Disneyland measles outbreak strikes in anti-vaccination hotbed of California

The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear

Officials from Mexico to California are now scrambling to contain an outbreak that began at Disneyland but has now spilled across state lines, infecting dozens, many of whom never received the measles-mumps-rubella vaccine (MMR).         Wakefield had what he needed to publish a study. It was based on 12 kids. And it broadcast concern that MMR could cause a bowel disorder and autism. Nine of the immunized children were found to be autistic. “If there is a causal link between measles, mumps, and rubella vaccine and this syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK in 1988,” he wrote. The news rocketed across the globe; the media ran hot with the story. “A controversial study has suggested that autism may be a side effect of immunization against measles, mumps and rubella,” New Scientist reported weeks later.     Under such circumstances, most doctors would retreat into obscurity. But not Wakefield. He still believes in the mission, attracting scores of supplicants. Even today, he fiercely defends his campaign against vaccines and has found a sympathetic community in his adopted state of Texas. Asked in 2011 by the New York Times if he still believed MMR had caused the autism in his now discredited paper, he was unequivocal. “Is that a serious question?” he asked. “Yes, I do still think MMR was causing it.”

The measles vaccine is a shot of common sense

DR. JAY Gordon, a pediatrician in Santa Monica, Calif., appeared in a “CBS Evening News” broadcast the other day, talking about the measles outbreak that began at Disneyland and now has infected 67 people in 11 states. Dr. Gordon has signed “personal belief exemptions” allowing parents in California to avoid vaccinating their children against the disease. “This measles outbreak does not pose a great risk to a healthy child,” he said. “And quite frankly, I don’t think it poses any risk to a healthy child.” He added that measles “is an almost always benign childhood illness.” This thinking is dangerous. Measles is a highly infectious, acute viral illness that threatens people who are unvaccinated. Dr. Gordon would be right to say it is not a great risk to children who have been inoculated. But he and others who enable people to avoid vaccination are trafficking in poor information that could lead to more cases of a disease that was eliminated in the United States 15 years ago. Is measles “benign”? The Centers for Disease Control and Prevention says measles “can lead to severe complications and death” and “even patients who experience uncomplicated acute measles have a small risk for developing a devastating neurologic illness . . . years after their infection.” Measles is common elsewhere in the world, with about 20 million cases reported each year and 122,000 deaths. Before vaccination began in 1963, about 3 million to 4 million people got the disease each year in the United States, of whom 400 to 500 died, 48,000 were hospitalized and 4,000 developed brain swelling. That does not fit our definition of benign. Last year, the United States experienced 644 cases of measles in 27 states and 23 outbreaks. This is the greatest number since elimination — zero transmissions from one person to another for a whole year — was declared in 2000. What is happening is that unvaccinated Americans and foreigners are bringing the virus to the United States after becoming infected abroad. There are outbreaks in Europe, Africa, Asia and the Pacific; last year most of the cases brought into the United States came from the Philippines, which has been struggling with a large outbreak. While it isn’t certain how the outbreak began at Disneyland, experts say a visitor carried it into the park from overseas between Dec. 15 and Dec. 20. Others were exposed, including at least five Disney employees. Just one infected person can spread the virus to others. According to the Centers for Infectious Disease Research and Policy at the University of Minnesota, the genotype linked to the Disney outbreak is circulating in 14 countries around the world. There is an effective shield in the United States. The measles, mumps and rubella vaccine works and has a 50-year safety record. Certainly there are enough serious public-health threats today in the United States that a new one should not be created out of a virus that was already eliminated. Those who refuse to vaccinate are wrong. They endanger themselves and those around them. **Read more** **on this issue:** The Post’s View: As measles cases increase, a sharp call for vaccinations Letter to the Editor: Not a strong argument for vaccination Michael Gerson: The enduring benefits of vaccination

The California Assembly just approved one of nation’s strictest mandatory vaccine laws

Months after a virulent measles outbreak spread from one Disneyland visitor to more than 100 California residents, the state that’s been described as an “anti-vaccination hotbed” is poised to pass one of the nation’s toughest laws requiring immunizations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The bill approved by the California Assembly Thursday strikes down the state’s personal belief exemption, which allows parents to opt their children out of vaccinations for religious reasons. Under the new rules, only children with serious health problems (such as a compromised immune system) would be exempt from mandatory vaccination schedules, and those who opt out will have to be homeschooled.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The legislation now goes to California Gov. Jerry Brown (D). According to the Los Angeles Times, it’s unclear if Brown will sign it. “The governor believes that vaccinations are profoundly important and a major public health benefit, and any bill that reaches his desk will be closely considered,” Evan Westrup, Brown’s spokesperson, told the Times Thursday.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _[Disneyland measles outbreak strikes in anti-vaccination hotbed of California] _    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico If the bill becomes law, California will become only the third state in the country to deny exemptions based on religious convictions. The other two are Mississippi and West Virginia. But in California, many if not most of those who opt out of the state’s mandatory vaccination schedules do so on the basis of “personal belief exemptions,” rather than religious ones. Though decades of studies have found vaccines to be safe, strains of vaccine skepticism are particularly high in some California communities. In January, the Post’s Wonkblog found that in some school districts the fraction of kindergartners with PBES is more than half. At a handful of private schools it topped 75 percent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Thirty-two other states bar vaccination exemptions based on personal or moral beliefs. The debate about the vaccination bill has been vitriolic in recent weeks. According to the LA Times, Sen. Richard Pan (D-Sacramento), a pediatrician and an author of the bill, has received death threats. Protesters at the California Democratic Party’s convention in Sacramento last month called the right to refuse vaccinations “a civil rights issue” and compared the state to Nazi Germany.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Hundreds of parents who converged on the Assembly this week said that the legislation would take away their right to make decisions about what’s best for their child’s health. And Assemblyman Mike Gatto (D-Glendale) told the LA Times that the bill was likely unconstitutional because it “infringes on the rights of children to attend school.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _[Amid measles outbreak, anti-vaccine doctor revels in his notoriety] _    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico For their part, proponents of the legislation were not above using tear-jerker tactics to support their cause. On Wednesday, advocates for stricter requirements stood beside 7-year-old leukemia survivor Rhett Krawitt as he delivered a petition bearing 30,000 signatures to the governor. Earlier this year, Krawitt gave a rousing speech at a local school board meeting in which the first grader said “I give a damn” about mandatory vaccinations. Because his own immune system has been compromised by chemotherapy, Krawitt’s parents say, he can’t be vaccinated, leaving him vulnerable to measles and other infectious diseases.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The issue of vaccinations is so charged because it pits personal choices against an epidemiology principle known as “herd immunity.” As the Department of Health and Human Services explains it:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico When the level of immunization drops low enough, diseases like measles, which is highly contagious, can spread rampantly among the unprotected population. While healthy unvaccinated kids usually survive a bout of measles (and it’s worth noting that there have been no fatalities reported so far from the Disneyland outbreak), people with weakened immune systems — the elderly, children under five, immunocompromised people like Krawitt — are vulnerable to severe and sometimes fatal complications. “Measles is not a benign disease,” Tara C. Smith, an epidemiologist at Kent State University, wrote in Slate earlier this year.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Ariel Loop, a Pasadena mother whose 4-month-old son Mobius was infected during the Disneyland measles outbreak, told the LA Times she was relieved that the bill got approved.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I’m hoping Jerry Brown does the right thing and signs it once it gets through the last Senate [vote],” Loop said.

The saddest story Roald Dahl ever wrote — about his daughter’s death from measles — is worth reading today

_Updated_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Some people seem to think the measles is a nuisance disease — irritating and briefly unpleasant, but otherwise harmless. For many, it’s not so bad. For others, the measles is serious and potentially fatal. Children under 5 are particularly vulnerable to complications, says the Centers for Disease Control and Prevention. One of the worst complications is measles encephalitis.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Acute encephalitis occurs in approximately 0.1% of reported cases,” says the CDC. “Onset generally occurs 6 days after rash onset (range 1–15 days) and is characterized by fever, headache, vomiting, stiff neck, meningeal irritation, drowsiness, convulsions, and coma. Cerebrospinal fluid shows pleocytosis and elevated protein. The case-fatality rate is approximately 15%.” Roald Dahl, the renowned author of “Boy,” “Charlie and the Chocolate Factory,” “Matilda” and scores of other books and screenplays, lost his daughter Olivia to measles encephalitis in 1962. In 1988, about seven years before his death, he wrote a poignant plea for the Sandwell Health Authority in Britain urging everyone to get their kids vaccinated. Dahl’s recounting of his experience has been rediscovered and recirculated in recent days because of the measles outbreak in California, spread largely by unvaccinated individuals who came in contact with an infected visitor to Disneyland.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Here, in part, is what he wrote: “Encephalitis has quietly been at work for hundreds of years, robbing families of their loved ones,” Ava Easton, Chief Executive of The Encephalitis Society, said in a statement emailed to the Post. She added:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico h/t News Everyday    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Read more: Everything you wanted to know about measles**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Baltimore health commissioner and physicians  call for measles vaccinations

Baltimore's health commissioner and a group of leading physicians Monday called on parents to vaccinate their children against the measles, warning that "the Disneyland outbreak raises the real risk that measles may come roaring back. "We have come too far to let that happen," the group said in a statement it released Monday. "...Make sure your child is up-to-date on all vaccines. This protects your child and will help safeguard all children in our community. Vaccines are more than individual choice; they are our obligation to one another." The city hasn't had a measles case in 10 years and boasts a 99 percent vaccination rate, Leana S. Wen, the city's health commissioner, said in an interview. Nevertheless, the spread of the highly contagious virus among unvaccinated children threatens others who can't be immunized, including those less than one year old and others with medical conditions. "The most important thing for people to know is that this is a wake up call, that Baltimore is not an island," Wen said. Last month, a suspected measles case involving a 12-month-old child set off an effort to trace the child's contacts before health officials determined that the child did not have the disease.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The Centers for Disease Control and Prevention reported last week that this year's measles outbreak, which officials believe started at Disney theme parks in Southern California in late December, had spread to 102 people in 14 states. Monday's statement adds Wen and the 15 physicians from Baltimore-area medical institutions to the growing chorus pushing back against vaccine skeptics. President Obama and U.S. Surgeon General Vivek H. Murthy have urged parents to vaccinate children against the measles virus. Wen was joined in the statement by senior physicians, most of them pediatricians, from the University of Maryland, Johns Hopkins and other medical centers and organizations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "We have to be vigilant. We have to be clear.  Vaccines are safe. They are effective," Wen said.  "When we as doctors in our region come together and speak with one voice, we are making a statement [about] the health of our community." **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles spreads to New York    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Christie clarifies comments on vaccinations    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Get your kids vaccinated, Obama tells parents    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical negligence of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Millennials more likely to say vaccination should be a choice    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We can't just blame anti-vaxxers. Parents skip vaccines for many reasons.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 2015 measles total is already greater than number of cases in a typical year    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Measles and the anti-vaccination movement meet at Disneyland

Read this terrific column by the Los Angeles Times' Michael Hiltzik from the heart of the anti-vaccination movement. It's not Disneyland's fault, of course, but it does show what can happen in a place where many visitors come from all over the world.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "The anti-vaccination movement is a corner of the United States that is backsliding into medieval ignorance," Hiltzik writes. **Here are a few other posts I've done** on measles, vaccines and the anti- vaccination movement:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Arguing with anti-vaxers may not be a good idea.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico CDC reports biggest measles outbreak since 1996.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Government anticipates a bad flu season this year.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Vaccination debate flares in GOP presidential race, alarming medical experts

CAMBRIDGE, England — Medical experts reacted with alarm Monday as two top contenders for the Republican presidential nomination appeared to question whether child vaccinations should be mandatory — injecting politics into an emotional issue that has taken on new resonance with a recent outbreak of measles in the United States. First, New Jersey Gov. Chris Christie, while visiting a vaccine laboratory here, called for “some measure of choice” on whether shots guarding against measles and other diseases should be required for children. _[Christie breaks with Obama over the measles vaccine, then walks back his comments]_ Then, Sen. Rand Paul (R-Ky.), an ophthalmologist who is also readying a 2016 campaign, said in two U.S. television interviews that he thinks most vaccines should be voluntary, citing “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.” “The state doesn’t own your children,” Paul said on CNBC, praising vaccines for their health benefits but insisting that the government should not mandate their use in most cases. “Parents own the children. And it is an issue of freedom and public health.” The vigorous outcry in response to the remarks underscored the sensitivity surrounding the vaccination debate, particularly given a widening multistate measles outbreak linked to a California theme park. Both Christie and Paul are leading GOP candidates who are likely to exercise significant influence over the direction of the 2016 primary race. The comments also illustrated persistent strains of skepticism within both parties over vaccination requirements, fueled in part by discredited claims of a connection between childhood shots and autism. Scientists have blamed a small but influential anti-vaccine movement for helping spark a new epidemic of measles, which was once virtually eliminated. _[Related: Everything you wanted to know about measles and the debate over vaccines]_ On Monday, the Centers for Disease Control and Prevention said that more than 100 cases of the highly infectious disease were diagnosed in January. Most of the cases appear linked to victims who became ill after visiting Disneyland in Anaheim, Calif., in mid-December. “When you see educated people or elected officials giving credence to things that have been completely debunked, an idea that’s been shown to be responsible for multiple measles and pertussis outbreaks in recent years, it’s very concerning,” said Amesh Adalja, an infectious-disease physician at the Center for Health Security at the University of Pittsburgh. He called the comments from Paul particularly troubling because Paul is a doctor. Christie’s aides quickly tried to clarify his remarks, insisting in a statement that the Republican governor believes vaccines are “an important public health protection.” After visiting a MedImmune vaccine laboratory in Cambridge, Christie was asked to weigh in on the debate in the United States over the measles outbreak. President Obama told NBC News anchor Savannah Guthrie on Sunday, “You should get your kids vaccinated.” “The science is, you know, pretty indisputable,” Obama said. “We’ve looked at this again and again. There is every reason to get vaccinated, but there aren’t reasons to not.” [ _Related: Vox got it wrong when it said Obama “pandered to anti-vaxxers in 2008”_ ] Christie, however, said Monday that “there has to be a balance, and it depends on what the vaccine is, what the disease type is, and all the rest.” He added: “Not every vaccine is created equal, and not every disease type is as great a public health threat as others. “I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide,” he said. As for Paul, he told talk show host Laura Ingraham that he had chosen to hold off on vaccinating his children for some diseases. “I didn’t like them getting 10 vaccines at once, so I actually delayed my kids’ vaccines and had them staggered over time,” he said. Both men’s remarks drew immediate rebuke from experts on the issue. _[Related: The saddest story Roald Dahl ever wrote is about his daughter’s death from measles]_ Seth Mnookin, a professor at MIT who has written a book on the vaccination debate called “The Panic Virus,” called the comments from Christie and Paul “incredibly, incredibly irresponsible.” Such remarks, he said, “basically fail at the first duty of a politician, which is to calm his constituents in moments of irrational crisis.” The criticism came too from some political strategists, who wondered whether Christie in particular might have been attempting to appeal to Republicans suspicious of government mandates. “There’s only one of two options,” said Rick Wilson, a Republican operative from Florida. “Either he’s so tone-deaf that he doesn’t understand why saying this is bad for him, or this is a considered political strategy. And that would be even more troubling.” Christie aides said he was not questioning science, and they acknowledged that his initial comments could be misconstrued. “The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated,” said a statement issued from Christie’s office in Trenton, N.J., after the uproar. “At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.” In substance, Christie’s overseas comments did not differ dramatically from remarks he has made previously in New Jersey, which faces higher than average childhood autism rates and an active community of parents who have questioned vaccinations. In 2009, Christie met with parents concerned about autism rates and listened to some who expressed fears that the disease might be linked to vaccinations, said Louise Kuo Habakus, who co-edited a book called “Vaccine Epidemic” and is active with the group New Jersey Coalition for Vaccination Choice. She said not everyone at the meeting held that view. Habakus said she gave Christie a copy of her book just before a 2011 town-hall meeting. During the public event that followed, Christie chose to call on her to ask a question, which she said she took as a sign that he wanted to allow her a forum to express her concerns. She praised Christie for supporting “greater dialogue” about parental rights but said she had never heard him link autism and vaccination or discourage parents from getting shots for their children. “I think he’s been very brave on this issue,” she said. “He’s been constant and courageous on this issue, saying parents should be more involved in the discussion.” The link between vaccinations and autism was alleged in a small 1998 study that has since been widely discredited in the scientific community. The journal that published the study retracted it in 2010, and its author lost his medical license. But many doctors had cast doubt on the study even before those actions, insisting that the measles, mumps and rubella vaccine was safe and effective at combating once-deadly but now preventable diseases. Both Obama and Sen. John McCain (R-Ariz.) drew fire in 2008 for seeming to give credence to the link. At one campaign appearance, Obama noted that “some people are suspicious” that skyrocketing rates of autism might be linked to vaccines. “The science right now is inconclusive, but we have to research it,” he said. McCain said at a town hall meeting in 2008 that there was “strong evidence that indicates it’s got to do with a preservative in vaccines.” Obama has said recently that the science is now settled and has urged vaccination. Nick Gillespie, editor in chief of the libertarian magazine Reason, said there is a vigorous debate over vaccines, particularly whether government should mandate their use. He said Christie may have been trying to curry favor with libertarian-leaning Republicans with his emphasis on parental choice. “There is a broadly ascending libertarian sentiment in the Republican Party,” he said. “Even mainstream establishment Republicans understand they need to speak to the libertarian wing.” Former Hewlett-Packard chief executive Carly Fiorina, who is considering a long-shot 2016 run, also appeared to endorse parental choice for vaccines in a BuzzFeed interview last week. “I think vaccinating for measles makes a lot of sense. But that’s me. I do think parents have to make those choices. I mean, I got measles as a kid. We used to all get measles,” she said. “I got chicken pox, I got measles, I got mumps.” Fiorina also drew a distinction between the measles vaccine and one intended to combat human papillomavirus (HPV), a common sexual infection that can lead to cervical cancer. The vaccine sparked controversy in the 2012 campaign when then-Rep. Michele Bachmann (R-Minn.) blasted then-Texas Gov. Rick Perry for helping to institute a mandate requiring most girls in Texas to get the vaccine. Some social conservatives object to a mandate because they argue it would suggest to young girls that having sex is acceptable. Bachmann later falsely suggested that the HPV vaccine might cause mental retardation. Mnookin said various studies have tried to examine the political leanings of those who oppose vaccination, finding that they are drawn from both parties. “It’s not a homogenous group,” he said. “People who don’t vaccinate are not more likely to congregate politically one side of the aisle or the other.” Helderman reported from Washington.

2015 U.S. measles outbreak already at 84 cases, more than in a typical year

The 2015 measles outbreak already has spread to 84 people, more than health officials typically see in an entire year, the Centers for Disease Control and Prevention reported Thursday. Most of the cases are traceable to an outbreak at Disneyland and another theme park in Southern California that began in late December and now has spread to six other states, including Utah, Washington, Oregon and Colorado. In all, measles has reached 14 states, according to Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases. The outbreak has generated sometimes fierce criticism of people who, for personal reasons or because they mistrust the vaccine, choose not to have their children immunized and prompted at least two school systems in California to ban unvaccinated students from school. Schuchat held a briefing for reporters and others Thursday in an attempt to “prevent measles from getting a foothold and becoming endemic again.” She urged parents to get the measles, mumps, rubella vaccine for their children and themselves, noting that the two-dose regimen is 97  percent effective and has been proven safe despite unproven concerns that it can lead to autism. She also said children should get their first dose at age 1, when it is recommended. Some parents have been delaying the age of first immunization. “MMR vaccine [is] very safe, very effective, really necessary,” Schuchat said. “And the 12-month routine first dose, we really strongly recommend. ">Measles, which is caused by a virus, is highly contagious. The respiratory illness is airborne, spread from person to person by coughing and sneezing. It is so infectious that an unvaccinated person can contract it by inhaling the virus hours after a person with the disease has left a room.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It can lead to potentially serious complications, including pneumonia, brain damage and deafness. About 15 percent of the people infected in the current outbreak required hospitalization, Schuchat said. The United States declared measles eliminated in 2000, but it has been resurgent in recent years, fueled by huge epidemics in other countries that were imported into the United States by travelers and spread mostly among unvaccinated people. Last year, for example, when the measles toll in the Philippines reached 50,000 cases, the United States saw 644, including a cluster in Ohio among unvaccinated people in the Amish community.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

More than 100 confirmed cases of measles in the U.S., CDC says

The measles outbreak that originated at a California theme park continues to grow, causing increased concern among public-health authorities. There are 102 confirmed cases of measles in 14 states across the country, the Centers for Disease Control and Prevention said Monday. In addition, there are also hundreds of other people being monitored for possible exposure. The large number of cases so far this year has already eclipsed the number typically reported each year, according to Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "This worries me and I want to do everything possible to prevent measles from getting a foothold in the United States and becoming endemic again," Schuchat said during a briefing with reporters on Thursday. Measles was deemed to be eliminated in the United States in 2000, but last year saw an incredible resurgence for the virus. There were 644 cases last year, more cases than occurred in the previous five years combined.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Most of the people who contract measles have not been vaccinated, according to the CDC. Officials believe the outbreak is linked to someone with measles visiting Disney theme parks in California in December. That state has been hit the hardest by this outbreak, with the California Department of Public Health reporting 91 cases there so far this year. In Arizona, meanwhile, more than 1,000 people \-- a fifth of them children -- are being monitored for potential exposure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We can't just blame anti-vaxxers for this measles outbreak    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical negligence of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

The measles outbreak that originated at a California theme park continues to grow, causing increased concern among public-health authorities. There are 102 confirmed cases of measles in 14 states across the country, the Centers for Disease Control and Prevention said Monday. In addition, there are also hundreds of other people being monitored for possible exposure. The large number of cases so far this year has already eclipsed the number typically reported each year, according to Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “This worries me and I want to do everything possible to prevent measles from getting a foothold in the United States and becoming endemic again,” Schuchat said during a briefing with reporters on Thursday. Measles was deemed to be eliminated in the United States in 2000, but last year saw an incredible resurgence for the virus. There were 644 cases last year, more cases than occurred in the previous five years combined.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Most of the people who contract measles have not been vaccinated, according to the CDC. Officials believe the outbreak is linked to someone with measles visiting Disney theme parks in California in December. That state has been hit the hardest by this outbreak, with the California Department of Public Health reporting 91 cases there so far this year. In Arizona, meanwhile, more than 1,000 people — a fifth of them children — are being monitored for potential exposure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Forget ‘anti-vaxxers.’ The Disney measles outbreak could change the minds of an even more crucial group.

