated are very effective vectors for the spread of the disease among the unvaccinated population.  Epidemiologists think that a MMR vaccination rate of 95% in children is necessary to prevent outbreaks.  We hover around 91%.

Does It Matter?

Those of us old enough to have lived in the measles era associate it with a flu-like illness that had a characteristic rash.  Recovery was usually not an issue, but it can be a dangerous disease.  Before the vaccine became available in 1963, three to four million people (mainly children) contracted the disease per year.  Of these, 48,000 were hospitalized, and 400 to 500 died each year.  Rare non-fatal complications include blindness, encephalitis, and pneumonia.  Currently, for every 1,000 children who get measles, one or two will die from it.

How Good Is the Vaccine?

The vaccine for measles is safe and is 97% effective in preventing the disease.  Given these data, one might conclude that almost any death from measles, or severe complications, is unacceptable. 

Anti-Vaccination Movement

Opposition to vaccines is as old as vaccines themselves.  Some of this springs from a purely libertarian anti-government sentiment, but the largest part is probably linked to religious beliefs.  For instance, orthodox Jews will not take vaccines if pigs are used in the process of making the vaccines.  Some religious sects oppose vaccines that are derived in part from aborted fetal tissue.

A big bump in anti-vax sentiment was the result of an article published in the respected British medical journal, The Lancet, in 1998.  Using data fraudulently, Dr. Andrew Wakefield linked the measles vaccine to autism.  The gathering of information was flawed and it was discovered later that his research was being funded by parents who were suing vaccine manufacturers.  

A fusillade of research debunked Dr. Wakefield’s findings, and the journal eventually withdrew the article.  But the fuse was lit.  From 1994 to 1997, the MMR vaccination rate in the United Kingdom was 91%; in 2003/04 the rate was 80%.  In the US, vaccination rates fell by two percent.

Celebrities and politicians got on board with the anti-vax movement.  Using the formidable tool of social media and appearances on sympathetic talk shows, such luminaries as Robert DeNiro, Bill Maher, Jim Carrey and Eric Clapton fear- mongered with the best of them.  Most startling was Senator Rand Paul’s contribution to vaccine skepticism.  He said “I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines.”  Paul is a physician, apparently trained at an institution that does not teach the basics of epidemiology.

Vaccine Hesitancy with Covid

As the grand champion of the spread of harmful and false information on vaccines, Dr. Wakefield continues his mission.  He speaks at anti-vaccination gatherings and has not backed off on his original findings.  He has fueled, and continues to fuel, the anti-vaccination movement… with remarkable results.  This has leaked into the vaccine hesitancy movement against the Covid vaccine.  

What is the import?  In March of 2022, the CDC (Center for Disease Control), assessed the effectiveness of vaccination against Covid.  Unvaccinated people had a mortality rate of 1.71, deaths per 100,000, while those vaccinated had a rate of .22 per 100,000.  If boosted, the rate was .1 per 100,000.  Vaccinated people with Covid enjoyed a 8 fold decrease in mortality compared to those not vaccinated, and a 17 fold advantage if boosted.

Upshot

It is impossible to definitively connect the dots between Dr. Wakefield’s work and Covid mortality.  But one physician in Britain observed Wakefield’s fraud was “the most damaging hoax in 100 years.”  It is possible (probable?) that Dr. Wakefield bears the responsibility for hundreds of thousands, maybe millions, of deaths worldwide.