The child was behind on her vaccinations. Wendy Sue Swanson took note of this as she talked with the girl’s parents last week at a medical clinic in Mill Creek, Wash., outside Seattle. Swanson, like many pediatricians, sometimes needed to coax parents to get the shots for their children. A few might be unmovable in their objections. But most were like this couple: A mom and dad who might harbor doubts or were just behind schedule. They were at least willing to listen. Now, Swanson had a new way to prod parents like them: Discussing the Disney measles outbreak in California, which has spread to at least 68 people in 11 states since Jan. 1 and raised alarms about the reemergence of a disease once considered all but vanquished. There was something powerful about the disease hitting a popular, recognizable vacation spot. The girl got her vaccination. Her parents were on board. “Their eagerness was different,” Swanson said later. “I think it is changing people.” Much of the scrutiny in the Disney measles outbreak has fallen on an entrenched anti-vaccination movement in places such as Orange County, Calif., home to the two Disney theme parks where the outbreak gained its foothold. These “anti-vaxxers” are viewed as dead-set against vaccinations. But doctors believe the current outbreak could change the minds of a less-known but even larger group: parents who remain on the fence about the shots. These “vaccine-hesitant” parents have some doubt about vaccinations, leading them to question or skip some shots, stagger their delivery or delay them beyond the recommended schedule. An estimated 5 to 11 percent of U.S. parents have skipped at least one vaccination or delayed a shot, according to studies. That compares to only 1 to 3 percent of parents who object to all vaccinations. Boosting compliance among the “vaccine hesitant” population could have major public health implications, doctors say, especially because last year the United States had its highest number of measles cases since 1977. The topic of “vaccine hesitant” patients has become the focus of a growing body of medical research in recent years. Doctors are trying to understand what triggers vaccine worries and which strategies work best for overcoming those fears.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Doctors spend many office hours trying to convince these parents that the scientific evidence proves the shots are, in fact, safe and effective. But these hesitant parents have been bombarded by conflicting information. And they don’t view all of the shots the same way. The vaccine to protect against measles, mumps and rubella faces particularly strong resistance as a result of thoroughly discredited studies linking the vaccine to autism. So some parents, even those generally open to other vaccines, push to delay or skip this one. The shot is supposed to be given at 12 months and again at age 4. “One of the problems that vaccines face now is they work too well,” said Michael Smith, a pediatric infectious disease specialist at the University of Louisville School of Medicine in Kentucky, who has studied vaccine-hesitant parents. Parents don’t have experience with measles, how children can become very ill and in rare cases suffer brain swelling or even die, Smith said. At the same time, these parents are confronted with stories about the unexplained rise in the U.S. autism rate. “I can understand as a parent why you’d skip the vaccine if you’d been convinced that it’s a choice between giving my kids a shot or giving my kid autism,” Smith said. But the Disney outbreak changes the discussion. Now, doctors have an event to point to. The threat is no longer abstract or distant. http://www.washingtonpost.com/posttv/national/health-science/measles-keeps-66-calif-students-home/2015/01/29/56375127-da7e-4f74-bbcf-f587083f3063_video.html “This is definitely going to be a talking point that pediatricians should keep in their back pockets,” Smith said. Studies have shown that “anti-vaxxer” parents are likely to remain steadfast in their opposition. Barbara Loe Fisher, president of the National Vaccine Information Center, a group that raises doubts about the shots, said she was not convinced that the Disney outbreak was even a story about the dangers of being unvaccinated. “I don’t think we know completely what’s going on,” Fisher said. But physicians such as Kathryn Edwards of the Vanderbilt Vaccine Research Program said the measles vaccine is at least 99 percent effective after the second dose. And measles is one of the most communicable diseases, much more so than the flu. The dangers posed by the disease have been forgotten. Many U.S. doctors have never even seen it. Edwards still recalls the only patient she ever saw with measles, years ago when she was a medical resident. He died. “So I have a lot of respect for measles,” Edwards said. At Boston Children’s Hospital, pediatrician Claire McCarthy said she is always happy when parents decide to vaccinate their children against measles in particular. She worries about the current situation in California. And she plans to use the Disney outbreak to try to convince hesitant parents that vaccinations are the right choice. “I am planning on talking this one up a lot with families,” McCarthy said. “I think this probably will make a difference.”

Two dozen babies and toddlers sent home from California day care after infant diagnosed with measles

As the measles outbreak and the debate over vaccination have increased in volume this week, public health officials have warned of the potential for a large outbreak. They have urged people to vaccinate their children, repeating the advice again and again. One particular danger they have cited is faced by a segment of the population that is effectively removed from the debate due to timing yet not isolated from potential infection — young children and other people who cannot be vaccinated. During an outbreak, what happens to those too young to get vaccinated? This is playing out in a very real way for a group of parents in southern California, where a day care center has sent home more than two dozen children — some as young as eight weeks old — after an infant there was diagnosed with measles. More than a dozen other infants have been sent home and told to remain effectively quarantined. The situation illustrates one of the dangers cited by medical experts and public-health officials amid an ongoing measles outbreak that has largely centered on California. While a debate over vaccinating has spilled from kitchen tables and doctor’s offices into the White House and the early stages of the 2016 presidential campaign, authorities have repeatedly stressed that the outbreak and unvaccinated people pose a risk to the most vulnerable members of the population — namely, children who are too young or ill to get vaccinated.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico All of the children sent home from the day care are too young to have received both doses of the measles, mumps and rubella vaccine, while many are too young to have received even one dose. After an infant at the day-care center on the campus of Santa Monica High School was diagnosed with measles, health officials said that this child, who is younger than 1, should stay home for three weeks. The same guidance was given to the other 13 infants who are normally at the day care. These infants are between eight weeks old and 18 months old, according to Gail Pinsker, a spokeswoman for the Santa Monica-Malibu Unified School District. There are also 12 toddlers at the day-care center, who range from 18 months to 3 years of age. Many of the infants and toddlers are the children of staff members and other teachers, while three are the children of students at Santa Monica High School. The Centers for Disease Control and Prevention recommends that children get their first dose between 12 and 15 months and a second dose when they are between 4 and 6 years old. Toddlers will only be allowed to return to the day-care center if they show proof they were vaccinated, school officials announced Wednesday. (They had hoped to reopen the toddler room Friday, but now the reopening date is uncertain.) “We understand the inconvenience these actions are causing some of our staff and community members,” Sandra Lyon, the school district’s superintendent, wrote in a letter to parents and staff members. “The priority is the health of the entire school community, which includes preventing the transmission of measles to additional students and staff.” This situation is also going to impact whether or not some teachers can return to work. The Los Angeles County Department of Public Health said that the 13 teachers in the school district who also have children in this day-care center must prove that they have been vaccinated before returning to work, Lyon wrote. Health officials are going to be provide vaccinations in the area through the end of the week for any high school student who has not been vaccinated, she said. This is the second time in a matter of days that this school district had a measles diagnosis. Last week, the school district had separately announced that a baseball coach had been diagnosed; the school determined that every baseball player had been vaccinated, Lyon said. The school district urged parents to make sure that all students are vaccinated, saying that anyone potentially exposed to measles who has not been vaccinated will be kept out of the school for 21 days. About 7 percent of students at the high school have waivers excusing them from the vaccination.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Meanwhile, on the same day that the school district said that only vaccinated toddlers could return to the day-care center, two state lawmakers announced a bill that would eliminate California’s “personal belief” exemption from vaccinations. California is currently one of 18 states that allows such exemptions.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **RELATED LINKS:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico ‘Not every vaccine is created equal.’ When politics and public-health outbreaks meet    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Everything you need to know about measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Why younger Americans are much more likely to say vaccination should be a choice    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Obama to doubting parents: ‘Get your kids vaccinated.’    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Obama to parents doubting ‘indisputable’ science: ‘Get your kids vaccinated’

In the face of a growing measles outbreak, President Obama is urging parents to heed modern science and vaccinate their children. “There is every reason to get vaccinated — there aren’t reasons to not,” Obama said in an interview with NBC News. Excerpts from the interview were aired Sunday night and Monday morning.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I just want people to know the facts and science and the information,” the president said. “And the fact is that a major success of our civilization is our ability to prevent disease that in the past have devastated folks. And measles is preventable.” An epidemic of vaccination skepticism — largely based on unfounded and discredited anti-vaccine beliefs — has contributed to the growing public health crisis.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Thanks to the widespread use of highly effective measles vaccination, the disease was effectively eliminated in the United States in 2000.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Yet, according to public health officials, a small — but growing — number of individuals are eschewing vaccinations for their children, which led to a record year for measles cases in 2014.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico [ **Chris Christie clarifies comments on measles vaccine after call for ‘balance’ causes stir** ]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The current outbreak, which has centered on unvaccinated people who visited the Disneyland theme park in California, has resulted in measles cases in 14 states. Among them: New York, where health officials say a college student with measles recently traveled across the state on a train, potentially exposing untold numbers of travelers to the virus, according to news reports.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On Sunday, Centers for Disease Control and Prevention Director Tom Frieden warned that the growing number of unvaccinated people could result in a “very large” outbreak if the problem isn’t brought under control. The CDC said Monday that there are now 102 confirmed cases of measles in the United States, with hundreds of people being monitored for possible exposure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Obama acknowledged that some people have concerns about the “effects” of vaccinations, but he cautioned, “the science is pretty indisputable.” He also noted that both his daughters Sasha and Malia have been vaccinated. “You should get your kids vaccinated — it’s good for them,” Obama said. “We should be able to get back to the point where measles effectively is not existing in this country.” **RELATED** : **The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Amid growing vaccination debate, measles continues to spread and is now in New York state**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Anti-vaccine doctor revels in his notoriety**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Why this baby’s mom is so angry at the anti-vaxxers**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **[This post has been updated.]**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Vaccine deniers stick together. And now they’re ruining things for everyone.

The rash of measles cases that started in Disneyland last month has now become one of the worst outbreaks of the diseases in California in the past 15 years. What started with a handful of cases has now grown to 62 confirmed cases across the state — and other cases have been reported in Colorado, Oregon, Utah, Washington state and Mexico.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California requires kids to get vaccinations for measles, mumps and rubella, but state law provides a loophole — parents can get a "personal belief waiver" if they think there's a link between vaccines and autism and other harmful effects. That's even though studies have continuously found vaccines to be safe.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Seth Mnookin, a journalist who's chronicled the anti-vaccination movement, observed a few years ago that you only had to go visit a Whole Foods to find anti-vaxxers. Now, it doesn't seem that anyone's actually done the science on that one, but Mnookin's point here is obvious — the anti-vaccination movement is fueled by an over-privileged group of rich people grouped together who swear they won't put any chemicals in their kids (food or vaccines or whatever else), either because it's trendy to be all-natural or they don't understand or accept the science of vaccinations. Their science denying has been propelled further by celebrities, like Jenny McCarthy, Robert F. Kennedy, Jr. and actress Mayim Bialik, who is also a neuroscientist and even plays one on TV. Of the 34 patients in the current measles outbreak whose vaccination status is known, only five were fully vaccinated, according to the Los Angeles Times. And the worst of the outbreak is centered in Orange County, ground zero for the anti-vaccination movement that's put children at risk over junk science.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico No one has put it more succinctly than James Cherry, a specialist in pediatric infectious diseases at the University of California, Los Angeles, who told the New York Times, "There are some pretty dumb people out there."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The real problem is that these people tend to stick together. A new study this week finds strong evidence that people who rejected vaccines for their young children are clustered together in the same communities. And that only increases the risk that measles — a highly contagious respiratory disease that was believed to have been eradicated 15 years ago — will spread to more children. Researchers analyzing records for about 55,000 children born in 13 northern California counties between 2010 and 2012 found five geographic clusters of 3-year-olds with significantly higher rates of vaccine refusal. These included East Bay (10.2 percent refusal rate); Marin and southwest Sonoma counties (6.6 percent refusal); northeastern San Francisco (7.4 percent); northeastern Sacramento County and Roseville (5.5 percent); and south of Sacramento (13.5 percent). By comparison, the vaccine refusal rate outside these clusters is 2.6 percent, according to the study published in the journal Pediatrics.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico These are some of the most privileged parts of the Bay Area, although South Bay counties around Silicon Valley aren't on the list. The median household income in Marin is $90,535, compared to $61,094 in the state of California. In Alameda County (home to towns like Berkeley) in the East Bay, it's $72,112. One exception is Sacramento, where median income is only $55,064.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The communities where anti-vaxxers cluster are also among the most liberal. Marin County, San Francsico County and Alameda County all voted overwhelmingly for Obama in 2008. In Marin, 78 percent of the vote went to Obama. In San Francisco, it was 84 percent. And in Alameda, it was 79 percent. That's all higher than what Obama got in his own home county of Cook County, Illinois. Here, too, Sacramento is an exception. Only 58 percent of the county went for Obama in 2008.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The study also found five clusters with significant greater rates of under-immunization among children who turned 3 years old between 2010 and 2012. The under-immunization rate ranged between 18 percent and 23 percent in these clusters, compared to 11 percent outside them, and they were generally in the same areas where vaccine refusers were clustered. The researchers wrote that they hope their analysis will help policymakers and health-care providers focus efforts to boost vaccination rates in specific areas. We'll see just how strongly that message is received, though. Previous research has shown that confronting anti-vaxxers with science only makes them more likely to reject vaccinations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Related link: The devastating impact of vaccine deniers, in one measles chart    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Authorities still trying to determine how measles outbreak began at Disney parks

California public health authorities have conducted genetic tests on the virus that caused the measles outbreak sweeping the country, but that has not led them to the source of the outbreak so far. Writing in the Morbidity and Mortality Weekly Report produced by the Centers for Disease Control and Prevention, state public health officials said they had genotyped the virus from 30 of 110 California residents who contracted the disease but still cannot determine the source of the outbreak, which began in late December in two adjacent Disney theme parks in Southern California.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico All the specimens "were measles genotype B3, which has caused a large outbreak recently in the Philippines, but has also been detected in at least 14 countries and at least six U.S. states in the last 6 months," they wrote. The Philippines had more than 53,000 confirmed cases of the measles last year. "International travel to countries where measles is endemic is a well-known risk factor for measles, and measles importations continue to occur in the United States," they wrote in the report, which was released late Friday. "However, U.S. residents also can be exposed to measles in the United States at venues with large numbers of international visitors, such as other tourist attractions and airports. This outbreak illustrates the continued importance of ensuring high measles vaccination coverage in the United States." The CDC said last week that 121 people in 17 states and the District of Columbia had come down with the measles. Authorities have blamed the spread of a disease that was eliminated in 2000 largely on people who, for personal or religious reasons, are choosing not to have their children vaccinated or are delaying their immunizations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Update** : On Tuesday afternoon, the CDC said the number of cases had grown to 141 in 17 states and Washington, D.C. an increase of 20 cases over the past week.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Among the 110 California patients, "49 (45%) were unvaccinated; five (5%) had 1 dose of measles-containing vaccine, seven (6%) had 2 doses, one (1%) had 3 doses, 47 (43%) had unknown or undocumented vaccination status, and one (1%)" appeared to have been vaccinated or was previously infected by measles, the officials wrote. Twelve of the unvaccinated patients were infants who could not be vaccinated because they were too young; the measles vaccine is not recommended for children under a year of age. Among the other 37,  "28 (76%) were intentionally unvaccinated because of personal beliefs, and one was on an alternative plan for vaccination," they wrote. Fifteen cases have been linked to the theme park exposure in six other states -- Arizona (seven), Colorado (one), Nebraska (one), Oregon (one), Utah (three) and Washington (two).  There also have been 10 cases in Canada and one in Mexico, they wrote. **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Everything you need to know about measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Adults are skipping vaccinations for many diseases    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical problem of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles outbreak spreads to three more states and D.C.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Young Americans are the only Americans who doubt vaccine safety    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We can't just blame anti-vaxxers. Parents skip vaccines for many reasons    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Baltimore health official: Parents should vaccinate kids against measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Fairfax County investigates suspected measles case

Fairfax County Health officials said Tuesday they are investigating a suspected case of measles. They did not say where in the county the possible case was located, but said they expected to release more details Wednesday. “We’re investigating a suspected case of measles,” said Tina Dale, a spokeswoman with the Fairfax County health department. She also would not elaborate on where the person was being tested. She said the testing takes 24 hours. “We don’t know if it is the measles or not until that test comes back,” Dale said. If the test comes back positive, she said, officials expect to hold a news conference Wednesday to “provide the full berth of information.” She said health department officials are “doing a comprehensive investigation” to see where this person has been and with whom he or she has come in contact. “At this time it is not a positive case,” Dale said. “We’re investigating one suspected case.” There has been an outbreak of measles throughout the country: Cases of measles have been reported in 18 jurisdictions, including Washington, D.C., with a total of about 120 people affected. Measles is caused by a virus and is highly contagious. It is spread from person to person by coughing and sneezing. It can lead to serious complications, including deafness, brain damage and pneumonia. In 2000, the U.S. declared that the virus had been eliminated but it has come back in recent years. Most of the recent cases have been traced to an outbreak at Disneyland and another theme park in southern California and has spread to other states.

Measles outbreak spreads to three more states and Washington DC; 121 people now affected

The measles outbreak spread to three more states and Washington D.C. last week, affecting 19 additional people, according to an update posted Monday by the Centers for Disease Control and Prevention. The highly contagious disease is now in 18 jurisdictions, with 121 people affected. The vast majority of the cases are part of the large outbreak that began in Southern California Disney theme parks in late December, the health agency said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The total is on pace to easily surpass the 644 cases in the United States in 2014, the greatest number since measles was declared eliminated in the United States in 2000. Last week, the CDC reported 102 cases in 14 states.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Authorities have said the resurgence is mostly caused by the growing number of people who are declining to vaccinate their children for personal reasons, or delaying the vaccinations. "This is a teachable moment for this country," former U.S. Rep. Henry Waxman said at a conference Monday at Johns Hopkins University's Bloomberg School of Public Health. "When we see a disease that was almost eliminated in the early 1980s now come back with a jolt all around this country, we have to ask ourselves what’s going on.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "Not even vaccines are immune to politics ... I've seen politics threaten vaccination efforts time and time again," he added. According to the CDC, measles spread to Nevada (2 cases) as well as Delware, New Jersey and the District of Columbia (1 case each), as it continued to plague California, which has 88 cases. Arizona has the second-largest case total with 7. Public health authorities have begun campaigning about the importance of vaccinating children against measles. President Obama, Surgeon General Vivek H. Murthy and Baltimore Public Health Commissioner Leana S. Wen, as well as the CDC and other public health organizations have called on parents to vaccinate children.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Everything you need to know about measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Adults are skipping vaccinations for many diseases    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical problem of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Young Americans are the only Americans who doubt vaccine safety    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We can't just blame anti-vaxxers. Parents skip vaccines for many reasons    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Baltimore health official: Parents should vaccinate kids against measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

California’s epidemic of vaccine denial, mapped

The Disneyland measles outbreak has shined a harsh spotlight on anti-vaccine communities in California and around the country. Dozens of people have fallen ill with the disease, the vast majority of whom are unvaccinated. The year 2014 was already a banner year for measles in the U.S., with preliminary data from the Centers for Disease Control and Prevention showing the highest number of cases in over two decades.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico My colleague Jason Millman reported last week on the results of a study showing that vaccine skeptics tend to cluster together in like-minded, often wealthy communities. Since the study focused on just a handful of northern California counties, I'd like to extend that analysis by looking at vaccine refusal across the entire state of California **** \-- as a result both of vaccine denial and religious objections.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The map below is a first crack at that. Using data from the California Department of Public Health, it divides the state into equal-area grids, and within each area it counts the number of public school kindergartners with what's known as a "personal belief exemption" (PBE) to state vaccine requirements. The hexagon markers are sized by the total number of kindergartners in the area, and colored according to the percent of them with PBEs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's important to note a couple things. First, the actual number of kindergartners entering school without their full slate of vaccines is considerably higher than this map suggests. This map only represents kids whose parents have taken a stance against vaccines by applying for a PBE. Statewide about 2.5 percent of kindergartners fall into this category. Overall nearly 10 percent of California kindergartners don't start school fully vaccinated. Most of these kids are "conditional entrants," who, for whatever reasons, are behind in their vaccines but plan to get them.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's also worth noting that the map only shows public school kids, as geographic data for private schools wasn't available. Kindergartners in private school are more than twice as likely (5.3 percent) to have a PBE than public school kids (2.5 percent). Still, the map provides a useful barometer of the level of principled opposition to vaccines in the state, and that's how I'll be discussing it. Orange County, home to Disneyland, stands out as a cluster of dark red, as do parts of coastal San Diego county. The wealthy southern California coast from Malibu up to San Luis Obispo also stands out. Farther north, Santa Cruz, Marin and Sonoma counties are dark red. Inland there's a belt of anti-vaccine intensity from about Fresno, up through Sacramento and into Yuba county. Pockets of high PBE rates dot most of the northern California landscape. On the other hand, the Los Angeles area is generally vaccine-friendly, as are much of the San Francisco and Silicon Valley regions. The relatively low-income areas in the central valley also have low rates of vaccine opposition. Since California provides district-level vaccination data going back to 2000, it's also possible to map the spread of anti-vaccine sentiment over time. Check out the three maps below.  Back in 2000, only 0.77 percent of California kindergartners had personal belief exemptions from vaccines. By 2013, that percentage had more than quadrupled to 3.15 percent. The scale on these maps tops off at 5 percent. But in some individual school districts, the actual PBE rate is much, much higher. At River Springs Charter School in Temecula, California, nearly a quarter of the 556 kindergartners had personal belief exemptions this year. A third of the kindergartners at the Visions in Education public school in Carmichael hold PBEs, as do 51 percent of kindergartners at Ocean Grove Charter School in Boulder Creek. At a handful of private schools, the PBE rate is 75 percent or more. It goes without saying that a measles outbreak in these communities could be devastating. These parents are gambling with the lives not only of their children, but of other kids in their communities as well -- especially of young children and toddlers who aren't old enough to get all their vaccines yet. According to USA Today, six of the Disneyland measles cases were among infants too young to be vaccinated.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We need what's known as "herd immunity" to keep these most vulnerable populations safe from infectious diseases. For measles, that immunity kicks in with vaccination rates somewhere between 83 and 94 percent, according to the CDC. So even letting five percent of the kids in your community skip the vaccine is inviting trouble.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Fortunately, the news out of California isn't all bad. Starting with the current school year, California parents are required to consult a health care professional before being certified for a PBE. That's resulted in a drop in the PBE rate from 3.2 percent last year to 2.5 percent this year -- a welcome trend. The Disneyland outbreak also seems to be giving the issue enough visibility that some Californians previously on the fence are willing to change their minds.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico I'm also singling out California simply because it does such a great job of making these numbers publicly available -- as far as the states go, it's far from the bottom of the pack on vaccination rates. According to numbers compiled by the Bloomberg Data team, California is ranked 39th in the nation on overall vaccination rates, with 65.3 percent of its children receiving all seven CDC-recommended shots. By contrast the bottom-ranked state, Alaska, only has a 59.1 percent vaccination rate, while the top, Mississippi, has a rate of 76 percent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico With any luck, in the aftermath of the California measles outbreak we'll see these number climb.

Mr. Paul’s and Mr. Christie’s irresponsible comments about measles vaccinations

TWO POTENTIAL Republican presidential candidates, Sen. Rand Paul (Ky.) and New Jersey Gov. Chris Christie, have made irresponsible comments about vaccines at a time when measles has reappeared in the United States. Their remarks call into question their judgment and their fitness for higher office. Mr. Paul, an ophthalmologist, said in a television interview, “I’ve heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines.” He added that he vaccinated his own children: “I’m not arguing vaccines are a bad idea. I think they’re a good thing. But I think parents should have some input.” Mr. Christie, visiting a medical research laboratory in Cambridge, England, said that he, too, had vaccinated his children, but “I also understand that parents need to have some measure of choice in things as well. So that’s the balance that the government has to decide.” Both comments reflect a streak of libertarianism, a political philosophy that champions the individual and freedom to choose. In principle, this isn’t irrational. The United States has often stood as a beacon of individual liberty over tyranny. But it becomes destructive when people resist government because of irrational fears and suspicions. To protect people from threats, government has a legitimate role. In the case of measles, the threat is a highly contagious virus that can bring serious consequences. According to the Centers for Disease Control and Prevention, “Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.” This is why states have passed laws mandating vaccination for children attending public schools (although 17 states, including California, scene of the outbreak at Disneyland, have waivers for personal beliefs, and 48 have waivers for religious beliefs). Both the governor and senator seem to be suggesting that it is fine for parents to avoid vaccinations for their children. But is this really a matter of individual rights? Liberty does not confer the right to endanger others — whether at a school or Disneyland or anywhere else. More broadly, a president must make decisions every day about science, and it is not always easy; consider the struggle over climate change, the hard-fought debate over the impact of the Keystone XL pipeline, the promise of genetically modified foods, the intensifying threat of cyberattacks and the growing danger of antimicrobial resistance. Every one of these requires decision-makers to be rational and clear-eyed, the president most of all. In the case of measles, proven science is well in hand. The vaccine has a half-century record of safety and effectiveness. The study linking it to autism has been discredited and retracted. Mr. Paul’s reporting of anecdotes that he has “heard” is particularly insidious. Measles was eliminated in the United States by 2000 with widespread use of the vaccine. No presidential candidate should endorse parental “choice” that could reopen the door to an ugly and preventable disease. **Read more about this topic:** The Post’s View: The measles vaccine is a shot of common sense The Post’s View: As measles cases increase, a sharp call for vaccinations The Post’s View: The United States should generously support Gavi’s immunization efforts Michael Gerson: The enduring benefits of vaccination Michael Gerson: Vaccines and what we owe to our neighbors

Parents who refuse to vaccinate their children are putting others at risk

The parents who are against vaccines for measles, mumps, rubella and other childhood diseases have proved a point — and it’s a scary one. They are no longer just putting their own kids at risk. By taking their unvaccinated children to the happiest place on Earth and touching off a measles outbreak at Disneyland, the anti-vaxxers put hundreds of other children in jeopardy, too. Measles on this level hasn’t been seen in the States since the 1970s. So far, the disease has spread to 11 states and Mexico, infecting about 70 people in less than a month. Also making a comeback: whooping cough and diphtheria. Bravo, anti-vaxxers. You’ve gone beyond sowing post-Super Bowl fear in 2012, when 14 people were infected with the measles after unvaccinated kids visited Super Bowl Village in Indianapolis. Now you’ve tainted Disneyland, too. Maybe this is all a stealthy attack on the mainstream stuff that some of the organic, cage-free, Buddha-mama, mindful-parenting philosophies shun? Is a mac-and-cheese factory next? An orchestrated sneezing attack on every McDonald’s? Diphtheria for every child in the Chuck E. Cheese’s ball pit? This didn’t have to happen. In 2004, there were just 37 measles cases in the United States. Ten years later? We saw 644, according to Pediatrics, the medical journal. It’s all about fashionable philosophy, not changes in medicine. The measles, mumps and rubella vaccine wigs out some parents because about a decade ago, people started to assert a link between immunization and autism, fueled by the studies of a now-disgraced British doctor, Andrew Wakefield. Problem was, study after study refuted Wakefield’s autism research. And in 2011, the British medical establishment withdrew its endorsement of Wakefield’s study and labeled his data bogus. Still, the movement persisted, fueled by folks like actress Jenny McCarthy. When I interviewed health officials in 2011, when the anti-vaxxer movement began to take hold, they said people like McCarthy were the bane of their education programs. One health-policy professor joked that they would have to compete with something like “CDC Barbie.” There are few cases in which doctors have decided that a child would not do well medically by being immunized. Some religions are against vaccinations, too. For those people, schools allow exemptions so that children can attend school at their own risk. But in thousands of schools nationwide, a third category has been added — a “philosophical” exemption from the vaccination requirement. The parents of about 3 percent of children in the United States have claimed that exemption, declaring themselves opposed to vaccinations. An additional 7 or 8 percent are disorganized, do-nothing parents who would rather take the easy out than go through the pain and effort of appointments, needle-sticks and paperwork. So about 10 percent of U.S. schoolchildren aren’t vaccinated against the diseases that once killed millions. The result? Infants who accompany families and older siblings, people too sick to be immunized or those who come from countries where they weren’t vaccinated got the measles simply by being in a spot where a measles-infected person sneezed two hours earlier. Now the problem gets to the part where you bring up that quote about your rights ending where mine begin. Whatever wackadoodle philosophy you might be embracing today — frutarianism or Bokononism — is cool as long as it doesn’t hurt those around you, right? Refusing to immunize puts the rest of us at risk. And unless there is sound science and the guidance of a good doctor, it’s a pretty bogus way to hedge a bet in that game of parenting roulette. Raising a child is a huge exercise in trust. Parents learn to trust a babysitter, a day care, a school, a coach. You’ve got to learn to trust the kids and their own, cockamamie judgment. The anti-vaxxer movement is being fueled by parents who refuse to trust government, big pharma, family physicians and decades of sound science. Those parents who won’t vaccinate their kids all took huge risks when they visited Disneyland — buckling their children into cars for the drive there, even though car accidents injure 300 children and kill three kids in America every day. They trusted that the drivers next to them would check before changing lanes, that the drivers behind them weren’t texting, that the ones merging from an on-ramp weren’t drunk. That’s a lot of trust they put in the way others kept their kids safe. Too bad the rest of the parents in Disneyland on the day they visited trusted them. **Twitter: @petulad**

We can’t just blame anti-vaxxers for the measles outbreak. Parents skip vaccines for many reasons.

In the panic over measles’ spread in California and beyond, the public has been quick to blame vaccine refusers concentrated in wealthy, educated communities for being too ignorant to realize that measles can be a serious disease.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This charge, however, ignores the history of measles. It’s an intractable disease that, despite decades of vaccination, rebuffs our best efforts at elimination. And each time it flares up, its resurgence points out unresolved tensions between this country’s “haves” and “have-nots.” When the first measles vaccine was released in 1963, vaccine developers and health officials were optimistic that it would be as widely used as the polio vaccine, which parents scrambled for when it first came out in the mid-1950s. But within just a few years, it was clear that only some segments of the population sought the new vaccine: predominantly white, middle- to upper-class families. As a result, a California epidemiologist noted at the time, measles became “a disease of the Negro population and the population with Spanish surnames.” Across the country, measles began to cluster in poor urban areas. And as the decade progressed, the pattern only worsened. When the Centers for Disease Control and Prevention announced a campaign to eradicate measles domestically via vaccination by the end of 1967, class disparities in measles infection rates provided part of the impetus. But the campaign, perhaps inadvertently, played to white, middle-class fears of diseases emanating from the “slums.” One cartoon depicted measles as a red-faced, yellow-eyed fiend who popped out of metal garbage cans left on the sidewalk and climbed through school windows to menace white children. Nonetheless, the number of measles cases declined dramatically. But at the end of the 1960s they ticked up again. They were once again concentrated in urban "ghettos" and central city indigent areas. And blame for measles’ persistence was often placed squarely on the poor;  on their purported ignorance of the disease, on their lifestyles, even on their living conditions in new urban high-rise apartments, where tight quarters fueled the disease’s spread. Laws requiring measles and other vaccines for school were adopted in the early 1970s, in part because they promised to address class disparities. As a CDC immunization official noted, “To reach the single preschool child in the slum is difficult, but to mount a campaign to attain really high levels of immunization in … school should be relatively easy.” And it was. President Jimmy Carter’s administration announced a renewed campaign to eliminate measles later that decade. By 1980, 96 percent of all children were vaccinated against measles and cases fell to an all-time low in 1981. But by the end of the 1980s, measles again climbed to epidemic heights. And again cases concentrated among minority children in inner cities. President George H.W. Bush proposed tying welfare payments to children’s vaccination status; the outbreaks, in this view, were a matter of personal responsibility. Democrats, meanwhile, tied the outbreaks to a health-care system that shut out the nation’s poor. New federal funds for vaccinating poor and uninsured children drove measles rates way down in the 1990s. In 2000, the CDC declared the disease "eliminated”: measles still occurred, but only when brought into the United States from abroad. In recent years, however, the size of measles outbreaks has grown, as has the number of cases coming in from outside the country.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As in the past, today’s vitriolic rhetoric around the causes of measles’ return tells us something about class relations in our own time. Blaming purportedly selfish upper-middle class families reflects a collective cultural discomfort with the wealthy’s increasing ability to opt out of shared responsibility for community welfare.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But as we focus on the alleged selfishness of wealthy, overeducated vaccine skeptics, other factors at the root of the outbreak are, as in the past, getting lost in the conversation. Parents avoid or delay children’s vaccines for an array of reasons: poverty, other challenges accessing health care, medical reasons, religious beliefs and an ever-expanding list of required vaccines. Parental acceptance of some immunizations has eroded in recent decades precisely because the overall number of vaccines and vaccine doses required for children has grown to historically unprecedented levels. We need to acknowledge these factors — just as we need to recognize that our vaccination debates continue to thinly veil class anxieties deeply rooted in our history. _Elena Conis is an assistant professor of history at Emory University in Atlanta and the author of "Vaccine Nation."_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Read more: 2015 measles total is already greater than number of cases in a typical year    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles spreads to New York    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Christie clarifies comments on vaccinations    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Get your kids vaccinated, Obama tells parents    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Millennials more likely to say vaccination should be a choice    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical negligence of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

The devastating impact of vaccine deniers, in one measles chart

If you want to quantify the alarming impact of the anti-vaccine movement, the chart above is a good place to start. It plots the cumulative number of new measles cases by month, for each year from 2001 to 2014. There were 644 new measles cases in 27 states last year, according to the CDC. That's the biggest annual number we've seen in nearly a quarter-century. The vast majority of people who contracted the disease were unvaccinated, including the dozens of cases related to an outbreak at Disneyland in Orange County, California, which is basically Ground Zero in our current epidemic of anti-vaccine hysteria.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico A 2014 AP-GfK survey found that only 53 percent of Americans were confident that vaccines are safe and effective, which is similar to the proportion who believe that houses can be haunted by ghosts. I don't need to make the case about how harmful these beliefs are -- it's been done plenty of times before, and moreover studies show that arguing with anti-vaxxers only makes them more confident in their beliefs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But the latest CDC data illustrate the troubling resurgence of a disease that, as of 2000, had been declared eliminated. Anti-vaxxers are quite literally turning back the clock on decades of public health progress. Related: Vaccine deniers stick together. And now they're ruining things for everyone    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _Correction: An earlier version of this post mis-stated the number of Americans confident in the safety of vaccines. It is 53 percent, not 51 percent._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Arizona tracking up to 1,000 potentially exposed to California-linked measles virus

The measles outbreak that originated in California’s Disneyland has now spread to seven people in Arizona, with up to 1,000 people in the state potentially exposed to the disease, including nearly 200 children. According to public health authorities, there are now 79 confirmed cases in California, 52 that have been linked to Disneyland. In addition to Arizona, cases have been reported in Colorado, Michigan, Nebraska, Oregon, Utah and Washington state — all connected to California, according to state health officials.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This week, two new cases in Arizona — a man and woman — were linked back to a local family reported to be infected when they visited the West Coast amusement park, according to the Arizona Republic.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Health officials say the outbreak is a direct result of the increasing number of people — particularly in California — who have chosen to remain unvaccinated, partly because of the erroneous belief that vaccinations can cause autism.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Arizona Department of Health Services director Will Humble said anyone who is unvaccinated or undervaccinated — those who have not yet received all doses — who has been exposed to the measles must be quarantined for three weeks. “To stay in your house for 21 days is hard,” he said. “But we need people to follow those recommendations, because all it takes is a quick trip to the Costco before you’re ill and, ‘bam,’ you’ve just exposed a few hundred people. We’re at a real critical juncture with the outbreak.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico According to the Centers for Disease Control and Prevention, the measles virus lives in mucus in the nose and throat. When measles patients cough or sneeze, “droplets spray into the air and the droplets remain active and contagious” for up to two hours.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Arizona public health authorities confirmed the woman, who was diagnosed with measles in Maricopa County, had been exposed to the family that recently traveled to Disneyland — ground zero for the current outbreak. Officials said she went on to expose as many as 195 children between Jan. 20 and Jan. 21 at Phoenix Children’s East Valley Center, an urgent care center. It’s still not clear why she was there and whether she was vaccinated, but she has since recovered, according to the health department. “Mitigating factors allowed this person to go unreported for a few weeks. Luckily, we were able to quickly identify the small group of individuals that may have been exposed,” Bob England, director of Maricopa County Department of Public Health, said late last week in a news release. “However, we are not out of the woods yet. California is only a state away and there may be more secondary cases in Maricopa County. This is why we need residents and our healthcare community to be vigilant in identifying measles’ signs and symptoms.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It’s unclear how many people have been exposed to the man who was diagnosed in Pinal County after he came in contact with the same family that had been to Disneyland. Pinal County health officials put out a notice listing five places of business the man had visited and urged people who might have been exposed to him to review their immunization history and monitor themselves “for illness with fever and unexplained rash” until Feb. 13.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The measles outbreak began in December, when someone reportedly infected with the virus visited the Disneyland Resorts in Anaheim, Calif. Over the past month, the disease has spread beyond that community, infecting close to 100 people in eight states. Mexico is also now battling the outbreak, according to news reports.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California is working to get ahead of the measles. This week, 30 babies were put in home isolation in Alameda County after possible exposure. The disease is especially dangerous for infants because children younger than one year cannot get the MMR vaccine. On Tuesday, nearly 70 students at Palm Desert High School near Palm Springs were banned from class for two weeks because they haven’t been vaccinated.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico According to the CDC, symptoms of the measles are similar to those of the common cold: fever, cough, runny nose and red, watery eyes.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Humble said although Arizona is working to contain the illness, he’s sure it will spread. “I am certain we will have more just based on the sheer number of people exposed this time,” he said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

The story of the U.S. measles outbreak, as the rest of the world might see it

_If the foreign press covered the U.S. measles outbreak the way the American press covered the Ebola crisis. . .  _ ■ Paranoia and fear have spread throughout this human-resource-rich but politically dysfunctional nation, allowing a disease once nearly eradicated to return and ravage large swaths of the U.S. population. Measles, a highly communicable and potentially deadly illness, has been mostly preventable since a vaccine was developed more than 50 years ago. And for decades this North American superpower — like other Western nation-states — had near-universal immunization rates. In recent years, though, locals have become increasingly distrustful of Western medicine. Many have opted for alternative methods to ward off illness, relying on dietary supplements, frantic Google searches and advice from former Playboy models. As superstitions and anti-elite conspiracy theories have taken hold, measles outbreaks have flared up around the nation in the past few years. The epidemic reached a fever pitch in December after it infiltrated one of the country’s holiest sites: a national shrine honoring a singing rodent who serves pilgrims fried dough in exchange for alms. (Pious natives refer to the site as “Disneyland.”) Unsuspecting wayfarers were reportedly exposed to measles while queuing for a popular worship site involving whirling teacups, revered for its ability to purify and purge believers’ insides by inducing vertigo; infected visitors brought the disease back to their home towns, whence it spread to unvaccinated communities around the country. Foreign leaders, fearful for the health of the United States’ most vulnerable ethnic groups (particularly those already suffering from the recent gluten-allergy epidemic), have urged the U.S. government to start mandating immunizations. But although American statesmen have almost uniformly treated their own offspring to such preventive measures, they are reluctant to force modern medicine upon their unruly and independent-minded constituents. Indeed, some American politicians have been fomenting distrust of the government’s public health initiatives. They seem to fear losing the coveted Anti-Science vote, a growing demographic expected to play a key role in deciding the next presidential election. “In traditional American culture, locals value ‘rugged individualism’ above all social or moral obligations,” said longtime U.S. observer and ethnographer Ike Arumba. “Many Americans believe liberty and public health are fundamentally at odds.” Arumba cited as evidence a political showdown last year over a prominent doctor’s suggestion that gun ownership and the incidence of gunshot wounds might be correlated. Meanwhile, the United States’ trading partners have begun screening and quarantining airline passengers arriving from the troubled Western nation. Some allies have even considered outright travel bans, fearing that American passengers may lie about their exposure as they become more desperate to escape the risk of infection. Of course, such bans seem futile, given how porous U.S. borders have proved in the past. The outbreak comes as observers grow increasingly frustrated with other public health developments in the United States. Several years ago, the country made a commitment to bring its health system up to international standards, by extending basic care to 26-year-olds and other indigents. But intertribal fighting has complicated the rollout of the new health-care initiative, as the country’s increasingly radicalized right-wing party has tried, repeatedly, to repeal it. The president has vowed to veto any such repeal effort, but observers worry that the nation’s highest court is also preparing to dismantle the program, on a semantic technicality. Despite such concerns, allies and economic rivals alike continue to lend trillions of dollars to the U.S. government, with no strings attached and at ultra-low interest rates. Many longtime America-watchers had hoped that this financial lifeline would be used to bolster humanitarian concerns, including health-care access and human capital accumulation, as well as much-needed basic infrastructure projects. Instead, critics say, the cheap foreign loans have been largely diverted to the country’s ruling class through tax expenditures. Federal monies have also been funneled to the country’s increasingly militarized police forces, to arm them for escalating conflicts with historically oppressed racial minorities. Experts say that the United States’ broken institutions and collective cultural allergy to scientific or technical expertise are to blame for both of these macro issues, as well as the recent public health scares. “Oh, sure, they’re more than happy to take our money, but time and again Americans have shown their unwillingness to shape up and join modern civilization,” said one diplomat, who requested anonymity because he has promised his son a trip to measles-ravaged Disneyland. “It’s really a shame, but you can’t vaccinate against stupid.” **Read more on this issue:** The Post’s View: The measles vaccine is a shot of common sense The Post’s View: Mr. Paul’s and Mr. Christie’s irresponsible comments about measles Michael Gerson: Vaccines and what we owe to our neighbors Kathleen Parker: Seeking a vaccine for ignorance Ruth Marcus: A GOP outbreak of scientific illiteracy

A new threat appears along the U.S.-Mexico border: Americans with measles

As Republican lawmakers suggest that undocumented immigrants crossing the southern border may be responsible for bringing measles and other diseases into the country, Mexican health authorities are warning people traveling to the United States about the risk of infection here following an outbreak of measles at Disneyland last month that has sickened dozens of people in several states.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's a remarkable reversal that demonstrates how far public health in Latin America has advanced in the past few decades -- especially in contrast to measles's alarming return in the United States. Health officials in the Mexican state of Chihuahua, which borders Texas and New Mexico, are distributing pamphlets with information about measles at airports, bus stations and border crossings. They're urging anyone with plans to travel to U.S. states where the outbreak has spread to immunize themselves, if they haven't already.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico These actions follow the arrival of two people with measles in Mexico from the United States last month, one of them an infant nearing her second birthday. Measles poses grave risks to small children, including permanent deafness, brain damage and death.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "The U.S. exported [the] measles virus to Mexico,” Anne Schuchat, an official at the Centers for Disease Control and Prevention, has said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico She told U.S. lawmakers at a hearing this month that in years past, travelers and immigrants from Mexico and Latin America brought measles and other diseases into the United States. Yet immunization rates in Latin American countries have improved, and the rate in Mexico has been higher than the U.S. rate for most of the past 20 years, according to the World Health Organization.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Now, although vaccination rates in the United States remain above 90 percent, sentiment has turned against vaccines in a few communities.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The country had 644 cases last year, by far the most in at least decades, and the recent outbreak, which has already infected at least 123 people and likely more, has spread south to Mexico.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "We see the virus unfortunately going the other direction," Schuchat said later. Measles's new reality is at odds with the warnings given by some G.O.P. lawmakers, such as Rep. Mo Brooks (R-Ala.), who recently suggested that the southern border was a risk to public health in the United States. "I don’t think there is any health care professional who has examined the facts who can honestly say that Americans have not died because the diseases brought into America by illegal aliens who are not properly health care screened as lawful immigrants are," he said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Schuchat told lawmakers that most measles strains are now brought into the United States by unvaccinated Americans traveling abroad, who probably enter the country without being screened in any way when they return home. Meanwhile, Americans who are worried about any public health risk from illegal immigration can still protect themselves through vaccinations for most diseases.

As measles cases increase, a sharp call for vaccinations

EVEN WHEN there are significant gains against infectious diseases, there can be reversals. In 2000, measles was considered all but eliminated in the United States. For a while, there were only about 60 cases a year, mostly brought in from overseas. Now, the number of cases and outbreaks in the United States is rising again. The Centers for Disease Control and Prevention reported Thursday that there have already been more cases this year, 288, than in any full year this century. Measles is a highly infectious respiratory disease caused by a virus that affects young children, with fever, runny nose, cough and a distinctive rash. Infrequently, it leads to more serious complications. There have been no deaths in the United States for a while, but in 2012 measles caused an estimated 122,000 deaths worldwide. That’s far fewer than in the past, thanks to a global campaign to vaccinate more than a billion children in high-risk countries. In the United States, a vigorous effort at immunization in recent years brought measles almost to a standstill. After an epidemic from 1989 to 1991 resulted in 55,000 cases and more than 100 deaths, largely because of lack of immunization among poor and uninsured children, a federal program approved in 1994, Vaccines for Children, resulted in much wider coverage. More than 90 percent of the children in the United States are immunized. Most of the recent measles cases in the United States arrived with travelers. For example, California reported 58 cases from January through April 18 this year, the highest number for that period in 19 years. According to the CDC, 93 percent of the California cases are linked to importation of the disease. The Philippines has seen an ongoing outbreak. Sometimes a single traveler can ignite a wildfire of infections. In 2013, a 17-year-old who had not been vaccinated returned to an orthodox Jewish community in Brooklyn from the United Kingdom, leading to an outbreak that affected 58 people; most were in three extended families that had declined the measles vaccine. This year, an outbreak in Ohio has reached 68 cases, apparently sparked by Amish missionaries, unvaccinated, who had visited the Philippines. The measles vaccine has been in use for half a century and is safe, inexpensive and effective. Some parents suspicious of vaccines have decided against immunization; in other cases, people are simply ignorant of the risks of inaction. Not all 50 states have the toughest immunization laws and standards. Thus, in some vulnerable pockets of the United States, a single person can touch off an outbreak. A nation’s borders provide no ironclad defense against viruses and bacteria. But measles can be stopped with comprehensive and proper immunization. **Read more about this issue:** Seth Mnookin: An early cure for parents’ vaccine panic Michael Gerson: The enduring benefits of vaccination Michael Gerson: Global vaccine efforts offer hope to millions Alexandra Petri: The one problem with that Jenny McCarthy Twitter backlash

Stop fussing over measles vaccination rates. Start worrying about flu shots.

You probably heard about the Disneyland measles outbreak last year. One infected person is thought to have visited the theme park, and thanks in part to low immunization rates, 142 people in California and six other states got sick. It wasn’t close to the worst recent measles outbreak in the United States, but because of its origin in the shadow of Cinderella’s castle, it produced a crescendo of media and public concern about the larger problem of childhood vaccination rates, which have dipped slightly in some states. The discussion around vaccine reluctance has been growing for years, amplified by the chorus of celebrities and politicians who’ve weighed in, and the childhood vaccination problem has been the primary focus of public health officials in charge of vaccine programs for more than a decade.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But by any imaginable metric, resistance to childhood vaccination is hardly the most worrisome category of vaccination reluctance in the United States. Yes, hundreds of children are getting sick from measles or dying of pertussis (whooping cough) in communities where vaccine refusal has allowed what should have been isolated cases to spread. It’s tragic and infuriating. But it is nowhere near the health threat Americans face because of the astoundingly low number of people getting vaccinated each year against the flu. The Centers for Disease Control and Prevention estimates that since the 1970s, influenza has killed between 3,000 and 49,000 people each year, most of whom were 65 or older. An average of 200,000 people per year get so sick they have to be hospitalized, including 20,000 children under 5, whose immune systems haven’t fully developed. In 2011-2012, the latest flu season for which the CDC has firm numbers, the illness killed 37 kids under 18. It killed 122 children the season before and 348 during the 2009-2010 H1N1 pandemic.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico These figures dwarf the stats for measles and pertussis. The CDC recorded 222 cases of measles in America in 2011, 120 in people 19 or younger. Nobody died. 2012 was a record year for pertussis, with 48,277 cases and 20 deaths, 18 of those in children. The health and economic costs of influenza are staggering. Five to 20 percent of the U.S. population gets the flu every year. A 2007 analysis in the journal Vaccine reported: “Based on 2003 US population, we estimated that annual influenza epidemics resulted in an average of 610,660 life-years lost, . . . 3.1 million hospitalized days, and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion . . . annually. Projected lost earnings due to illness and loss of life amounted to $16.3 billion . . . annually. The total economic burden of annual influenza epidemics using projected statistical life values amounted to $87.1 billion.” (Population growth since 2003 suggests that these numbers are roughly 10 percent higher now.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The CDC recommends an annual flu vaccination for anyone 6 months and older. Herd immunity for flu — which means enough people are vaccinated so that if one person gets sick, the disease can’t spread — would be achieved if roughly 80 percent of us were inoculated. There isn’t a single age group that meets those targets. The CDC estimates flu vaccination rates of 67 percent for adults 65 and older, 47 percent for people 50 to 64, 34 percent for those 18 to 49, and 59 percent for kids 17 and under.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico If the risk is so high, why are these vaccination rates so low? In short, because facts alone don’t determine how we feel about a risk. The affective, emotional nature of risk perception is such that we sometimes worry more than the evidence warrants — parents overly concerned about the health risks of childhood vaccines, for instance — and we sometimes don’t worry as much as the evidence warns. When it comes to the flu, people aren’t nearly as worried as the facts suggest they should be. In one study of adults who didn’t get the flu vaccine, 28 percent of respondents said, “I don’t need it,” and 16 percent said, “I didn’t get around to it” — essentially, they weren’t worried enough. Fourteen percent said, “I don’t believe in flu vaccines,” even though in most years, the vaccine reduces your chance of getting sick by more than half. Another 14 percent said, “I might get the flu from the vaccine.” (Like the association between childhood vaccines and autism, this common myth is incorrect.) Five percent said, “I dislike needles,” even though the vaccine now comes in nasal-spray form. And 3 percent said, “No vaccine was available,” which is stunning, since tens of millions of doses are prepared each year and millions of doses are thrown away unused at the end of every flu season.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Studies of the psychology of risk perception by Paul Slovic and others have found that we worry much more about risks to kids than risks to adults, and we worry much less about risks with which we’ve grown familiar, such as the regular seasonal flu. What worries us more prompts more widespread and more passionate advocacy, including more media attention. Together those factors raise pressure on the government to respond to what we’re most afraid of, even though what we fear more might not be what threatens us the most. That’s why we need better programs to increase flu vaccination rates, including improved public education and communication about risks. We should also consider requiring vaccination for health-care workers and for other workers who physically interact with the public; economic incentives, such as discounts on health insurance similar to those already offered to nonsmokers or people who join a gym; and disincentives, such as higher out-of-pocket doctor’s visit fees for those who choose not to vaccinate. Such programs would undoubtedly be cost effective. They certainly would protect public health, and children’s health, far more than efforts to increase childhood vaccination rates for other diseases (work that should continue, of course). A CDC report in December 2014 found that if flu vaccination levels had reached the government’s target of 70 percent during the 2013-2014 flu season, 5.9 million illnesses and 42,000 flu-related hospitalizations could have been avoided.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico National Influenza Vaccination Week, an annual CDC observance to draw attention to the importance of flu vaccination, came and went in December with no fanfare, even though tens of thousands of us are getting sick or dying from influenza. These illnesses and deaths could be dramatically reduced if we had the right priorities — and if we all simply got our flu shots. _Correction: An earlier version of this story incorrectly stated the flu vaccine’s efficacy rate in a typical year._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Vaccines and what we owe to our neighbors

The measles outbreak that began at California’s Disneyland — and spread like pixie dust — along with several other, smaller flare-ups, has health officials warning of worse to come. Preventable infectious disease is making its return to the developed world, this time by invitation. The scientific consensus on measles is effectively unanimous: 1) It is not trivial. Children with measles can get seriously ill, and there is chance of complications such as middle ear infections, pneumonia and encephalitis. 2) Measles is highly transmissible — one of the easiest viruses to get or give. 3) The measles vaccine is highly effective — one of the most successful against any virus or microbe. I’ll turn “4)” over to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases: “The ‘evidence’ that measles vaccination is associated with serious adverse events such as autism and other afflictions,” Fauci told me, “has been completely discredited by a number of independent scientific bodies.” Yet, a significant minority of parents — often well-educated parents — are opting out of vaccination. Many states (including California) make it relatively easy to refuse vaccination for “philosophic” reasons. This does not, I suspect, mean that people are reading Immanuel Kant or John Stuart Mill; it means they are consuming dodgy sources on the Internet. Resistance to vaccination on the left often reflects an obsession with purity. Vaccines are placed in the same mental category as genetically modified organisms (GMOs), DDT and gluten. But the problem with organic health care is that the “natural” rate of child mortality is unacceptably high. Organically raised children can get some very nasty diseases. Opposition to vaccination on the right often reflects an obsession with liberty — in this case, freedom from intrusive state mandates. It has always struck me as odd that a parent would defend his or her children with a gun but leave them vulnerable to a microbe. Some conservatives get especially exercised when vaccination has anything to do with sex — as with the human papillomavirus (HPV) vaccine — on the questionable theory that teenagers are more likely to fornicate if they have a medical permission slip (or less likely to without it). Whether hipsters or home-schoolers, parents who don’t vaccinate are free riders. Their children benefit from herd immunity without assuming the very small risk of adverse reaction to vaccination. It is a game that works — until too many play it. Herd immunity requires about 90 percent vaccine coverage. Some children with highly vulnerable immune systems — say, those being treated for leukemia — can’t be vaccinated for medical reasons. When the number of non-medical exemptions from vaccination gets large enough, the child with leukemia becomes the most vulnerable to the spread of disease. The government (in this case, state governments) has the responsibility to keep vaccination rates above 90 percent, which benefits everyone. This requires burdening the freedom of parents in a variety of ways — not putting them in jail if they refuse to vaccinate but instead denying them some public good (such as public education) and subjecting them to stigma (which they generally deserve). As the rate of vaccination goes lower, the level of coercion must increase — making exemptions more difficult and burdensome to secure (as California needs to do). This issue is important in itself. It also demonstrates a point that is properly called “philosophic.” Vaccination is communitarianism in its purest, laboratory form. The choices of citizens are restricted for a clearly (even mathematically) defined social good. Things get murkier with other kinds of goods. Does the same coercive power apply to chronic diseases involving lifestyle choices? Government has taken a position against the use of tobacco. What about substances such as sugar, salt and saturated fat? Does the common good extend to the moral and social health of a community? Maybe just to the moral health of people younger than 21 or 18, who can’t buy or consume certain things? How about prostitution, which degrades women and men (even as willing participants) and results in a squalid social atmosphere? How about the legal availability of concentrated forms of tetrahydrocannabinol (THC), the active ingredient in marijuana? In all these matters, there is a balance between individual rights and the common good. This may sound commonplace. But some Americans seem to believe that the mere assertion of a right is sufficient to end a public argument. It is not, when the exercise of that right has unacceptable public consequences, or when the sum of likely choices is dangerous to a community. Sometimes we need 90 percent of the public to make the right choice, or innocent people suffer. _Read more fromMichael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook _. **Read more on this topic:** The Post’s View: The measles vaccine is a shot of common sense The Post’s View: As measles cases increase, a sharp call for vaccinations Michael Gerson: The enduring benefits of vaccination Paul Waldman: What Chris Christie gets wrong about vaccine deniers

Chart: New measles cases skyrocketed in January

Data released Monday from the Centers for Disease Control shows 102 confirmed new measles cases in the month of January this year. That's far and away a monthly record for the years since 2000, when the disease was officially declared eradicated. The majority of cases stem from an outbreak at Disneyland in California.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico To put it another way, we've had about twice as many new measles cases in the past 31 days as we did in all of 2012. Last year was a record year for measles, with 644 new cases confirmed in 2014 \-- the highest in decades. If the California outbreak continues to spread, this year's totals could end up much higher.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico From a public health standpoint, policymakers are in something of a bind. The impulse is to urge parents to vaccinate their children, as President Obama recently did. But when politicians get involved, the danger is that a public health issue becomes a political one. On Monday morning, New Jersey Gov. Chris Christie tried to set himself apart from Obama's position by calling for "balance" on the vaccine debate, only to hastily walk back his statements hours later.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's nigh impossible to change hearts and minds on vaccines; a recent study found that presenting vaccine skeptics with facts only reinforced their views. Over at The Upshot, political scientist Brendan Nyhan warns that "news articles focusing on an extreme and unrepresentative group of anti-vaccine parents and celebrities may cause others to wrongly infer that their views are mainstream." In reality, their numbers are small -- in California, for instance, only about 2.5 percent of kindergartners hold "personal belief exemptions" that allow them to opt out of state vaccine requirements.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Large outbreaks and big infection numbers, like what we're seeing in California, may scare some skeptical parents into holding their nose and getting their kids the required shots. Reporting out of California from my colleague Todd Frankel suggests this may already be happening.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Surgeon General Vivek Murthy urges parents to vaccinate children against measles

_This post has been updated._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Surgeon General Vivek H. Murthy urged parents Wednesday to vaccinate their children against the measles, saying that while he understood concerns some may have, the immunizations have been proven safe and effective.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "The most important message I have is to please, please, please get your child vaccinated," Murthy said in a brief interview. "I recognize that some of the concerns parents have about vaccinations come from a place of wanting to do the best to protect their children," he added. But "I believe that on this topic, the science is very clear." _[Related: Everything you want to know about the measles and the vaccine debate]_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Murthy's remarks add the voice of the government's top public health official to the debate over vaccinations that has erupted in the wake of a measles outbreak that began in December in Disneyland theme parks in Southern California. As of Monday, there were 102 confirmed cases of the highly contagious disease in 14 states. That pace would surpass last year's total of 644 cases. Measles was declared eliminated in the United States in 2000, but has bounced back.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Officials from the Centers for Disease Control and Prevention have attributed the spread to communities, some in California, where larger than average groups of people decline to have their children vaccinated for personal reasons or because they mistrust the vaccine. A discredited 1998 study suggested that the measles vaccine could cause autism, but belief in that idea persists.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico President Obama has urged parents to immunize children. But Republican Sen. Rand Paul (R-Ky.), a likely presidential candidate, said Monday he believes most vaccines should be voluntary and, on the same day, New Jersey Gov. Chris Christie called for "some measure of choice" on whether injections that protect children against measles and other disease should be required.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Update:** On Wednesday, likely GOP presidential candidate Jeb Bush said that "parents ought to make sure their children are vaccinated."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Murthy noted that physicians have a small amount of flexibility in the vaccine schedule for parents who find it difficult to see children receive multiple injections at one visit. But the government's recommended immunization schedule, and the vaccines themselves have been repeatedly studied and determined safe and optimally effective, he said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles is highly contagious, so pockets of unvaccinated people, children too young to be inoculated and people who cannot be immunized because of other health problems are vulnerable to the virus, which is best known by a rash of red dots on the skin. Most people recover, but complications can include pneumonia, deafness, brain swelling and, in rare cases, death.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Like Ebola, measles entered the United States from other parts of the world where much larger outbreaks have been raging. But in this case, Murthy said, "we have a vaccine that is proven safe and effective. We can protect ourselves [and] protect those around us." **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles spreads to New York    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Christie clarifies comments on vaccinations    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Get your kids vaccinated, Obama tells parents    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The ethical negligence of refusing to vaccinate children    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Millennials more likely to say vaccination should be a choice    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We can't just blame anti-vaxxers. Parents skip vaccines for many reasons.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 2015 measles total is already greater than number of cases in a typical year    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

U.S. measles outbreak sets record for post-elimination era

The ongoing measles outbreak in the United States has reached a record for any year since the disease was eliminated in this country 14 years ago, with 288 cases of the potentially deadly infection reported in 18 states, the Centers for Disease Control and Prevention said Thursday.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday The largest measles clusters are in Ohio (138 confirmed cases), California (60) and New York (26), according to the CDC. Almost all — 97 percent — have been brought into the country by travelers, mainly Americans, who contracted the infection abroad. About half of those were people who picked it up in the Philippines, where a large measles outbreak has affected more than 32,000 people, causing 41 deaths,  since January alone, said Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. In this country, the biggest outbreak is centered in the Amish community in Ohio, where many of the residents are unvaccinated, the CDC reported. In Virginia, two cases were confirmed earlier this month.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday "This is a wake-up call for travelers and parents to make sure vaccinations are up to date," Schuchat said. "Measles vaccine is very safe and effective and measles can be serious," she added. "It's very infectious." Forty-three of the people in this country who have come down with measles required hospitalization, most often for pneumonia, she said. No deaths have been reported here. Measles is a highly contagious respiratory disease that generally affects young children, causing fever, a runny nose, a cough and a distinctive rash all over the body. This year, however, more than half the people who have come down with it are 20 years old or older, according to CDC data. About one in 10 children also gets an ear infection and one in 20 comes down with pneumonia. A person with measles is contagious as long as four days before the symptoms are apparent. Parents and even physicians who haven't seen measles in years may be unaware of the early warning signs. The largest number of confirmed cases of measles since the infection was eliminated in the United States in 2000 occurred in 2011, when 220 were recorded. The CDC hasn't seen this many cases so early in the year since 1994, when 764 people were infected by this time, Schuchat said. In the past 20 years, a concerted public health campaign, especially among lower-income families, has made measles outbreaks rare in the United States. But an estimated 20 million people are infected in Europe, Asia, Africa and elsewhere each year, and 122,000 of them die. In the United States, the number of people who choose not to be immunized for religious, philosophical or personal reasons has begun to become a public health problem, Schuchat said. Others are unaware of, or unable to get, vaccinations before they arrive in the United States. A small number of adults can lose their immunity over time and may need to be re-vaccinated. Authorities aren't sure how the Amish community in Ohio contracted the disease, but Schuchat said they believe that people traveling to conduct faith-based work abroad are involved. According to the CDC, 40 importations of the infection were attributed to unvaccinated U.S. travelers returning from abroad. Steven Nolt, a history professor at Goshen College in Indiana who has written about the Amish, said some groups do travel to places such as Kenya, Ukraine and Central America to do mission or relief work. He said many Amish do vaccinate themselves and their chidren, but others refuse.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Some, Nolt said, have a "more traditional, conservative, old-fashioned way of life and set of sensibilities that views medicine as something that is used to heal or cure, rather than to prevent" disease. Others have a "theologically informed...sense that we should place our trust in God and not in vaccines." Schuchat urged anyone who isn't sure whether his or her immunizations are up to date to get another dose of the vaccine, especially if traveling to places like the Philippines or doing health care work. Though the vaccine generally isn't given to children before the first birthday, infants traveling abroad can be inoculated with one dose as young as six months, Schuchat said. The vaccine is generally administered in two doses a few years apart. People whose immune systems are suppressed and pregnant women should not receive the vaccine, she said. Adults born before 1957 likely had the measles and should be immune, she added. The vaccine became available in 1963. Related: Potential measles exposure in Fairfax, Loudoun counties    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Va. health officials report second confirmed measles case    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday CDC reports biggest measles outbreak since 1996    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Woman’s cancer killed by measles virus    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday A vaccinated person contracted and passed on the measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday

Measles case confirmed in the District

A case of measles has been confirmed in the District, a spokesman for Mayor Muriel Bowser said Tuesday. Michael Czin said in an e-mail that the case is linked to international travel, not to an outbreak of more than 100 cases that is believed to have started at Disneyland in California. Czin called the case in the District “isolated” but said that the Bowser administration was monitoring the situation and encouraged everyone, especially young children, to be vaccinated against the disease. “Getting vaccinated is the best way to prevent the harmful spread of measles in and around the District of Columbia,” said LaQuandra S. Nesbitt, director of the D.C. Health Department. “It’s imperative for residents to understand the effect measles can have on the human body and the public health threat it poses to young unvaccinated children and adults.” Health Department officials did not respond to requests for information on the current case. Measles is very contagious. Its symptoms can include pink or red eyes and cough, followed by a red blotchy rash that appears on the third to seventh day, the department said. The rash begins on the face and spreads around the body. The effects of the disease are most serious in infants and adults. Related: Everything you need to know about measles ****

Parents with doubts about vaccinations face backlash from pediatricians, peers

The letter arrived in the midst of a growing furor about the country’s worst measles outbreak in years. Cindy Shay, a Maryland health-care lawyer, had been taking her children to Bayside Pediatrics in Annapolis for a decade when her doctor wrote last month that he was “no longer able to continue as your child’s pediatrician.” Her twin 13-year-olds are up to date on all state-mandated vaccines, Shay said. But she was told that the practice also wants them to have boosters and new vaccines recommended by the Centers for Disease Control and Prevention and the American Academy of Pediatrics. Shay has questions, as she has since her son lost his ability to speak and was diagnosed with autism shortly before his second birthday. “I’m an attorney,” Shay said. “Research is what I do. I think parents should ask questions and inform themselves.” It’s a tough time for parents to express doubts about vaccines. The measles outbreak that began at Disneyland in December has spread to 14 states and infected more than 100 people. On Tuesday, D.C. health officials confirmed a case of measles in the District that they say is linked to international travel. The disease’s march, public health officials say, has been fueled by pockets of unvaccinated children, including those of members of anti-vaccine movements in California and other places. [ _Measles passes Ebola as the subject of Americans’ terrified Google searches_ ] The debate has become both medical and political, with President Obama and 2016 presidential contenders weighing in this week. The outrage online, on television and in social media has been ferocious, with parents condemning “anti-vaxxers” for putting other people’s children at risk. The backlash has spread like an epidemic through pediatric practices, preschools and play groups, becoming a topic of blistering discussion on community e-mail groups. Parents who harbor doubts about vaccines say they feel as if they are flunking a new litmus test for sanity. [ _OPINION: We need a vaccine for ignorance _] “I get angry that we’re all lumped together as anti-vaxxers,” said Alison Hamilton, who has a 14-year-old daughter with autism and is the co-coordinator of the Maryland chapter of Talk About Curing Autism, an advocacy group. “Parents who are just asking questions are labeled as crazy, as selfish. We’re not all followers of Jenny McCarthy,” she said, referring to the outspoken celebrity closely associated with the anti-vaccine movement. Hamilton hears regularly from parents who feel caught between the certainty of the medical establishment that vaccines are safe and the anguish of their fears that shots might permanently injure their babies. “It’s a very easy view to take when your child has never spiked a fever, lost all language, and become someone who will require care for the rest of their lives, with very few adequate supports available,” said Hamilton, whose husband works in information technology at The Washington Post. While Shay doesn’t necessarily attribute her son’s autism to the battery of shots he got as an infant, she began to worry about their number and intensity in light of a sharp rise in food allergies and autoimmune disorders. She’s become cautious. She has spent “thousands of hours” looking at vaccine safety studies and the relative risks of the diseases they prevent. Until last month, Shay said her doctors have been willing to work with her concerns. When it came time for a measles, mumps and rubella (MMR) booster, she paid for a blood test that showed her children already had sufficient immunity from their first shots, a substitute that most doctors accept. The practice agreed, signing school and sports forms that certified them as up to date. Now, Bayside won’t continue seeing her daughter unless she gets a range of new shots: boosters for tetanus, polio, chicken pox and MMR, and new vaccines for meningitis and human papillomavirus (HPV). Shay thinks the meningitis shot may be a good idea. “That’s a nasty disease,” she said. But she’s hesitant about the others, which are not required by the state. Maryland doesn’t mandate HPV or a fourth polio shot, and new school requirements for boosters for tetanus and chicken pox apply only to children younger than Shay’s. She has doubts, but this time, the practice won’t accommodate them. “They said they’ve changed the policy,” Shay said. [ _What a Measles outbreak looks like when no one is vaccinated_ ] The practice declined a request for an interview but said in a statement, “Our vaccine policy is based on the American Academy of Pediatrics guidelines and for the concern of the welfare of our patients who do vaccinate.” Pediatricians say they, too, are torn between wanting to care for every child and ensuring that reluctant parents don’t erode the “herd immunity” that protects the whole society from polio, chicken pox and measles. [ _To Your Health: Everything you need to know about measles _] Gary Bergman, a longtime Virginia pediatrician, said he has never had to expel a patient, because he won’t admit children who have not received their scheduled immunizations. “We just think it would be morally and legally neglectful to have people sit in our waiting room who might infect other children,” said Bergman, who practices in Alexandria. “I tell parents: ‘I respect your feelings, but I disagree with you. The science just isn’t there.’ ” He said the number of parents looking to avoid vaccinations or tweak the schedule has declined in recent years. But in the past week, he’s been getting calls of another kind. More parents want to make sure all his _other_ patients have gotten their measles shots. The alleged link between vaccinations and autism was first raised in a small 1998 study by a British doctor, Andrew Wakefield, whose work has since been widely discredited in the scientific community. The journal that published the study retracted it in 2010, and Wakefield lost his medical license. But Rita Montoya wasn’t worried about autism when she began to question the heavy slate of immunizations she was expected to approve for her 8-week-old son in the fall. The Northwest Washington mom did fear putting so much stress on her baby’s fledgling immune system. She suffers from an immune disorder, and she’s a big believer in natural medicine and nutrition. She sought out a pediatrician who would be flexible, warily asking for advice on the same online discussion group where she had seen another woman “bullied” for questioning the vaccine schedule. But when she and her husband, both lawyers, expressed their interest in slowing the regime, the doctor wouldn’t budge. “I’m a pretty strong-willed person, and I felt very pushed along,” Montoya said. “We got more than I was really comfortable with. I was crying when they were giving them to him.” In the end, they delayed only the vaccine for hepatitis B, an infection that is typically transmitted through contact with body fluids. The doctor made them sign a waiver. Kim Taylor is used to trying to wring as must wiggle room from the vaccine regime as she can. Her two sons, 12 and 14, are fully vaccinated, she said. But after her older son was diagnosed with autism at age 3, she decided to space out the shots as much as possible. She found a pharmacist to sell   her separate vaccines for the usually combined measles-mumps-   rubella shot. When her insurance company pushed her to combine them, she paid out of pocket for three separate doctor visits to have them administered. Now her boys are aging into the next round. Her oldest will need a tetanus booster and the meningitis vaccine to run track. She’s negotiating with her doctor to go slowly, but she knows that resistance to giving parents any say is growing. “I’m not against vaccines. I just want a safer schedule,” said Taylor, a graphic designer in Edgewater, Md. “It’s just very difficult to talk to people about it right now.” **Read more:**   Map: Which states allow exemptions for vaccines   Everything you wanted to know about measles

How the U.S. went from eliminating measles to a measles outbreak at Disneyland

In 2000, the United States declared that measles had been eliminated. But the country experienced a record number of measles cases last year, while an outbreak this month that began at Disneyland has been linked to dozens of cases in California and other states. This has raised obvious concerns, both because of the overall anti-vaccination movement in this country and because it’s not considered a good thing for a virus to suddenly surge back into circulation. So, how did we get here? How did we travel from elimination to a record number of cases and a new, dangerous outbreak in just 15 years? Let us take a walk through the recent history of measles and the United States. **ELIMINATION**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico First, it is important to know that “elimination” does not really mean “eradication.” When the United States said that measles had been eliminated in the country, this did not mean there would be no other cases within the nation’s borders; rather, it meant that it was no longer endemic. In other words, any measles cases that occurred would come from people traveling to the country. (The Centers for Disease Control and Prevention defines measles elimination as 12 months or more without “continuous disease transmission” in a geographic area.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **BEFORE AND AFTER ELIMINATION**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Before the virus was eliminated and before vaccinations became routine in 1963 (well, for the most part, but we’ll get back to that in a moment), it infected millions of people each year and was responsible for hundreds of deaths. The CDC says that until that point, every year 3 to 4 million people were infected, 48,000 of them went to the hospital and 400 to 500 people died. After the elimination declaration in 2000, between 37 and 220 people reported having measles each year in the United States — until last year.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **WHAT HAPPENED LAST YEAR?**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The number of measles cases in the country skyrocketed, nearly tripling the highest number seen in the preceding 13 years. As noted above, there were no more than 220 cases in a given year between 2001 and 2013. In 2014, there were 644 cases stemming from nearly two dozen outbreaks. The jump was dramatic, with more cases just last year than there were in the five preceding years combined. **VACCINATIONS AND THE ANTI-VACCINE MOVEMENT**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Obviously, the recent surge in cases is highlighting the still-extant anti- vaccination movement in the United States. Celebrities like Jenny McCarthy, among others, have been given large platforms from which to express their views about the dangers of vaccinations, even though the gas that seemingly fueled the anti-vaccination movement for so long — a medical study published in 1998 — was retracted in 2012. (My colleague Terry McCoy has much more here about the doctor who wrote the retracted paper.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There are other reasons a person may not get vaccinated, of course, ranging from religious or philosophical reasons to someone moving to the country and not being aware of or able to obtain the vaccination. Yet there is a different danger posed by people who choose not to get vaccinations for their children: A recent study found that these people are clustered together, which means that measles, a highly-contagious disease, can more easily spread to additional children.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Ultimately, the vast majority of children in the United States are vaccinated for measles. The majority of people who get measles have not been vaccinated. In California, for example, half of the people with measles in the current outbreak have not been vaccinated (and vaccination status is still not known for many of the others). Still, even if people aren’t getting vaccinated, they aren’t spontaneously developing measles. The disease has to come from somewhere. A huge number of measles cases originate outside the United States, as measles remains common in other countries. (The CDC estimates that each year, about 20 million people around the world get measles and that 122,000 people die from it.) “The only way it can come is from other countries, usually from U.S. travelers who travel abroad and who are not protected through vaccinations, who get infected overseas and bring it back,” Jane Seward, deputy director of the CDC’s viral disease division, told me during one of the outbreaks last year. A study published in the Journal of the American Medical Association — Pediatrics last year found that 88 percent of measles cases in the country “were internationally imported or epidemiologically or virologically linked to importation.” There were a few cases not linked to any kind of importation over a period from 2001 to 2011, but they did not seem to be endemic, researchers said. The study ultimately found that while endemic measles was still eliminated, international importation remained a serious risk.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As long as people are traveling to and from other countries, and as long as some of these people may be unvaccinated and they may come into contact with other unvaccinated people, the risk remains of measles cases in the United States. **WHAT IS HAPPENING IN CALIFORNIA?**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There are 59 confirmed cases of measles in California residents this month, and 42 of those cases were tied to exposure at Disneyland or Disney’s California Adventure Park, the state’s Department of Public Health said Wednesday. (The CDC says there are also cases in five other states.) Those 59 people ranged from seven months to 70 years old. The vaccination status of 34 of these people is known, the health department said, and all but six of those people had not been vaccinated. One other person had received one of the two recommended doses. The situation in the state points to a specific danger presented by an infectious disease that can be spread by people who have traveled overseas and those who have not been vaccinated. Travelers from overseas who do not live in the United States or visit it frequently will often go to tourist attractions such as theme parks, which draw very large crowds. If those crowds contain people who have not been vaccinated, they can potentially contract a disease and bring it back to a community full of other people who may be susceptible. For public health officials in the state, they are monitoring possible measles cases and expecting additional cases to emerge in the near future. They also have a clear message about what they say can help stave off this sort of thing. “The best way to prevent measles and its spread is to get vaccinated,” Ron Chapman, director of the health department, said Wednesday.

California may opt out of its ‘personal belief’ vaccine opt-out

Momentum is building in California to eliminate the ability of parents to opt out of vaccines for their kids on the basis of “personal beliefs.” Reacting to a measles outbreak in the state, five Democratic members of the California legislature proposed legislation Wednesday that would repeal the “personal belief exemption.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The provision allows a waiver of the vaccination if a parent or guardian signs a form that says immunization is contrary to his or her beliefs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico According to the Los Angeles Times, more than 13,000 California kindergarten students have waivers due to their parents’ personal beliefs, with more than 2,700 of those based on religious beliefs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There is no official breakdown of the nature of the beliefs specified by parents. However, significant numbers of Americans think vaccines are harmful to the health of children, despite the absence of supporting evidence, and are egged on by a few medical professionals as well as some libertarians.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **[Amid measles outbreak, anti-vaccine doctor revels in his notoriety]**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Anti-vaccine sentiment is blamed in part for the current measles outbreak that began in California’s Disneyland in early December and has since spread to at least eight states and Mexico, with 103 cases in California.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The bill would not change provisions of the law allowing exemptions certified by a physician and based on concerns about children with medical conditions, such as allergies, that could cause them to react badly to vaccination. “People are starting to realize, ‘I’m vulnerable, my children are vulnerable,'” State Sen. Richard Pan, a sponsor and Democratic pediatrician from Sacramento, said at a news conference. “We should not wait for more children to sicken or die before we act. … As a pediatrician, I have personally witnessed children suffering life-long injury or death from vaccine-preventable infection. This does not have to happen.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **[The saddest story Roald Dahl ever wrote, about his daughter’s death from measles] **_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California Gov. Jerry Brown (D) indicated he would be open to the legislation, though he did not commit himself. “The governor believes that vaccinations are profoundly important and a major public health benefit, and any bill that reaches his desk will be closely considered,” spokesman Evan Westrup told the Associated Press.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Separately, U.S. Sens. Barbara Boxer and Dianne Feinstein, Democrats from California, released an open letter to the California secretary of health and human services expressing their concerns about the state’s exemptions. “While a small number of children cannot be vaccinated due to an underlying medical condition,” they wrote, “we believe there should be no such thing as a philosophical or personal belief exemption, since everyone uses public spaces. As we have learned in the past month, parents who refuse to vaccinate their children not only put their own family at risk, but they also endanger other families who choose to vaccinate.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico ** _Related_**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **Everything you need to know about measles**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Why this baby’s mom is so angry at the anti-vaxxers

Parents who choose not to immunize their children may cite medical or religious reasons to health authorities. In some states, they hardly need to explain themselves at all. But immunization advocates claim many of these parents are relying on “herd immunity” to protect their unvaccinated kids. Those who are vaccinated, after all, can protect those who are not. Unless, of course, they don’t. “I think some parents see it as a personal choice, like homeschooling,” 36-year-old Jennifer Simon of Oakland, Calif., told The Washington Post. “But when you choose not to vaccinate, you’re putting other children at risk. You’re relying on others to vaccinate their kids but you’re not taking on your social responsibility to protect others. You’re putting your child above other people’s children.” Earlier this month, Simon and her husband, Dave, took their 6-month-old daughter, Livia, to the doctor. Both Jennifer Simon and her infant were battling runny noses, so she wanted to be a “good parent” and get their child checked out. It was just a common cold but, just two days later, the couple got a call from the doctor’s office that made them afraid it could turn into something much worse. Simon said they were told that an unvaccinated child had come into the doctor’s office with the measles — and their daughter might have been exposed. “Then we got a call from the county asking us to quarantine her for 28 days — keep her at home, away from anyone who hasn’t had the vaccine and booster,” she said. The current measles outbreak is particularly scary for babies. Like Livia, children in their first year of life cannot get the measles, mumps and rubella vaccine (MMR), meaning the health of their immune systems is dependent on everyone else. Especially in young children, the measles virus can have some serious consequences — pneumonia, brain damage, hearing loss and even death. In California, where the virus is most rampant, 30 babies exposed to measles have been placed under in-home isolation.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The Simons’ infant is still symptom-free. And, if all goes well, she’ll be removed from quarantine today. Still, it’s something her parents say shouldn’t have happened. Some parents who choose not to vaccinate their children may be against orthodox medical interventions. Some may have watched their children experience an adverse episode and linked it to their immunizations. Others may just be scared. After “The View” co-host Jenny McCarthy’s son was diagnosed with autism — and she started speaking out about discredited connections between the syndrome and the nation’s fast-paced vaccine schedule — it was concerning.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This anti-vaccine movement, which has been around for years, got a big boost from a 1998 study purporting to show a link between vaccination and autism. The paper was later discredited and retracted, and it’s author, Andrew Wakefield, was disciplined. But his message still resonates with the anti- vaccine movement.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico All states permit parents to choose not to vaccinate their public school children for legitimate medical reasons, such as anaphylactic allergic response, a life-threatening allergic reaction. All but two states, Mississippi and West Virginia, allow religious exemptions. And 19 states let parents opt-out for philosophical reasons, according to data from the National Conference of State Legislatures.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But some claim the opt-out process in some states is too easy, encouraging the anti-vaccine movement. In New Jersey, for example, parents are required only to sign a note claiming the vaccination would violate their “free exercise of the pupil’s religious rights,” USA Today reported in a strongly worded editorial titled “Anti-vaccine parents boost measles comeback.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Indeed, a 2012 Emory University study found that nine “easy” states require only a form.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Of 19 states that allow philosophical exemptions, fewer than a third require parents to reapply each year, state their case in writing or obtain a notarized letter from a doctor, Mother Jones reported.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico http://www.washingtonpost.com/posttv/national/health-science/measles-keeps-66-calif-students-home/2015/01/29/56375127-da7e-4f74-bbcf-f587083f3063_video.html Non-medical vaccine exemptions are risky because they threaten those who cannot be immunized — babies, children too young to finish their boosters, those who have medical reasons such as pregnancy, immune system issues or life-threatening allergies. Those who are not vaccinated can help spread disease during an outbreak. California public health officials said nearly half of the state’s infected residents weren’t vaccinated. The state has been in the spotlight since someone infected with the measles virus visited Disneyland in California. Now, the disease has spread to nearly a hundred people among eight states. Although vaccination is no guarantee against disease, research shows one dose of the measles vaccine is 95 percent effective and two doses provide 99 percent protection. And adverse reactions are rare.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Jennifer Simon said she has been concerned, upset and scared over the past month. She and her husband took time off work to stay home with their quarantined baby. Her mother flew in from Texas to help. But, she said, mostly she has been angry that another parent chose not to vaccinate and put her daughter at risk. She said she started posting her story on mommy blogs and social media. “A Kaiser doctor said it was a child that could have been vaccinated but wasn’t. She said they chose not to vaccinate the child,” she said. “I go into planning mode when I feel things are out of control, so I think I went to a place where I said, ‘Let’s not let this happen to anyone else.'” And some state lawmakers feel the same way. Maine has one of the highest exemption rates in the United States, Boston.com reported, citing the Maine Center for Disease Control and Prevention.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Maine state Rep. Ralph Tucker (D) has proposed a bill to remove philosophical exemptions altogether, and fellow Rep. Richard Farnsworth (D) has sponsored legislation to require a doctor’s signature for any opt-out request. “From a public health point of view, we absolutely have to increase our rate of immunizations in order to reduce the risk of transmission for early childhood diseases,” Farnsworth told Boston.com. “We’ve already seen problems with whooping cough, measles, and mumps recently. It’s not fair to the general public to have kids who are running around with the potential to expose everybody. “I would hope we would increase our immunization rate, but my primary concern is to make it so people have to visit a physician before they make this decision.” That’s exactly what California did. Earlier last year, the state enacted a law that requires parents to obtain a doctor’s signature on all exemption forms.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But these things take time. “We went to the doctor to be good parents,” Simon told The Post. “Instead, we came out with a potential for measles because someone else chose not to vaccinate and, therefore, expose our child to the disease.” **RELATED** : Arizona tracking up to 1,000 potentially exposed to measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Decision to get vaccinated against measles is ‘almost obvious,’ says health official

Measles is a contagious but preventable disease, and the choice to get vaccinated against it is "really almost obvious," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Sunday. The measles outbreak that originated at Disneyland in December and continues to spread across the country has sparked a debate over whether parents should vaccinate their children. There are people with deep, philosophical reasons for refusing vaccines, but there are others who can be convinced otherwise, Fauci said during an interview on CBS's "Face the Nation." The CDC is working with local and state public-health officials to educate the public about the measles vaccine, he said, referring to the Centers for Disease Control and Prevention. "You have a very good vaccine, you have a highly contagious disease, and you have a disease that's entirely preventable. When you look at the data, with a safe vaccine, the conclusion is really almost obvious," Fauci said. The current outbreak is not yet a major epidemic, but it is affecting vulnerable populations, he said. It has been especially harmful to those who cannot get vaccinations, he said, such as children under 1, children with leukemia and others with weakened immune systems. His comments referenced the concept of herd immunity, according to which a large segment of a population must be immunized to reduce the risk of exposure to everyone within the community, including the most vulnerable, who can't receive vaccines, or those who refuse them. In a separate interview on "Fox News Sunday," retired neurosurgeon Ben Carson said that concerns about side effects to vaccines have been "debunked." Carson, who said he could formally announce a bid for the 2016 Republican presidential nomination by May, compared getting vaccinated to wearing seat belts or not engaging in texting while driving: "That's not optional. We know that it works."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "You look at the benefit-to-risk ratio for vaccinations: way in favor of getting them. Is there an occasional problem? An occasional allergic reaction? Of course there is. But you have to look at the overall good," Carson said.

CDC reports biggest measles outbreak since 1996

Measles have infected 129 people in 13 states in 2014, the most in the first four months of any year since 1996, officials from the Centers for Disease Control and Prevention reported Thursday as they warned clinicians, parents and others to watch for the potentially deadly virus. Thirty-four of the cases were imported via travel to other countries, including 17 from the Philippines, where a huge outbreak has affected 20,000 people and caused 69 deaths, said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases. There have been no measles deaths reported from the outbreak in the United States, and none since 2003. But Schuchat acknowledged that "it's probably just a numbers game, probably just a matter of time until we have more." One or two of every 1,000 cases of measles are fatal, according to the CDC.    *[WSU]: Wayne State University California, with 58 cases, has been hit hardest by one of the 13 separate outbreaks of measles in the United States. New York has seen 24 infections and Washington state has had 13. Measles is a highly contagious respiratory disease that generally affects young children, causing fever, a runny nose, a cough and a distinctive rash all over the body. About one in 10 children also gets an ear infection and one in 20 comes down with pneumonia. A person with measles is contagious as long as four days before the symptoms are apparent, Schuchat said. Parents and even physicians who haven't seen measles in years may be unaware of the early warning signs, she said. In the past 20 years, a concerted public health campaign, especially among lower-income families, has made measles outbreaks rare. The disease has been considered eradicated since 2000. But today, the number of unvaccinated children has begun to become a problem, Schuchat said. Some people are choosing not to have their children immunized for personal reasons and others are unaware of, or unable to get, vaccinations, before they arrive in the U.S. She said the CDC is also seeing growth in the disease pertussis, also known as whooping cough. Before vaccinations were available, about 500,000 people were infected with measles annually in the U.S., a number that fell to about 60 after the disease was all but eliminated in 2000. Since 2010, it has increased to an average of 155 cases per year. Still, she said, fewer than one percent of the toddlers in the United States have received no vaccines at all. "Vaccinating your children is still a social norm in this country," she said. In a telephone news conference Thursday, CDC Director Thomas Frieden lauded the Vaccines For Children program started in 1994, after a measles outbreak from 1989-1991 resulted in 55,000 cases, primarily because poor and uninsured children had not been immunized. Among children born in the following two decades, the CDC estimated, vaccinations prevented an estimated 322 million illnesses and 732,000 deaths, saving about $295 billion. The program provides free vaccinations for measles and 13 other diseases.    *[WSU]: Wayne State University But "we can’t let our successes result in complacency," Frieden said. "In fact measles, is very common in some parts of the world...An it travels fast." He said 20 million people across the globe get the disease annually, and 122,000 of them die. In a separate commentary Thursday in the Annals of Internal Medicine, epidemiologist Julia Shaklee Sammons warned that "as more parents decline to vaccinate their children, measles incidence is increasing—a fact that alarms me both as a hospital epidemiologist and as a parent of a vulnerable infant too young to receive the measles vaccine." When infected patients seek medical care, she noted, "hospitals and clinics may inadvertently fuel transmission if those with measles are not rapidly triaged and isolated."    *[WSU]: Wayne State University The proportion of vaccinated children varies by state, depending on the toughness of their immunization laws, Sammons said. Nationally the measles, mumps, rubella vaccination rate is over 90 percent, but in 15 states it is below that standard, she wrote. New York magazine reported last month on schools in California and New York with low immunization rates among students, in part because parents are choosing not to vaccinate them. The CDC said that 54 of this year's 58 California cases were in some way associated with importation of the virus from abroad. Twenty-five of the people infected were not immunized--19 of them because of philosophical objections--and 18 more had no documentation of vaccinations. Three were too young for routine vaccination and three others were not vaccinated for unknown reasons. Eleven had received two or more doses of vaccine that did not protect them. The vaccine is about 97 percent effective, said CDC official Gregory S. Wallace, so about three in 100 people who are vaccinated and exposed to the infection will contract it.

How the anti-vaccine movement is endangering lives

Infectious diseases that we normally think of as rare in the United States are making a comeback. In recent years, pertussis -- also known as whooping cough -- has returned to the headlines. A measles outbreak that struck a Texas megachurch community late last summer sickened 21 people. And just recently, at least 16 people got sick during a measles outbreak in Ohio. In fact, the Centers for Disease Control and Prevention recently reported 13 measles outbreaks so far in 2014 \-- the most since 1996.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday The diseases are highly contagious, but they are also preventable; two of the many recommended childhood vaccinations protect against measles and pertussis. And measles had been considered effectively eliminated in the United States. What's going on, exactly? Here are some answers.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **Why are so many outbreaks happening?** Although it's a complex problem, health officials say one key culprit is that more and more people are choosing not to get their kids vaccinated against these diseases. For instance, in California parents are increasingly seeking personal or religious exemptions from vaccination requirements for their kids to attend schools. Substandard vaccination rates create an opening for outbreaks, which often start when an unvaccinated person catches the disease while traveling abroad and spreads the illness to friends and family upon returning.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **But aren't overall vaccination rates really high?** Nationally, yes, though it wasn't always this way. Before the 1990s, rates languished below 80 percent for most childhood vaccines at the time. In 1993, after the 1989-1991 measles outbreak, Congress enacted the Vaccines for Children (VFC) program to promote childhood vaccinations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday CDC data show that vaccination rates are now above 90 percent range for several routine vaccines, including the measles-mumps-rubella (MMR) and whooping cough vaccines. Public health officials target a 90 percent vaccination rate for most routine childhood vaccines. Experts say that a population has "herd immunity" when enough people are vaccinated to prevent a disease from taking hold. This chart shows how vaccination rates climbed after VFC's enactment:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **If vaccination rates are high, why are we seeing so many outbreaks?** That's because vaccination rates aren't geographically uniform. Public-health experts say that high non-vaccination or exemption rates can occur among pockets of people, particularly at the county or city level. And some research has found that outbreaks are far more likely to happen in these areas, such as during the recent whooping cough outbreaks in California.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **Why are people not vaccinating their kids?** There are a number of factors at play. Many of the diseases we vaccinate against are so rare here now that the public's awareness of vaccination might have decreased. But the one reason that has most alarmed public-health experts lately has been the rise of the anti-vaccine movement. Groups and activists such as celebrity Jenny McCarthy have repeatedly claimed that vaccines cause autism. This vaccine-autism concern may be causing a drop in childhood vaccination rates in many communities, including in affluent, well-educated ones.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **Do vaccines cause autism? Science gives a resounding no.** Anti-vaccine activists often hang their case on a study published in the British journal The Lancet in 1998. This study, which posited a link between the MMR vaccine and autism, was widely discredited by the scientific community and eventually retracted. But the anti-vaccine movement has still gained steam.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Anti-vaccine activists have also raised concerns about vaccines made with the mercury-based preservative known as thimerosal, which they worry could cause brain damage in developing kids. It's true that vaccines once routinely contained thimerosal, which government officials recognized as generally safe. But this preservative has been phased out of nearly all vaccines as a precautionary measure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Anti-vaccine activists also worry that the CDC's recommended vaccination schedule could overwhelm infants' immune systems by packing too many doses into a short period of time. Although the number of vaccinations that kids receive now is higher than it used to be, the main ingredients in the vaccines have actually decreased in amount. Even if these ingredient amounts hadn't decreased, research has found no relationship between those amounts and autism risk.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday Vaccines do carry a risk of side effects, but they are usually minor. The CDC has concluded from reviewing the scientific evidence that there's no causal link between childhood vaccinations and autism. **Routine vaccines save lives, says science.** A new study from CDC researchers led by Anne Schuchat analyzed what happened to disease rates as childhood vaccination rates increased starting in the early 1990s. The researchers used these findings to model the resulting effect over the kids' lifetimes. In the analysis, the researchers factored in most routine vaccines recommended for children below age 6 (among them the MMR and whooping cough vaccines). Their findings: Routine childhood vaccinations given between 1994 and 2013 will save 732,000 lives and prevent 322 million cases of illness and 21 million hospitalizations over the course of the children's lifetimes.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **Vaccines provide high public-health bang for the buck.** The CDC researchers also weighed the benefits of the vaccinations ("savings in direct and indirect costs that accrued from averting illnesses, hospitalizations, and deaths") against costs ("program costs included vaccine, administration, vaccine adverse events, and parent travel and work time lost"). In 2009 alone, the researchers determined, each $1 spent on vaccines and their administration yielded $10 in benefits to society. And the vaccinations from 1994-2013, the researchers found, will save society a net $1.38 trillion, both directly (by reducing health expenses) and indirectly (via the economic activity that is saved from avoided illnesses). That's almost 10 percent of the U.S. economy's gross domestic product.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **The CDC study may actually underestimate some benefits. Here's why.** It doesn't account for cost savings to society brought on by preventing the diseases' spread to unvaccinated populations, "a powerful driver of cost- effectiveness" in the researchers' view. The study also excludes the influenza and hepatitis A vaccines, and thus fails to capture their benefits.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday **What's the bottom line?** Vaccines may not be perfect. But the science suggests that they are effective -- especially when enough people are receiving them -- and there's still no evidence that they cause autism.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday

7-year-old cancer patient gives ‘a damn’ about the measles vaccine

Amid a measles outbreak that has spread across 17 states and the District of Columbia, a 7-year-old boy has made a plea. He urged his San Francisco Bay Area school district to support a bill to abolish an immunization exemption that currently allows unvaccinated children to attend his school.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico First-grader Rhett Krawitt spoke up earlier this week at a Reed Union school board meeting in Tiburon, Calif., as the board prepared to vote on a proposed exemption ban that would eliminate the state’s philosophical exemption. Rhett, who has been fighting leukemia, has been too ill to get the measles, mumps and rubella vaccine (MMR), so he has been relying on immunized children to protect him from the outbreak. At the school board meeting, he stepped up to the microphone wearing a blue blazer and sneakers and read loudly from a speech his father helped him write. “My name is Rhett, and I give a damn,” he said to a cheering crowd, according to KGO-TV. “Soon we will say, ‘Gone with the measles.'”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The board voted 4-to-1 on Tuesday to support the legislation. It was proposed by state senators in California who want to scrap the “personal beliefs” exemption that allows parents to choose not to vaccinate their public school children for non-medical reasons. All states allow medical exemptions for legitimate issues, such as anaphylactic allergic response, a life-threatening allergic response. Twenty states let parents opt out for philosophical reasons, according to the National Conference of State Legislatures.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But many consider non-medical vaccine exemptions unsound because they create risk for people who cannot be immunized — babies who are too young, children who have not finished their boosters, women who are pregnant and others, like Rhett, whose immune systems are too weak. “As a pediatrician I have personally witnessed children suffering lifelong injury or death from vaccine-preventable infection,” California state Sen. Richard Pan (D), who co-wrote the proposed legislation, said in a statement.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico ** _[RELATED:Why this baby’s mom is so angry at the anti-vaxxers]_**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Rhett, who completed his chemotherapy a year ago, is set to meet with his doctors to determine whether he is now healthy enough to be vaccinated. “For three-and-a-half years, I took chemo to get the bad guys out,” Rhett told the school board, ABC News reported. “Now I can say, ‘Gone with the cancer.'”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Rhett’s father said his son is now fighting not only for himself but also for others at increased risk for contracting the measles. “The importance of vaccinations is about the expectant mothers and babies under the age one and hundreds of children who are at risk for getting these diseases that don’t even need to be here,” Carl Krawitt told ABC News. “It’s really around making sure that we have public health policy that protects everyone in our community.” “Herd immunity is real science. It keeps our children from getting sick,” he told KPIX5-TV.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **[RELATED:The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear]**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The measles outbreak is believed to have started when a person infected with the disease visited Disneyland in California. It has spread to 121 people from 17 states and Washington, D.C., according to the Centers for Disease Control and Prevention. Late last month, California public health authorities said about half of those infected in the state weren’t vaccinated.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The anti-vaccination movement was fueled by a 1998 study that claimed to reveal a link between the MMR vaccine and autism. Although the author, Andrew Wakefield, and his research were later discredited, some still lean on it.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico One parent in Rhett’s school district said his daughter isn’t fully vaccinated because he doesn’t completely trust vaccines. If California’s proposed legislation passes, he might be forced to get his daughter immunized. “Whether I could get a medical exemption for my daughter or not, I don’t know,” he told KGO-TV. Pan told the news station that vaccines are “safe and effective.” “The rate of adverse effects from vaccination is much less than the disease itself,” he said. _ **[RELATED:California may opt out of its ‘personal belief’ vaccine opt- out]**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

California: Land of infectious disease?

California, land of sun and surf, also is unfortunately having a terrible run of infectious disease. After a difficult flu season that resulted in more than 300 deaths of people under 65, the state is now grappling with a huge whooping cough epidemic, a large measles outbreak and, most recently, a localized outbreak of tuberculosis in Sacramento.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday There appears to be no connection between the four public health threats, but that must be little solace to officials working to contain them. The most widespread is the outbreak of whooping cough (also known as pertussis), a bacterial infection that has spread to 4,558 people and killed three infants, according to this June 27 report in the San Jose Mercury News.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday The disease is preventable via vaccine given to infants. Pregnant women can protect themselves and convey some immunity to their babies by getting immunized during the third trimester of pregnancy, according to the Centers for Disease Control and Prevention. The last epidemic in California was in 2010, and officials say the disease has a three- to five-year cycle. But a contributing factor is people who refuse to vaccinate themselves or their children.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday That is also an issue in the state's measles outbreak, which, the CDC reported in May, had grown to include 60 people. State officials say 25 of them were unvaccinated, 19 by choice, and there were 18 more whose vaccination status was unknown. Measles was declared eradicated in the United States in 2000, but the CDC said in May that the outbreak had set a record nationwide for any year since then, with 288 cases. Public health officials admit they are alarmed and are urging U.S. residents to make sure they are immunized, especially if they are traveling to places such as the Philippines, where measles is widespread.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday On Tuesday, health officials in Sacramento, California's capital, reported that four more students at a high school had tested positive for the active type of tuberculosis, bringing the total to five since a student tested positive in February. Authorities have screened about 500 people, turning up another four with active TB and about 120 with the latent type. Only one of the five students was contagious, said Olivia Kasirye, the Sacramento County public health officer. Kasirye said that the four public health issues "are not connected" in any way and that "it is strange that they're all happening" within a short span. "California is a large state, and so you get a lot of things going on," she said in an interview. Although the prevalence of tuberculosis is at historical lows in the United States, at about 10,000 cases annually, local outbreaks are not uncommon, said Lee Reichman, executive director of the Global Tuberculosis Institute at Rutgers University. It is much more common in other parts of the world, with about 8 million cases annually, he said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday The slow-growing bacteria are spread from person to person by aerosolized droplets emitted by coughing. Reichman expressed worry about cutbacks in spending on public health in places such as California, though he knew of no link to the current outbreaks. "I think the message across all three diseases is that public health is a great secret until there's an outbreak," he said. "You pay for it, we keep people well, find disease" and contain it, he said. "Tuberculosis is an excellent canary in the mine."

Anti-vaccination beliefs are contagious like a disease

A recent and disturbing trend in California is making headlines in the popular media: An increasing number of parents are opting out of vaccinating their school-aged children. California, like all states, mandates that children receive certain vaccinations before they enter school. However, like all but two states, California also has a provision for voluntary exemptions (called Personal Beliefs Exemptions, or PBEs, in California). Statewide, the rate of voluntary exemptions has been rising steadily for almost two decades—from 0.5 percent of kindergarteners in 1996 to 3 percent as of the most recent data.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This pattern reflects a growing number of parents who worry that vaccines are unsafe, ineffective, or unnecessary. These increases are troubling, especially in the face of recent outbreaks of childhood diseases such as measles and pertussis (whooping cough)—diseases that used to cause widespread illness and even death in the United States, until they were all but eliminated by successful immunization programs. Now those diseases are back: there have been 593 cases of measles to date this year in the U.S. Compare that to only 119 cases per year on average in 2009-2013.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But statewide exemptions data don’t reveal the true severity of this trend. Infectious diseases don’t operate at the state level—they are transmitted from person to person. We need to look at local data to fully understand the risk of outbreaks. And it is the rates of vaccine exemptions in some localities—counties, school districts, individual schools—that are really making epidemiologists’ hair stand on end. As articles in The Atlantic and the The Hollywood Reporter have recently highlighted, some affluent Los Angeles schools currently report that upwards of 60 or 70 percent of their students have PBEs on record.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The threshold varies by disease, but as a rule of thumb about 90-95 percent of a population needs to be immune (either through vaccines or prior exposure to disease) in order to produce what is known as “herd immunity”.  What is herd immunity, exactly?  When most people in a population have immunity to a disease, an infected person is less likely to bump into a susceptible person (someone with no immunity) —so the disease doesn’t readily spread.   One susceptible person may get it, but will be very unlikely to pass it along.  Herd immunity doesn’t provide direct protection to individuals who have no immunity and are exposed to disease, but it does make it very hard for a disease outbreak to start, which protects everyone from being exposed in the first place.  Certain vulnerable populations rely on this statistical protection—especially babies too young to be vaccinated and people with immune system problems. The 3 percent statewide PBE rate in California is troubling because it’s starting to bump up against those herd immunity thresholds for diseases like measles; and the fact that it’s increasing steadily each year is even more worrying. But large _clusters_ of exempted kids in close proximity to one another, for example in a classroom—that’s truly scary. These micro- communities have rates of immunity far, far below herd immunity thresholds. One sick kid in one of these schools can readily spread disease to the other unvaccinated kids at the school (as happened in 2008 in San Diego).    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico And of course the outbreaks may not be confined to school. Baby brothers and sisters at home are at risk from declining herd immunity (babies aren’t fully protected from pertussis until their 6-month vaccinations, and don’t get their first measles shot until they are 12 months old). And sick kids go to the doctor. The same doctors who have allowed their patients to go unvaccinated may be fostering another hotspot where herd immunity is in trouble—their own waiting rooms. Even if most of the kids in any given practice _are_ protected, there are always a few kids who can’t get vaccinated—either because they are too young or they have an immune system problem. With so many unvaccinated kids in affluent communities like Santa Monica and Malibu, it’s easy to see how a serious epidemic could take hold. And when we’re talking about an epidemic of measles or whooping cough, we’re talking about very sick kids.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico How do these clusters of exempted kids form? We think that the idea of vaccines being unsafe or ineffective or unnecessary spreads—like a disease itself—from person to person within social networks.  Parents talk to their friends, other parents at their child’s school, and to their neighbors.  Normal social processes produce clusters of vaccine refusers in the social landscape.  When it’s time to enroll in school, like-minded parents are drawn to certain schools—and this is especially pronounced when parents have the resources to be choosy about their child’s education.  Soon, there are schools and communities where vaccine refusal is not an anomaly; it is the norm. State and local public health officials across the country are understandably worried about this situation. In January 2014, new legislation known as Assembly Bill 2109 went into effect in California. The law is intended to make it more difficult to get an exemption by requiring that parents submit a signed statement from a healthcare provider stating that the parent has received information about the risks of forgoing immunization. We have our doubts about how effective the law will be at addressing the problem, however. Kindergarten enrollment occurs well after most of the recommended vaccines on the childhood schedule, and parents who truly want to opt out of vaccines have probably already negotiated this with their doctor, and will have no trouble meeting the new exemption requirements.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We do think AB2109 will reduce the number of exemptions that are obtained for “convenience” rather than for “conviction” –parents who file an exemption at the time of enrollment because they can’t produce up-to-date vaccine records for their kids. But guess what? Kids with these “convenience” exemptions have probably received most or even all of their shots anyway. It’s the “conviction” exemption kids who are likely have to received fewer shots and therefore undermine herd immunity. We’ll be watching closely to see how California’s new law affects exemptions and disease outbreak. _Malia Jones is a Postdoctoral Fellow at the Department of Preventive Medicine, Keck School of Medicine, University of Southern California._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _Alison Buttenheim is an Assistant Professor at the Department of Family and Community Health, University of Pennsylvania School of Nursing._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Hillary Clinton likens anti-vaxxers to science deniers: ‘The earth is round, the sky is blue, and #vaccineswork’

With the vaccination debate spreading into the GOP presidential race, Hillary Rodham Clinton jumped into the fray by taking a swipe at some of her prospective Republican opponents.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “The science is clear: The earth is round, the sky is blue, and #vaccineswork,” Clinton wrote on Twitter. “Let’s protect all our kids. #GrandmothersKnowBest” Clinton made her remarks on Monday night, hours after New Jersey Gov. Chris Christie (R) and Kentucky Sen. Rand Paul (R) went in the other direction by giving credence to the fears of people opposed to vaccinating children. Christie called for “some measure of choice” in the matter, and Paul said that he thinks most vaccines should be voluntary, citing “many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.” An outbreak of measles that has now spread to 14 states began after an unvaccinated family visited Disneyland in California. The outbreak — years after the disease was effectively eliminated — has revived a debate about whether public health officials are losing to “anti-vaxxers” when it comes to the well-established science supporting both the safety and efficacy of the measles vaccination. However, while running for president in 2008, Clinton appeared to have held different beliefs on the now-discredited claims that vaccines cause autism. Asked in a questionnaire by an autism group whether she would support investigating vaccines as a possible cause of autism, Clinton said that she would.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I am committed to make investments to find the causes of autism, including possible environmental causes like vaccines,” Clinton wrote.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **RELATED** : **Vaccination debate flares in GOP presidential race, alarming medical experts**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Obama to parents doubting ‘indisputable’ science: ‘Get your kids vaccinated’**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Amid growing vaccination debate, measles continues to spread and is now in New York state**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Anti-vaccine doctor revels in his notoriety**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Why this baby’s mom is so angry at the anti-vaxxers**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Second measles case confirmed in D.C.

A second case of measles was confirmed Tuesday in the District of Columbia, said health director LaQuandra S. Nesbitt. Like the first one, Nesbitt said the infection appeared to be an isolated incident, likely unrelated to the outbreak that began last month at a Disney theme park in California. She said the individual who contracted the virus was not suffering from severe medical problems as a result. Nesbitt declined to say if the victim was an adult or child, citing patient confidentiality. But she said that based on the person’s recent travel history, the District was confident it had contacted each individual who might have been exposed to the person who tested positive. That person had neither traveled to California or been exposed to anyone known to have traveled to California, Nesbitt said. The new victim also had not traveled internationally, which was believed to be the source of the District’s first infection. Though apparently unrelated, the two cases are the District’s first since 2012. They also feed to a growing list of isolated outbreaks in the United States this year. As of early this month, there were 121 cases in 17 states and the District. Nesbitt said District residents should be confident that if they have not been contacted by city health officials that they were not exposed to the individual during the period in which the virus was contagious. She also said there should be a broader takeaway for District residents to seek immunization if they have not done so already. “The message is that for measles, and for all other vaccine-preventable illnesses – we want to make sure our community is protected,” she said. “We are a popular tourist destination, so there may be people who visit us before they have any symptoms, and people who walk around in our community who are not vaccinated, they could be at risk.”

All our politicians should join together to end the dangerous anti-vaccination madness

Intentional non-vaccination is causing avoidable public health disasters in the United States. The problem is particularly acute for measles — though similar things might be said for flu and other diseases -- because measles is so efficiently transmitted from one susceptible person to another. Measles herd immunity requires more than 90 percent of Americans to be immunized. This daunting number may understate the challenge, since small communities that are ambivalent about immunization provide local pockets of vulnerability within which local outbreaks can take hold and spread. It’s all-too-easy to see how these issues could become enmeshed in the culture wars, partisan politics or even the 2016 presidential campaign. This would be a public health disaster. We will never sustain herd immunity if Americans’ beliefs and behaviors in the realm of vaccination harden along cultural or religious or ideological lines. Ambivalence about vaccines crosses conventional political boundaries. People of varying backgrounds and views find powerful reasons to doubt medical and public health authority, to distrust Big Pharma. These doubts and distrust don’t come from nowhere, and are deeply-held—which is why so many pro- vaccination messages often fall short. Many others simply wish to free-ride on the herd immunity provided by others.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We must continue to debunk false rumors about vaccines—most prominently the debunked theories that that the MMR vaccine causes autism. We must recognize, however, that providing and repeating credible medical information only accomplishes so much. The required information has been out there for many years, available in two minutes to anyone with access to Google.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's not just the message that matters. To reach the people we most need to persuade, the messenger matters, too. There is and long has been ample evidence for the safety of common vaccines. Repeating this message only accomplishes so much with intentional non-vaccinators. So here’s what President Obama, Presidents Jimmy Carter, George HW Bush, Bill Clinton, George W. Bush, Majority Leader McConnell, Governor Mitt Romney, Senator Bernie Sanders, House Speaker Boehner, Senator Rand Paul, Dr. Ben Carson, Governor Bobby Jindal,  Senator John McCain, and others should do. They should get together on the White House lawn. Maybe better yet, we need one of those YouTube viral videos:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In whatever form, our political leaders must dramatically convey a simple, utterly nonpartisan message that cuts through the clutter to makes five points: Such display of social and political consensus won’t reach everyone. States should revisit some relatively lax exemption policies in light of disease outbreaks. I’m sure other policy changes would be useful, too.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Still, a bi-partisan campaign of goodwill can help, too. It’s not just the message. The messengers matter, too.  Some issues are larger than partisan politics. This is one. _Harold Pollack is the Helen Ross professor at the School of Social Service Administration and co-director of the Crime Lab at the University of Chicago._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

California’s vaccination bill may go a bit too far

THE RIGHT to swing one’s fist ends at the next person’s nose, and — at least according to California legislators — the right not to get vaccinated ends at a statewide measles outbreak. That’s what lawmakers decided last week when they passed a bill mandating vaccinations for schoolchildren, regardless of personal or religious objections. California’s move to increase vaccination rates is welcome, though it may go slightly too far. The legislation, which Gov. Jerry Brown (D) signed Tuesday , will bring a huge change to the state’s policy, which until now had been one of the more lenient in the nation: California was among 17 states that have allowed broad philosophical objections to vaccines, essentially allowing parents to exempt their children from vaccination for whatever reason they choose. This helps explain the startling rate — nearly 10 percent — of unvaccinated kindergartners in the state. It also may account for the measles outbreak that infected 131 people in California this year. With the bill’s signing, California will swing in the opposite direction, joining the company of just two other states that refuse to recognize not only personal qualms but also religious ones. Put simply, vaccines — particularly against highly infectious, dangerous diseases such as measles — save lives. Anti-vaccinators seize on widely discredited studies linking vaccines to autism and other medical maladies. But doctors who support vaccinations point to the real and deadly results of outbreaks that can and have occurred because of under-immunization. Those who refuse vaccinations for their children put at risk those too young or too sick to be vaccinated. California’s personal exemption policy allowed immunization rates to dip too low to protect public safety, and legislators were smart to change the rule. But religious exemptions are trickier. The freedom to exercise one’s religion is a constitutional cornerstone, and any state should protect the rights of those whose religion genuinely conflicts with vaccination to the extent possible without threatening public health. It happens that no such doctrinal conflict exists in any major religion: some sects of smaller religions such as the Dutch Reformed Church appear to prohibit vaccination. On the one hand, this does not make writing an appropriately narrow religious- exemption provision into a law any easier. On the other, it means allowing these exceptions would be unlikely to lead to immunization levels low enough to risk outbreak. California’s lawmakers have taken a step toward safety and charted a course that other states with similarly lenient policies should follow. But when it comes to religious objections, those states should take care not to stay anyone’s fist until they are sure someone else’s nose is in jeopardy. **Read more on this topic:** The Post’s View: As measles cases increase, a sharp call for vaccinations Michael Gerson: Vaccines and what we owe to our neighbors Michael Gerson: A global conspiracy of health The Post’s View: The measles vaccine is a shot of common sense

The U.S. just recorded its first confirmed measles death in 12 years

Health officials on Thursday confirmed the country's first measles death since 2003, and they believe the victim was most likely exposed to the virus in a health facility in Washington state during an outbreak there. The woman died in the spring; a later autopsy confirmed that she had an undetected measles infection, the Washington State Department of Health said in a statement. The official cause of death was announced as "pneumonia due to measles."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _[Everything you need to know about measles]_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The woman was at a Clallam County health facility "at the same time as a person who later developed a rash and was contagious for measles," the health department statement read. "The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death." The release did not provide any other identifying details, including the woman’s age. According to the U.S. Centers for Disease Control and Prevention, 178 people from 24 states and the District were reported to have measles from Jan. 1 through June 26 of this year. Two-thirds of the cases, the CDC noted, were "part of a large multi-state outbreak linked to an amusement park in California."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This newly confirmed case marks Washington's 11th reported instance of measles this year, and state health officials urged people to vaccinate against the virus. "This tragic situation illustrates the importance of immunizing as many people as possible to provide a high level of community protection against measles," the state health department's statement read. "People with compromised immune systems often cannot be vaccinated against measles." Following the outbreak in his state, California Gov. Jerry Brown (D) this week signed one of the nation’s strictest laws regarding school vaccinations. Starting in the 2016-2017 school year, parents can’t claim personal belief exemptions, and medical exemptions will only be allowed for children with serious health problems.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _[Jim Carrey denounces new Calif. vaccine law in Twitter rant]_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles were effectively eliminated in the United States in 2000, according to the CDC. Health officials have said that the disease made a comeback recently, in part because of a growing number of adults deciding to delay or abstain from vaccinating their children. Last year brought the highest number of recorded measles cases since 2000, according to the CDC.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Earlier this year, President Obama acknowledged the concerns some have about effects of vaccines but said: "The science is pretty indisputable."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "You should get your kids vaccinated — it’s good for them,” Obama said. “We should be able to get back to the point where measles effectively is not existing in this country.” _This post has been updated._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Citrus consumption and skin cancer: How real is the link?    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico SPECIAL REPORT: Can IBM's Watson computer superbrain defeat cancer?    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Amid measles outbreak, anti-vaccine doctor revels in his notoriety

It’s 6:30 p.m. in eastern Arizona, and an energetic doctor who has gained notice due to his disdain for vaccinations has just gotten home. It’s been a busy day. He’s already spoken to USA Today. He just did a segment on CNN. And he’s closely monitored his Facebook page, which has collected 4,000 “likes” in the span of 48 hours. But Jack Wolfson always has time to discuss vaccinations — his hatred of them and his abhorrence of the parents who defend them.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Don’t be mad at me for speaking the truth about vaccines,” Wolfson said in a telephone interview with The Washington Post. “Be mad at yourself, because you’re, frankly, a bad mother. You didn’t ask once about those vaccines. You didn’t ask about the chemicals in them. You didn’t ask about all the harmful things in those vaccines…. People need to learn the facts.” But whose facts is he talking about? Every respectable expert totally disagrees with him and his anti-vaccine movement and, along with the Centers for Disease Control and Prevention, urges parents to get their kids vaccinated. And Wolfson himself, who has quickly become something of a spokesman for the anti-vaxxers, is in no way an expert on vaccines or infectious diseases. He’s cardiologist who now does holistic medicine. What the experts say: “The measles vaccine is one of the most highly effective vaccines that we have against any virus or any microbe, and it is safe, number one,” Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, told CBS. “Number two, measles is one of the top two most contagious infectious viruses that we know of…. So you have a highly infectious virus and you have an extraordinarily effective vaccine.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **[‘Get your kids vaccinated,’ Obama tells parents doubting ‘indisputable’ science]**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Wolfson, who himself lives in a state now affected by the California measles outbreak that many blame on the anti-vaccination movement, does nonetheless prove the power of assuming a contrarian stance. The controversy has transformed Wolfson — last week, just another doctor — into a hero for those who share his views. “Thank you for breathing truth into all of the B.S. out there,” one fan wrote him on Facebook. “Wish all doctors were like you.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Then there are the critics. Of which there are many. “I’ll be sending a copy of your highly irresponsible and reckless comments to the Arizona Medical Board for review,” one said. “As a pediatrician who has seen unvaccinated children die from vaccine preventable diseases and also seen whooping cough go through my practice area in 2013 thanks to declining vaccination rates, you do not deserve to hold a license to practice medicine in AZ.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Weeks ago, someone infected with measles at Disneyland sparked an outbreak that has so far infected at least 84 people in 14 states, according to the CDC, many of whom weren’t vaccinated. In Wolfson’s Arizona, as many as 1,000 people, including 200 children, have potentially been exposed to the disease, and seven are infected.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Amid this outbreak, Wolfson actively urges people to avoid vaccines. “We should be getting measles, mumps, rubella, chicken pox, these are the rights of our children to get it,” he told the Arizona Republic. “We do not need to inject chemicals into ourselves and into our children in order to boost our immune system.” He added: “I’m a big fan of what’s called paleo-nutrition, so our children eat foods that our ancestors have been eating for millions of years…. That’s the best way to protect.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Wolfson is the latest incarnation of a trend that long precedes him. Those wary of vaccinations have always latched onto any doctor who affirms their reservations, regardless of the absence of research supporting them. Before Wolfson, there was Sherri Tenpenny, an osteopath who long inveighed against vaccinations and just canceled an Australian tour, citing fears of “anti-free speech terrorists” and “pro-vaccine extremists.” And before Tenpenny, there was Britain’s Andrew Wakefield, who authored a study — since retracted — linking autism to vaccines. After it was thoroughly discredited, it cost him his medical license. But it also got him a following.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Which is something that’s happening to Wolfson, too. “I’m getting inundated from all over the country from people who are coming to support me,” he said. “There are a lot of people in our corner.” It began last week when Wolfson did an interview for NBC Phoenix — and another, quoted above, for the Arizona Republic, which got more than 30,000 “likes” on Facebook. “Valley doctor: Don’t vaccinate your kids,” the headline said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Following the ensuing outrage, he addressed his critics in Health Impact News. It was shared on Facebook 110,000 times.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Wolfson himself came to his anti-vaccination stance late in life. “I’m the son of a cardiologist,” he told The Post. “I was trained to believe in the power of vaccines…. And going through school, as a medical student you don’t question anything. You don’t question what’s going on.” Then in 2002, Wolfson, originally from Chicago, moved to Arizona where he met his wife, a chiropractor, who “opened my eyes.” He said he soon embraced “natural and holistic” medicine. That was when he started challenging vaccines. He said viruses — not vaccines — are a part of the natural world. “Unfortunately, they mean that some people get sick and some people die,” he said. “But the reality is that we can’t inject our children with chemicals.” Measles isn’t a big deal, he said, though the CDC definitely disagrees. “This quote-unquote ‘outbreak’ has infected 70 people who are quote-unquote ‘infected,’ ” he said. “This is a country of 300 million people, and no one has died, and no one is sick as far as I know. We are all worried, and we are all getting crazy, and what we’re talking about is really just a fever and a rash.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **RELATED** : **The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Why this baby’s mom is so angry at the anti-vaxxers**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **[Amid growing vaccination debate, measles continues to spread and is now in New York state]**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Why measles could be worse for West Africa than Ebola

As the unprecedented Ebola outbreak slowly fades in West Africa, it has left plenty of other public health worries in its wake. One of the biggest threats: measles. The massive disruptions Ebola caused to the health-care systems in Liberia, Guinea and Sierra Leone led to a significant drop in the number of children getting vaccinated for a range of diseases, including whooping cough and polio. In a study published Thursday in the journal Science, a group of researchers has calculated the potential fallout in the region if there was a measles outbreak. The measles virus is highly contagious and has surfaced in the wake of other humanitarian crises.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "It's so transmissible, and it's one of the first diseases you often see when there are crises leading to reductions in the vaccination rates," Justin Lessler, an assistant epidemiology professor at the Johns Hopkins Bloomberg School of Public Health and the study's lead author, said in an interview. Lessler and his colleagues used data-backed mathematical models to simulate how quickly a measles outbreak could spread through vulnerable West African populations. Before the Ebola epidemic, they estimated, the region had about 778,000 children between 9 months and 5 years old who had not received a measles vaccine. Eighteen months after the Ebola outbreak began, there could be more than 1.1 million unvaccinated children — an increase of 45 percent. The researchers found that a large measles outbreak could affect 100,000 more people in West Africa than it might have before the Ebola outbreak, or more than 200,000 overall, with most of the victims being young children. They estimated that such a catastrophe could cause 2,000 to 16,000 deaths. By contrast, the Ebola outbreak, which triggered a slow but massive global response last year, officially has led to 24,247 confirmed or suspected cases and 9,961 deaths, according to the latest figures from the World Health Organization.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Lessler acknowledged that the measles estimates in the Science study amount to an educated guess. As with Ebola, it's nearly impossible to predict whether a measles outbreak will happen, whether it would originate in crowded cities or rural countrysides, and how long it might last. In addition, he said researchers initially assumed in their models that 75 percent fewer children in West Africa were receiving vaccines as a result of the Ebola epidemic. That figure was in line with the best information available at the time, he said, but that "new information indicates that was probably a touch pessimistic." The actual drop in vaccination rates appears to be between 25 and 50 percent, Lessler said. But even that less ominous scenario "still translates to tens of thousands of additional cases," he said. The threat isn't merely hypothetical. Lessler noted that a measles outbreak from 2010 to 2013  in the Democratic Republic of Congo — a country long plagued by political instability and civil unrest — led to nearly 300,000 cases and more than 5,000 deaths, many of them children under 5. Measles accounted for scores of childhood deaths during a famine in Ethiopia in 2000.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Mit Philips, a health policy analyst for the international aid group Doctors Without Borders, said Liberia has reported 180 suspected measles cases this year, and it's likely that here are cases that haven't been reported because of overburdened or nonexistent disease surveillance systems in the region. "We don't have a full assessment of the situation," Philips, who recently returned from West Africa, said in an interview from Belgium. "But here's an indication that there's something going on." Beyond the obvious suffering Ebola has inflicted on the region, the epidemic also created a less obvious but no less tragic crisis. The outbreak destroyed the already fragile health-care systems in West Africa, shutting down hospitals and clinics and leaving entire populations without access to routine medical care. The result was people dying of otherwise treatable or preventable conditions such as pneumonia, malaria, diabetes and strokes. Victims of heart attacks or those injured in car or bike accidents often had nowhere to turn. "If you broke a leg and you needed surgery, sorry," Sister Barbara Brillant, national coordinator of the Liberian Catholic Church's health council, told a Post reporter in September. "If you had appendicitis and needed surgery, sorry. It's not available."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Pregnant women have been particularly vulnerable. Even as more hospitals and clinics have reopened, Philips said she witnessed cases of women not being admitted unless they first tested negative for Ebola. Health workers, traumatized by the risk of infection and the deaths of their colleagues, remain reluctant to participate in procedures involving a lot of blood, such as C-sections and other surgeries. "It's a huge challenge," Philips said. Doctors Without Borders and other aid groups, along with ministries of health in each country and outside agencies such as the WHO and the Centers for Disease Control and Prevention, have been working to help reopen medical facilities and supply them with protective gear, basic medications and trained staff. Officials also are meeting to discuss the feasibility of national vaccination campaigns, something the authors of Thursday's Science paper say is needed as soon as possible to combat a potential measles outbreak. Philips said worries remain about the lack of reliable surveillance efforts for a range of other diseases, including meningitis, cholera, yellow fever and Lassa fever. While cases of those disease likely exist in the region, she said, officials worry they might not be able to spot an outbreak quickly. Lessler, the Hopkins researcher, agreed that Ebola left behind a long list of public health problems. But he said finding a way to vaccinate as many West African children as possible against measles could help prevent one major risk. "Measles is not the only health threat that's been made worse by the Ebola crisis. It may not even be the worst," he said. "But it's certainly one we can do something about."

Reminder: Most people think vaccinations should be mandatory for children

The ongoing measles outbreak that originated at Disneyland has infected dozens of people so far this year, with hundreds of additional people being monitored for exposure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California has confirmed 79 cases as of Wednesday, a number public health officials expect will increase. In Arizona, more than 1,000 people — nearly 200 of whom are children — may have been exposed to the disease, according to the Arizona Department of Health Services.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “This is a critical point in this outbreak,” Will Humble, the director of the department, posted on his blog. He wrote that if potential cases are isolated, the outbreak could stop, adding: “However, if we miss any potential cases and some of them go to a congregate setting with numerous susceptible contacts, we could be in for a long and protracted outbreak.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The outbreak has served as a reminder that quite a few people choose, for various reasons, not to vaccinate their children. While most people do get vaccinated for measles, the majority of those who get measles have not been vaccinated; many of the people with measles in California have not been vaccinated, the state’s health department said. This has also sparked yet another round of debate over the vaccination issue entirely. Well, if you are wondering, most people tend to agree with the idea of vaccinating. A new Pew Research Center study shows that while a majority of people — a really sizable majority of people, nearly seven in 10 people — say vaccinations should be required, there remains a considerable pocket of people who say parents should be able to opt out:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As the outbreak has continued, and authorities have warned of the danger faced by people who are exposed, the opposition to measles — which is highly contagious and which, in children, can lead to pneumonia and brain swelling — has also caused issues at schools and for families in California and beyond. About 70 students at a high school near Palm Springs have been told to stay home from school because they have not been vaccinated, the Riverside County health department said Wednesday. The father of a 6-year-old boy in the Bay Area with leukemia asked the school district to similarly keep unvaccinated students out. Parents of a six-month-old girl had to keep her quarantined for 28 days after she was possibly exposed when an unvaccinated child went to her doctor’s office.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Meanwhile, here is the story of how we went from eliminating the disease in 2000 to an outbreak this year.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

A LinkedIn employee with measles potentially exposed Bay Area transit riders, officials say

A person who traveled on San Francisco’s public transit system before being diagnosed with measles might have put passengers at risk, health officials said. Officials don’t know how this person came to be exposed to the disease. The person traveled in the system during the morning and afternoon rush hour commutes between Feb. 4-6 and also visited a restaurant on Feb. 4. LinkedIn a Bay Area company with offices in Mountain View and downtown San Francisco, confirmed in a statement that the person in question was one of its employees. Measles is highly contagious and is transmitted through the air by an infected person who coughs or sneezes. It can also remain in the air for up to two hours. Health officials in two San Francisco area counties warn that people who traveled in the system during that time — especially if they have not been vaccinated — could have come into contact with the disease. “Measles is circulating in the Bay Area and we don’t know yet where this person was exposed,” said Erika Jenssen, communicable disease program chief with Contra Costa Public Health, in a statement. “The ongoing measles outbreak in California highlights the need for people to be vaccinated, and this is just another example of how interconnected our region is and how important it is for everyone to be up to date on their immunizations.” Health officials said passengers who traveled in the Bay Area Rapid Transit (BART) system between the Lafayette and Montgomery stations between 6 and 8 a.m. and 7 and 9 p.m on those three days should be particularly aware of the situation. At greatest risk are unvaccinated people with suppressed immune systems, pregnant women or people who have HIV. For everyone else, the easy solution that greatly reduces the risk is to get vaccinated. “The measles vaccine is very effective and is a standard part of pediatric primary care,” said Dr. Tomas Aragon, San Francisco health officer, in a statement. “While we are concerned about the current outbreak in California and its potential to spread, we cannot emphasize enough that the solution is simple and available: be vaccinated.” The ongoing measles outbreak has brought into focus exactly how widespread vaccine denial is. And parents who choose not to vaccinate their children due to discredited and unfounded claims about the risks of vaccines have popped up in unexpected places. Public health records show that vaccination rates are dangerously low in some of California’s most well-heeled locales.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico For example, according to a Wired investigation, vaccination rates at day-care facilities for several prominent Silicon Valley start-ups are lower — in some cases far lower — that the vaccination rates necessary to confer “herd immunity.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Among the company-affiliated facilities with low vaccination rates was, ironically, Pixar, creator of kid-friendly animated movies: Over at LinkedIn, the company says that it is cooperating with health officials to protect its employees and the general public. “On Tuesday, Feb. 10, we were informed that an employee based in our San Francisco office was diagnosed with measles. We are working very closely with the San Francisco Department of Public Health, and following their recommended protocol for managing this situation,” said Hani Durzy, director of LinkedIn’s corporate communications, in a statement on Wednesday. “The health and well- being of our employees is our absolute top priority, and we will take whatever steps are advised to ensure their safety and the safety of the general public.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **RELATED:** _ **Adults are skipping their vaccinations, too — for lots of diseases**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **Which states are the best (and worst) at vaccinating their kids**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **Autism Speaks, leading autism advocate, urges vaccination**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _ **The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Please stop vaccinating your children. I want to go to Disneyland.

Are you thinking of vaccinating your kids? I wish you wouldn’t. I know what you’re going to say. “You’re a measles germ. You’re biased.” But maybe you’re the one who’s biased. Ever thought about that? I see your charts. I hear you calling the resurgence of measles “devastating.” That’s hurtful.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “There’s more measles now,” you say. “That is a bad thing.” Maybe it’s a bad thing. Or maybe it’s a GREAT thing. Maybe a beautiful specimen that was hunted almost to extinction is making a surprise comeback, and you should be a little more supportive! I mean, when someone hunts down all the spotted owls you’re like “Oh, boo hoo, we’re wiping out a species, waaah, conservation, blaaah” — but suddenly it’s okay to destroy measles and its whole microbial culture and you’re all congratulating yourselves? Do you see the inconsistency here? Come on. I think there are two sides to this issue, and it is important that we hear both of them out. After all, you’ve heard Jenny McCarthy on this issue, and she is definitely a human person, not a large number of measles viruses cleverly disguised as a human person by standing on each other’s porous membranes under a big coat. The idea that she is not a human person is completely ridiculous. It is just another lie spread by scientists, like the idea that having measles is somehow “bad” or “lesser” than _not_ having measles. But just so we’re clear: Jenny is definitely one of you. Would talented human actor Donnie Wahlberg kiss a bunch of measles viruses? I rest my case.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “You should be exterminated,” you are saying. You know who else said that? Don’t make me say it. He had a mustache. I know there are scientists saying things like “YOU NEED TO GET VACCINATED.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico I’m like, “Whoa, scientists! Cool your jets!” I think we can all agree this is no time for panic. Maybe vaccination is completely safe and keeps you from catching diseases and maybe there are lots of facts that support that, but maybe we’re all putting too much emphasis on facts and not enough emphasis on Anecdotal Feelings That Some Parents Told This One Doctor About.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In that same article, doctors call people who don’t get vaccines “stupid.” That sounds like bullying to me. These “doctors” sound less like medical professionals and more like MEANIES. And I don’t listen to MEANIES. Do you? Sure, the connection between autism and vaccines has been completely disproved by science, but you know what else has been completely disproved by science? Dragons. And who wants to live in a world without those? Not me(asle). These are the same scientists who say that having measles, mumps or rubella is bad. And we know _that_ ‘s not true. Some of my best friends are rubella viruses, and they are delights to be around. I think if you took the time to get to know rubella, you would see how wrong you are. (Mumps can be a drag, though. I’ll give you that.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Besides, you let chicken pox and the flu just ROAM FREE among you. You even have a season where you celebrate flu and pass it around to all your family members. And suddenly MEASLES is the villain here? Um, prejudice, much? People are even saying that they don’t want Measles in Disneyland. Excuse me, but the last time I checked, Disneyland was a dreamworld of magic that welcomed EVERYONE, and your narrow-minded judgments have no place there. I’ve never been, myself, but it’s on my bucket list. Frankly, I do not get out as much as I would like, having been contained in a glass vial until just recently. Listen, the science on vaccination is very, very unsettled. Super unsettled. I bet if the Senate voted on the science of vaccinations right now, they would be about split down the middle. That’s how unsettled it is. People who believe in vaccines probably think that the earth is more than 6,000 years old or that evolution is some kind of weird conspiracy, and, hey, I’m pretty sure there is room for discussion on both of those, and we should have a full debate.Debates are good. The more debates the better, I, a measles germ, say. http://www.washingtonpost.com/posttv/national/health-science/measles-outbreak-worries-calif-parents/2015/01/23/25254d04-fada-4521-bb08-c71d90835f70_video.html

California officials warn against ‘measles parties’

In a warning issued yesterday, the California Department of Health seemed to state the obvious: “CDPH strongly recommends against the intentional exposure of children to measles,” the agency said. “It unnecessarily places the exposed children at potentially grave risk and could contribute to further spread.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But the words of caution may not have been obvious to everyone. The warning came after San Francisco radio station KQED reported a local woman offered to connect a mother of two unvaccinated children with someone who had the measles. The mother declined the offer and, to date, there is no evidence of anyone holding what the California media is calling a “measles party.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “The basic notion is ‘This is my opportunity for my kid to get immune the old-fashioned way, the way God intended,’ ” epidemiologist Art Reingold of the University of California at Berkeley told KQED. Aside from the KQED report, California officials say they haven’t heard of other instances of intentional exposure to measles, though a local public health officer did tell the Los Angeles Times his office received several inquiries about the benefits of “natural immunity,” rather than immunity from a vaccine.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But if parents are considering a deliberate attempt to infect their children with the disease, it would not be the first time. Before the introduction of the chicken pox vaccine in 1995, it was common for parents to host “chicken pox parties” when one of their children fell ill. The theory was that it was better for kids to get sick and get it over with, rather than waiting for the disease to come later in life. But the practice didn’t die out with the invention of a vaccine. Instead, families who declined the vaccine continued to try to immunize their kid “in the wild.” A 2004 story in “Mothering,” a magazine that promotes “natural family living,” described one such party as “jubilant.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Sharing sippy cups, whistles, and lollipops (sugar- and saccharine-free, of course), the wee revelers romped and stomped and ran amok as microscopic varicella viruses triggered the alarms of their mucous membranes, manufacturing ideal antibodies for a lifetime of immunity,” the story read. “We at the party were doing what we felt was safest, after weeding through the propaganda and rhetoric about America ‘s latest ‘Red Scare’: the deadly scourge of chickenpox panic.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The strategy was popularized again during the 2009 swine flu pandemic, when the New York Times reported bloggers and even some doctors were weighing the benefits of self-infection. Inspired by a history of the 1918 Spanish flu epidemic — mild in a first wave and more deadly during the fall and winter — it seemed logical, if risky, to attempt to contract the disease’s milder strain. But most flu experts panned the idea.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I think it’s totally nuts,” said Anne Moscona, a flu specialist at Cornell University’s Weill Medical College. “This is like the Middle Ages, when people deliberately infected themselves with smallpox. It’s vigilante vaccination — you know, taking immunity into your own hands.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Soon, self-infection took to social media. In 2011, posts appeared on Facebook advertising mail-order lollipops infected with the chickenpox virus. That start-up was swiftly shut down by law enforcement — intentionally mailing infected items is a federal crime. Meanwhile, “pox party” groups have popped up on Facebook and local listservs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Chickenpox is typically a mild illness, particularly for those who contract it while they’re young, so most deliberate infections are unlikely to go awry. But measles is another matter entirely. The disease hasn’t been endemic in the United States since the 1990s, so good data is hard to come by, but the Centers for Disease Control and Prevention reported 28 percent of cases in children under 5 resulted in hospitalization between 2001 and 2013. The hospitalization rate for the current breakout is around 15 percent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “It doesn’t make sense to say I’d rather have my kids get the measles than the measles vaccine,” Reingold, the epidemiologist at UC-Berkeley, told the L.A. Times. “That’s based on misinformation that the measles is a benign childhood illness.” **More from Morning Mix:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Kenji Ekuan, famed designer of Kikkoman’s iconic soy sauce bottle, dead at 85**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **The surprising heart of the Earth’s core has been revealed, scientists say**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Darwin’s children liked to draw and thank goodness for that**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

New data shows a deadly measles complication is more common than thought

NEW ORLEANS — A complication of measles that kills children years after they have been infected is more common than previously thought, according to disturbing data released Friday.  The complication is a neurological disorder that can lie dormant for years and then is 100 percent fatal. Researchers don't know what causes the virus to reactivate, and there is no cure once it does. The only way to prevent the disorder is by vaccinating everyone possible against measles.  The first MMR dose is typically administered at 12 to 15 months of age. (Babies may be vaccinated at age 6 months or older if they are at risk of exposure to measles, for instance if they are traveling to an area with an outbreak.) Unvaccinated babies can be infected with measles and later develop this complication, which is called subacute sclerosing panencephalitis, or SSPE.  “This is really frightening and we need to see that everyone gets vaccinated,” James Cherry, a study author and expert on pediatrics and infectious diseases at UCLA's medical school, said at a press conference Friday. He said the findings suggest that other cases of SSPE are likely occurring and being missed. Many parents who intentionally refuse to vaccinate their children believe "they are trying to do the right thing," said Gary Marshall, a pediatrics professor at the University of Louisville School of Medicine in Kentucky. "Unfortunately, they're mistaken. The right thing to do to protect their children is to vaccinate them to prevent them from getting measles and getting a horrible complication." In 2014, the United States experienced a record 667 cases of measles, the largest number since the disease's elimination here, according to the Centers for Disease Control and Prevention. One major outbreak occurred primarily among unvaccinated Amish communities in Ohio.   Vaccinating a very high proportion of the population — typically about 90 percent regardless of the disease — ensures herd immunity, which means those who can't be inoculated are still protected because the disease is less likely to spread. The MMR vaccine isn't recommended until after a first birthday because children retain some of their mother's antibodies until that age, making the vaccine less effective, experts say. Others who can't get vaccinated include people with immune system disorders. The researchers analyzed cases of California children who got measles between 1998 and 2015, finding that 1 in 1,387 were younger than 5 when they were infected. They identified 17 cases of SSPE during that period, all of whom had measles before being vaccinated. All but one of those patients have died. A 5-year-old boy, who was infected during travel to Germany, is now in hospice, unable to move or respond to commands, researchers said. The average age of SSPE diagnosis was 12, but the range was from 3 to 35 years. Many of the patients had ongoing cognitive or movement problems before they were definitively diagnosed. SSPE typically progresses in stages. Initially, the signs are subtle, starting with behavioral problems, Cherry said. Then seizures develop until the person becomes comatose. An additional suprising finding is that Asians are disproportionately affected by SSPE, Cherry said. He is not sure why but suspects the disorder could behave like some other diseases, such as influenza, which seem to hit Asians harder and cause higher mortality than other ethnic groups. Measles infection causes fever, runny nose, cough, red eyes, sore throat and rash. The virus spreads throughout the body and is usually cleared within 14 days. In rare cases, the virus spreads to the brain but then becomes dormant. Eventually, that can lead to SSPE and result in death. Among other severe complications of measles, as many as 1 of every 20 children will develop pneumonia — actually the most common cause of death from measles in young children. And about 1 of every 1,000 children will develop encephalitis, or swelling of the brain, that can lead to convulsions and can leave the child deaf or with intellectual disability. Because there is a 5 percent failure rate with the MMR vaccine, a second dose is given to children before they begin school. Measles is so contagious that 95 percent of people need to be vaccinated with two doses to protect those who aren't, experts say. That means all who are eligible, including adults who haven't been previously vaccinated, should receive two doses of the vaccine. Nearly 92 percent of U.S. children 19 to 35 months old have received the MMR vaccine, according to the CDC. Through Oct. 8, 54 people from 16 states were reported to have measles this year.

Five infants in Chicago area diagnosed with measles

http://www.washingtonpost.com/posttv/national/health-science/5-test-positive-for-measles-at-illinois-day-care/2015/02/06/0311474e-d645-428b-bb7d-037ee0d4275e_video.html Five infants in the Chicago area have been diagnosed with measles, a situation that highlights the dangers posed by the current measles outbreak, public health officials said Thursday. This is the second time this week that a measles case infecting an infant has potentially exposed other very young children to the virus.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The children are all younger than 1 year old. They were all at a KinderCare Learning Center day care in Palatine, Ill., about 30 miles northwest of downtown Chicago. Two of the children were diagnosed with laboratory tests, while the other three children were diagnosed based on clinical factors, the Illinois Department of Public Health and the Cook County Department of Public Health said in a joint statement. Lab tests on these three children are pending. “At this time, the source of infection for the children is not known,” the statement said. This particular cluster of measles seems to be focused on one part of suburban Cook County, officials said. But they asked all unvaccinated children and faculty at the KinderCare center to remain at home and away from other unvaccinated people for 21 days. Earlier this week, a California day-care center sent home more than two dozen infants and toddlers after a child younger than 1 was diagnosed with the measles.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico These situations point to the dangers posed by the current measles outbreak, which has largely centered on California and has sparked renewed focus on the people who do not vaccinate their children. (Officials say that so far, it does not appear that the Illinois cases are linked to the outbreak that began at Disneyland.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Even as politicians have said parents should get to decide if their children should be vaccinated, public health officials have repeatedly stressed the safety and necessity of vaccinations. In particular, they point to the threat an infectious and deadly virus like measles poses to children too young to get vaccinated or other people who cannot, for health reasons, receive the vaccinations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Individuals who are under the age of one or with certain clinical conditions cannot be vaccinated and are therefore at highest risk for measles,” the Cook County and Illinois health officials said. The Centers for Disease Control and Prevention recommends that children get their first dose between 12 and 15 months and a second dose when they are between 4 and 6 years old. **Related:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico ‘Not every vaccine is created equal.’ When politics and public-health outbreaks meet    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Everything you need to know about measles    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico How the U.S. went from eliminating measles to an outbreak in Disneyland    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Why younger Americans are much more likely to say vaccination should be a choice    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Obama to doubting parents: ‘Get your kids vaccinated.’    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Dear anti-vax parents: We’re not mad at you. Sincerely, your doctor.

Dear anti-vax parents, In the wake of the Disneyland measles outbreak, there’s been a lot of heated talk about parents who choose not to vaccinate their children. It seems like the medical community is now protesting even louder than the anti-vax groups were a couple of years ago. But I want to take a moment and apologize for the harsh tone some of us have taken. It’s not personal. We’re not mad at you. We are mad at people like Andrew Wakefield, who fabricated a study linking vaccines to autism and scared millions of parents into avoiding vaccinations. We are confused by television personality and former Playboy model Jenny McCarthy, who has zero medical training but somehow managed to lead a massive movement against immunizations (although she now claims that she’s _not_ anti- vaccines). We are infuriated by California pediatrician Bob Sears, who advises parents to delay or decline vaccines, placing the lives of your children at risk. It’s not your fault. You’ve been misled. You’ve been lied to. And all you wanted to do was to protect your children, whom you love deeply. We’re really not that different. Pediatricians across the country have dedicated their lives to protecting your children. None of us picked pediatrics for the money(although I like to make surgeons laugh by telling them that I did). We don’t get kickbacks from vaccine companies. None of us sells millions of books recommending that you follow the CDC’s immunization schedule — that would be a hard book to get published. We get no joy from sticking your kids with needles (and neither do our nurses). We do it because we care, and because we love your kids, too. Really, the only difference between you and us is that we know how effective vaccines can be. We know the diseases they prevent. We know that about 2 in 1,000 kids with measles will die, that pertussis can kill babies and that varicella (chickenpox) can cause more than just an itchy rash. We understand that the Vaccine Adverse Event Reporting System (VAERS) is a quality control system designed to monitor for potential complications, not a registry of adverse events that are indisputably linked to vaccines. We view immunizations as one of the most important medical advances in the prevention of infectious diseases. We know that immunized children are less likely to die from preventable diseases. So let’s band together. We’re not evil — and you’re not, either. We all want nothing more than healthy, happy kids. And you don’t have to trust us: Feel free to do your research. But get your facts from reputable sources. Talk to your doctor openly about your concerns. And if your child isn’t immunized, tell the health-care providers who take care of her; it changes our medical management, and it could save your child’s life. Your Child’s Pediatrician

Refusing vaccination is anti-social, not irrational

The recent outbreak of measles in Disneyland and the increase in measles cases nationwide have led to public health concerns, as well as a backlash against parents who refuse to vaccinate their children. Most media coverage has framed the issue as science versus irrationality, ignorance, and fear. However, this framing misses a key motivation for refusing vaccination. In some cases, the problem arguably isn’t the reluctance of anti-vaccine parents to accept overwhelming scientific evidence that vaccines are safe and effective. It’s that anti-vaccine parents are exploiting others by behaving rationally and strategically.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Public health experts see parents who refuse to vaccinate their children as irrational people who cannot accept clear and convincing evidence that vaccines are safe and effective. Public health experts encourage vaccination by emphasizing our vast historical experience with vaccines and the absence of significant side effects. Some commentators have linked parental decisions to refuse vaccines to broader skepticism about science and experts. However, vaccine skeptics have pushed back, claiming that they have conducted research and made independent judgments about risks of vaccination based on the evidence.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Public health experts do not argue that vaccination is risk free. Rather, they argue that the risk of vaccination is insignificant compared to the public health benefit from preventing the outbreak and spread of infectious diseases. This is settled science. However, parents who decide not to vaccinate their children are not deciding whether to have their children live in a world without vaccines. Their choice is whether or not to subject their own child to the very slight risk of vaccine-related side effects or instead to make their child a rare exception by refusing vaccination. Public health research reluctantly acknowledges that rational parents may refuse to vaccinate their kids. This survey looked at parents of intentionally undervaccinated children in San Diego following a measles outbreak in 2008. A child is intentionally undervaccinated when the parent refuses or delays vaccination. The survey revealed that most of the children’s families were affluent, white and college-educated. It’s extremely unlikely that most of these parents were motivated by religious concerns. Vaccine skeptics moderated their views when they considered the possibility of international travel (which would be likely to expose their kids to more infectious diseases). It’s also clear from the survey that these parents had accepted some debunked claims about the risks of vaccination, in particular the possibility that vaccination may cause autism or other adverse reactions. But this doesn’t fully explain why parents decided not to vaccinate.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico A second, experimental study of motivations for immunization provides a clue. This study identified altruism, free riding and bandwagon effects as affecting these decisions. This highlights, as the authors note, a clash between public health concerns and individual self-interest. People who accept vaccination not only reduce their own chances of contracting contagious diseases, they also reduce the possibility that they will transmit the disease to others. This “herd immunity” provides a social benefit. Altruistic people are motivated in part by this social benefit when they get vaccinated. However, others see things differently. As the proportion of the population that is vaccinated grows, the individual benefits of vaccination decline, because people are less likely to contract the disease. This makes it more attractive for people to free ride on the vaccination decisions of others. The results of the experiment show that people experience cross-cutting motivations when making vaccination decisions. Bandwagon effects were the most powerful motivating force, suggesting that people are most likely to get their children vaccinated when others around them are doing the same. However, differences in people’s levels of altruism and willingness to free ride also affected their decisions, especially when the issues of vaccination were framed in particular ways.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This clinical report in Pediatrics provides further evidence that parents may refuse vaccination because they are making a strategic decision to exploit herd immunity by free riding on the affirmative vaccination decisions of others. Parents who refuse immunization on behalf of their children are, in a sense, free riders who take advantage of the benefit created by the participation and assumption of immunization risk or burden by others while refusing to participate in the program themselves (p. 1429).    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Anti-vaccine parents do not live in a world in which they weigh the risk of infectious diseases versus the risk of vaccination. They live in a world in which their child faces only very slight risks of contracting infectious disease, due to the decisions of all the other socially responsible parents around them who vaccinate their children. This allows them — if they are narrowly self-interested — to avoid the even slighter risk of side effects from vaccination. It is only the socially responsible decision of parents who vaccinate their children that allows anti-vaccine parents to live in that world. When you put it all together, this evidence suggests that vaccine refusal can be strategic and rational. Many people who refuse to vaccinate their children do not fit the profile of irrational science skeptics; they are affluent and well-educated. In addition, skeptics are more likely to accept vaccinations when there is lower protection from herd immunity (as during international travel). Experimental research shows that people are likely to recognize and exploit vaccination decisions made by others. Clinical advice from pediatricians identifies free riding as a substantial barrier to affirmative vaccination decisions. Free riders may be anti-social, but they are not irrational. To the contrary, free riders are rationally pursuing their narrow, individual self-interest by exploiting the socially responsible behavior of everyone else. This may, of course, eventually make things worse for everyone. It may also be self-defeating, especially if free riders are clustered together. However, education about the social benefits of vaccines is unlikely to solve the problem of selfishly rational people who refuse to vaccinate their kids. What’s needed instead is government intervention to enforce socially responsible (though not individually risk-free) norms. _Robert Stoker is an associate professor of political science and public policy at George Washington University._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

CRS Report of the Week: ‘The Measles: Background and Federal Role in Vaccine Policy’

With measles cases popping up around the country, CNN/ORC surveyed Americans on whether vaccinations should be mandatory. Nearly 80 percent said yes, parents should be required to vaccinate their children. And nearly 60 percent said children who are not shouldn’t be allowed to attend public school. Other public polls have shown similar findings.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Whether vaccinating kids should be up to their parents or the government was a hot political topic early this month with probable presidential candidates weighing in. This week’s Loop Congressional Research Service Report pick looks at the federal government’s role in immunization policy. The federal government can buy and distribute vaccines, as well as keep data and funding research, but is “constrained in its ability to mandate the use of specific vaccines by individuals,” the report says. Requiring immunizations is a states issue. Our colleague Todd Frankel wrote last month that Mississippi (yes, Mississippi) has the lowest number of unvaccinated children in the country because it has “a strict mandatory vaccination law that lacks the loopholes found in almost every other state.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico States require children enrolling in public schools to be vaccinated, but there are exemptions for any number of reasons, including some states that allow parents to opt out for religious or philosophical reasons. Gov. Chris Christie (R-N.J.) and Sen. Rand Paul (R-Ky.) made headlines for wavering on whether vaccinations should be mandatory in early February, but in the heated aftermath, most politicians quickly asserted that they should be. The debate has resurfaced with the resurgence of measles in the United States. Last year, there were more than 600 reported U.S. cases — the highest by far in 20 years. In the first month of 2015 there were 102 cases. As of this week it’s up to 154 cases. While the annual rate of children getting their measles shots remains above 90 percent, “the increased number of imported measles cases, combined with pockets of unvaccinated individuals, has resulted in a larger number of outbreaks in recent years,” the CRS report says. Even though the federal government can’t force anyone to vaccinate their kids, it can keep urging folks to do so. U.S. Surgeon General Vivek Murthy, on the White House blog this week, noted the measles outbreak is a serious concern and said: “The most important thing people can do to protect themselves against measles is to get vaccinated.” The Measles Background and Federal Role in Vaccine Policy    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico  **Previous Loop CRS Reports of the Week:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 1. State of the Union facts    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 2. Immigration Executive Action   *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 3\. Obamacare and small business impact    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 4. In-progress and lapsed monuments and memorials   *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 5\. Cuba sanctions    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico 6\. ISIS    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Outbreaks of disease may not boost vaccination rates. Here’s why.

When an outbreak of a vaccine-preventable infectious disease hits, how might people in the affected area respond? You might think once parents become aware of vaccination's benefits, they would choose to get their children fully immunized. As it turns out, at least in one case, that conventional wisdom didn't hold. Washington state's 2011-2012 whooping-cough outbreak didn't increase the number of infants who were fully up-to-date with their whooping cough immunizations, a new study suggests. In recent years the U.S. has experienced a number of outbreaks of vaccine-preventable infectious diseases such as pertussis (whooping cough) and measles, both previously rare in the United States. Vaccination rates have actually grown nationally over the past couple of decades. But health officials in recent years have reported increases in the fraction of parents who don't have their children fully vaccinated or who seek vaccination exemptions for their children. Often, large numbers of non-vaccinated or under-vaccinated children are clustered together, particularly in areas or states where it's easier for parents to get exemptions from school vaccination requirements. The rareness of such diseases might have reduced public awareness of the benefits of the vaccinations that are so crucial to preventing their spread. But it's also clear that the anti-vaccine movement has gained more traction.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday And rising proportions of non-vaccinated or under-vaccinated children very likely played at least some role in past whooping-cough outbreaks. Research has linked clusters of non-medical exemptions in California to the state's whooping cough outbreaks in 2010.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday With whooping cough, another factor may be at play. For reasons researchers still are trying to understand, a relatively new formulation of the children's whooping-cough vaccine doesn't appear to work as well as its predecessor. Although the vaccine still protects most people who get it, that protection may wane faster than before. That doesn't mean we should stop administering the vaccine; rather, it means that the public-health risks of _not_ vaccinating become magnified.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday But Washington state has had a strong anti-vaccine movement, and it shows in how many parents received non-medical vaccination exemptions for their kids in recent years. In the late 2000s, the percentage of kindergarteners who received at least one exemption from a vaccination surged, peaking at a whopping 7.6 percent in the 2008-2009 school year.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday The state went on to suffer an epidemic of whooping cough in 2011 and 2012 that made national headlines. Since then, the state's recently toughened requirements to receive an exemption have helped cut exemption rates, but the damage may have already been done.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday In the epidemic's immediate aftermath, did vaccination rates rise for whooping cough? To answer this question, Elizabeth Wolf of the University of Washington-affiliated Seattle Children's Research Institute and her colleagues assessed state immunization records from September 2011, before the epidemic, and September 2012, after it had started, and they determined whether Washington infants (3 to 8 months old) were up-to-date on their diphtheria, tetanus and pertussis (DTaP) vaccine. Infants were considered up-to-date if they had received one dose of the DTaP vaccine by 3 months old, another dose second by 5 months old and a third dose by 7 months old. Wolf and colleagues had predicted that a lot more infants statewide would be up-to-date after the outbreak. But to their surprise, the proportion of infants who were up-to-date increased only 2.1 percentage points, from 67.4 to 69.5 percent. That change, the researchers said, was too small from a statistical standpoint for them to conclude that more infants were up-to-date post-epidemic. What do the findings tell us? "This finding may challenge the assumption that vaccine acceptance uniformly increases when risk of disease is high," Wolf said in a statement. She and her colleagues presented the findings at a recent scientific meeting in Vancouver, British Columbia.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday It's only one study of one outbreak, so in that regard we should be cautious in how we apply these findings to other outbreaks. But the findings should give pause to public-health officials, who are already having to combat strong anti-vaccine sentiment as they try to encourage parents to keep their children up-to-date on their vaccinations. If an epidemic isn't enough to boost vaccination rates, one might wonder: What is? "Our results support the idea that there is likely not one issue or strategy that will convince all hesitant parents," Wolf told me in an email. Researchers will have to figure out which combinations of approaches work best on specific groups of hesitant parents, she suggested.

What one of the anti-vaccination movement’s least favorite doctors discovered about Jesus

Dr. Paul Offit was pretty sure that religion was harmful to children. But while writing his newest book on medicine, the co-inventor of a rotavirus vaccine was surprised by Jesus. Offit says he always had moderate respect for religion but started to doubt when, as a young attending physician, he saw five children die within 10 days during an outbreak of measles in Philadelphia in 1991. At the center of the epidemic were children who were unvaccinated in accordance with their parents’ radical brand of Christian belief. A professor of pediatrics and vaccinology at the University of Pennsylvania, Offit has been branded as “Dr. Proffit” by anti-vaccination activists. In previous books, he has defended vaccinations, challenged the now widely discredited autism-vaccine link and sharply criticized the alternative medicine industry. When he published “Autism’s False Prophets” in 2008, he didn’t go on book tour because had received death threats. _ **[Anti-vax mom changes her tune when all 7 of her children come down with whooping cough]**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Having seen children die because of their parents’ religiously-motivated neglect — including the use of religious exemptions to vaccination, Offit began to read and to appreciate new atheist writings, including books by Sam Harris and Christopher Hitchens. As he began writing his new book, “Bad Faith: How Religious Belief Undermines Modern Medicine,” he assumed that he would arrive at similar conclusions: that religion was too often the culprit in preventable deaths, and that it was best left behind.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Bad Faith” is full of stories of needless deaths: the children of Jehovah’s Witnesses dying for lack of a blood transfusion, the children of Christian Science believers dying for lack of antibiotic treatment and the infants of ultra-Orthodox Jews dying or suffering brain damage after being infected with herpes from unsanitary ritual circumcision. Most states allow religious exemptions to vaccines and permit parents to claim a religious defense if their child dies from a treatable disease. “I took it at face value when people said, ‘Jesus was our doctor,'” Offit said of vaccination and treatment. “The choice to put your child in harm’s way is not a religious act.” When Offit began to read the Hebrew Bible/the Old Testament and the New Testament and look into the history of Christians’ work in the areas of child welfare and health care, he said he found himself largely embracing religious teachings. Offit told me he was surprised by his reaction to faith. Asked what particularly changed his mind about religion, he said, “I read the New Testament!” “Reading slowly and carefully, in context, I came to feel that independent of Jesus’ divinity, independent of questions about the Gospels’ accuracy, you have to be impressed by Jesus,” he said. [ _ **How the U.S. went from eliminating measles to a measles outbreak at Disneyland**_ ]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico  Offit said that Jesus’ advocacy on behalf of children, who were treated as property in the ancient Greco-Roman context, moved him “to the point of tears.” He referred to Christianity as “the single greatest breakthrough against child abuse” in history. Offit highlights and praises the Christian tradition of caring for the sick and vulnerable. He notes, for example, that the first Christian emperor of Rome, Constantine, outlawed infanticide in 315 and provided a nascent form of welfare in 321 so families in poverty would not have to sell their children. Historical expressions of care for the sick, Offit said, are aligned with “the religion of Jesus.” He has little patience for Christian practices (“religion about Jesus”) that place children in harm’s way by pitting modern medicine against faith. Those who insist that medical treatment is unnecessary “because Jesus is my doctor” are promoting ideas antithetical to Jesus’s values, he said. Offit has not converted to Christianity, but he has newfound respect for the religion that motivated people to abolish slavery and establish the Red Cross. “Stating a religious belief is seen as a kind of immunity from responsibility,” Offit said. Offit believes that religious exemptions to vaccinations — and the freedom for parents to refuse medical treatment on behalf of their children — should not be allowed. “It’s not much different from child sacrifice,” he said. To others, removing the religious shield currently protecting parents in most states is an example of government overreach and a violation of the free exercise of religion. [ _ **Reminder: Most people think vaccinations should be mandatory for children**_ ]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Using the state to defend parents who refuse modern medicine, Offit suggests, is not the kind of religion Jesus established. “That’s making religious freedom an idol,” Offit said. “How on earth in the name of Jesus can people watch children die?” _Rachel Marie Stone is a writer living near Philadelphia. She is author of “_ _Eat With Joy: Redeeming God’s Gift of Food_ _” and “_ _The Unexpected Way_ _,” a book about Jesus for children._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

As the school year begins, it’s time to think about vaccination policies

As kids start a new academic year, some won’t have had their recommended vaccines because their parents have claimed exemptions from school requirements for medical, religious or philosophical reasons. Following the much-publicized outbreak of measles that started in Disneyland in California in December, these exemptions have drawn increased scrutiny. That outbreak, which eventually infected 147 people in seven states, was a wake-up call for state leaders and for parents who may not have realized how contagious or serious the disease can be, public health officials say. “States are beginning to realize that they have effective measures to combat these outbreaks, and philosophical exemptions are eroding these protections and resulting in significant costs to states,” says Carrie Byington, a professor of pediatrics at the University of Utah and the chairwoman of the American Academy of Pediatrics Committee on Infectious Diseases. Research shows that eliminating or limiting exemptions can improve vaccination rates and reduce disease outbreaks. California and Vermont passed laws this year eliminating exemptions for philosophical reasons starting next year; California’s law eliminates religious exemptions as well. The Centers for Disease Control and Prevention suggests vaccination schedules for children and adults, but there’s no federal requirement that parents vaccinate their children. All states, however, have laws or policies requiring that children be up-to-date on recommended vaccines in order to attend school or day care. Unvaccinated children can generally attend only if their parents have obtained an exemption from their state. Every state allows medical exemptions — for children whose immune systems are compromised because of congenital problems or cancer treatment, for example. Nearly all states allow exemptions because of religious beliefs; excluding California and Vermont, 18 permit exemptions because of parents’ personal or philosophical convictions, according to the National Conference of State Legislatures. Just three states – West Virginia, Mississippi and now California — allow vaccine exemptions only for medical reasons. In recent years, exemption rates for children have soared, but they vary. On the low end, New Mexico’s rate was less than half a percent in 2012, while Oregon’s led the nation at 6.5 percent, according to a study this month in the journal Health Affairs. Local rates may be much higher, though. There are pockets in California and Colorado, for example, where the exemption rates top 30 percent, says L.J. Tan, chief strategy officer at the Immunization Action Coalition, an advocacy group that works to increase compliance with immunization schedules. But because in most places the percentage of children getting the recommended vaccines tops 90 percent for most diseases, many parents have never seen someone with measles, for example, or whooping cough and may not understand their dangers. “In the absence of disease, the alleged risks of the vaccine become easier to sell,” Tan says. Those risks are real, says Barbara Loe Fisher, president of the National Vaccine Information Center, which advocates that people be able to decline mandatory vaccines based on their philosophical or personal beliefs. Fisher testified before the California legislature against the new state law. “Some people are more susceptible than others to injury or death from vaccines,” Fisher says. “But it’s not clear who is at higher risk.” For the vast majority of people, however, vaccines are very safe, and studies have failed to show a link to autism, a common concern of parents who don’t vaccinate their kids. “The risk of getting the disease is higher than the risk of getting a vaccine,” says Mark H. Sawyer, a pediatric infectious-disease specialist at the University of California at San Diego. The Health Affairs study analyzed the different elements of state rules to tease out the extent to which they affected vaccine exemptions. It found, for example, that policies requiring a state health department to approve nonmedical exemptions or policies permitting exemptions only for specific vaccines rather than all vaccines had a significant effect on reducing exemptions. So, too, did laws that imposed civil or criminal punishments such as expulsion from school (for the child) or criminal negligence charges (for parents) for not complying with vaccination rules. The threat of penalties alone may be enough to deter parents from refusing vaccinations, says study co-author W. David Bradford, a professor of public policy at the University of Georgia. The more restrictive policies were reflected in lower rates of whooping cough. States with the most effective exemption policies had an average incidence of 7.3 pertussis cases per 100,000 people from 2002 to 2012, while states with the least effective policies had an incident rate more than twice as high at 16.06 cases, the study reported. More broadly, the study shows that there are tools that work. “There is room for lots of states to improve their policies in ways that encourage people to get their kids vaccinated,” Bradford says. “I take that as encouraging.” This column is produced through a collaboration between The Post and Kaiser Health News, an editorially independent news service that is a program of the Kaiser Family Foundation. To submit a question, go to kaiserhealthnews.org/contact-insuring-your-health.

Anti-vaccine doctor behind ‘dangerous’ autism therapy found dead. Family cries foul.

James Jeffrey Bradstreet’s life was full of controversy. To thousands of supporters, he was a savior: a physician who claimed vaccines caused autism and promoted radical procedures to treat those afflicted, including his own son. To many others, however, he was a crackpot: a man who, despite his medical license, ignored science and championed dangerous, discredited and occasionally deadly treatments. It’s no surprise, therefore, that Bradstreet’s death is proving equally divisive. On the afternoon of June 19, a fisherman spotted Bradstreet’s lifeless body lying in the Broad River in the tiny town of Chimney Rock, N.C. He had a gunshot wound to his chest, authorities said. A gun was found in the water nearby.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico That’s about all that everyone can agree on. Like his research, Bradstreet’s death has become a Rorschach test in which his supporters see a conspiracy, while most everyone else — including law enforcement — sees a slow downward slide towards suicide. The Rutherford County Sheriff’s Office said it is investigating Bradstreet’s death, but that the wound appears to have been self-inflicted.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Bradstreet’s family, however, has set up an online account to raise funds for “an exhaustive investigation into the possibility of foul play.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Jeff dedicated his life’s work to finding answers, always pushing the envelope, and never giving up, even at the risk of being perceived as controversial,” wrote his niece, Cali Bradstreet Howell, on the gofundme Web site. “Now, in this moment, we find ourselves in a position, where we too are in search for answers … and we intend on finding them.” [ _Disneyland measles outbreak strikes in anti-vaccination hotbed of California_ ]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Bradstreet had been a leading voice in the anti-vaccine, or “anti-vaxxer,” movement for nearly two decades. He was a former preacher who traded the pulpit for a physician’s gown, according to the Gwinnett Daily Post. Bradstreet received his medical degree from the University of South Florida and completed his residency at the Wilford Hall USAF Medical Center in Texas, according to a paper he wrote.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico His interest in autism was as much personal as professional. He made no secret about the fact that family had been touched by the disorder. “Both [my] son and stepson have autism spectrum disorders and have experienced significant recovery as a result of intensive biomedical interventions,” he claimed. On his blog, Bradstreet detailed the painful story of how his own son’s struggles had pushed him to study autism — and increasingly controversial therapies.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “It takes a lot of courage to face the world with autism,” he wrote in a 2012 birthday letter to his autistic son: But as the National Enquirer coverage suggests, some of these treatments were salacious but scientifically iffy. (A 2012 study, for instance, found “no evidence that single or multiple dose intravenous secretin is effective” for treating autism.) Bradstreet also wrote about including his son in an intravenous immunogloblin (IVIG) trial that “made a huge difference.” But another study found IVIG only helped 10 percent of patients and “should be undertaken only with great caution.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Nonetheless, his son’s case helped convince Bradstreet that vaccines caused autism. He took his message to the highest levels of government. Twice he testified about the supposed link between vaccines and autism before the U.S. House of Representatives. “He was a very happy, well connected child prior to his MMR at approximately 12 months of age,” Bradstreet told representatives in 2002, presenting copies of his son’s various tests. “Matthew completely lost about 2 months after his MMR vaccine.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico From his clinic in Buford, Ga., Bradstreet treated patients from around the world, many who sought him out online. Desperate parents seeking answers for their children’s maladies would write to him on his blog, begging him for help. But leading autism experts say Bradstreet was simply wrong, and that the autism therapies he espoused were “dangerous.” “There is no evidence that vaccines cause autism,” Peter Jay Hotez, dean for the National School of Tropical Medicine at Baylor College of Medicine, told The Washington Post. “It is pseudoscience based on a misunderstanding of the whole neurobiology of autism. “But there are a lot of worrying conspiracy theorists that keep on making up allegations about vaccines,” he said. “Every five years, the main variables change. I’ve seen about six iterations of this. As soon as one pseudoscience theory is debunked, someone comes up with something new.” Hotez, who also has a child with autism, said it was understandable that Bradstreet and others sought answers to the still somewhat mysterious disorder. Bradstreet’s beliefs were doubly dangerous, Hotez said. Not only did they scare people off of vaccines — something that has led to a resurgence of measles in the U.S. — but the treatments themselves can also be deadly.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico [ _The devastating impact of vaccine deniers, in one measles chart_ ]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Bradstreet was promoting chelation therapy, which is dangerous and without any benefit,” Hotez said. Chelation involves the use of chemicals to remove metals from a patient’s blood. The U.S. Food and Drug Administration says chelation can be used in cases of acute poisoning, but Bradstreet believed the procedure could treat autism by removing mercury — supposedly introduced by vaccines — from an autistic person’s blood. The FDA, however, has warned against such “chelation therapies” for autism: “Chelating important minerals needed by the body can lead to serious and life-threatening outcomes.” “Chelation therapy never made any sense from a scientific standpoint,” Hotez added. “So in the zeal to chelate mercury, which, again, there is no basis showing [it is the problem], Bradstreet would also chelate the calcium, and that would cause a very toxic reaction.” “Chelation is certainly not appropriate” for treating autism, Michael Katz, a senior adviser to the March of Dimes and professor emeritus at Columbia University, told The Washington Post. He added that numerous studies have debunked the link between mercury in vaccines and autism, rendering chelation pointless. Bradstreet was also a believer in hyperbaric oxygen chambers and stem cell therapy for the autistic.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It is unclear what role Bradstreet’s controversial research and therapeutic techniques might have played in his death. According to the Gwinnett Daily Post, the FDA and Georgia’s Drugs and Narcotics Agency raided his Buford clinic in the days before his death.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Multiple law enforcement officials said the U.S. Food and Drug Administration searched Bradstreet Wellness Center last week,” the newspaper reported on June 26. “On Monday, [June 22] plastic sheets covered the windows of the two suites the office takes up in a complex off Commerce Drive, and the doors were locked. ” It’s still unclear why the raid was carried out. For many, however, the timing seemed to fit with the official explanation of a suicide. Bradstreet’s body was found near where he and his wife vacation, the Daily Post reported. And, although less frequent than bullets to the head, suicide shots to the chest are not uncommon.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But Bradstreet’s family and broad network of supporters see a nefarious scheme in the series of events leading to his death. “He was a fighter and would never just quit,” Bradstreet’s former wife, Lori, wrote on the gofundme Web site. “What we were told happened really does defy all reason. Thank you for all your help to find the truth.” The Bradstreet family did not respond to multiple requests for comment. “I can not accept the notion that Jeff would take his own life,” wrote former colleague, John Reinhold Sr. “His research was a threat to many representing huge financial losses in the hundreds of billions, if the direction his research was validating came to be accepted as ‘fact.’ We discussed this many times when he was in the earliest stages of his work. The public is unaware of how easy it is for someone knowledgeable whose financial interests are threatened to make a phone call and simply state, ‘He’s an annoyance we don’t need right now,’ and that simple statement putting plans in motion. If Jeff’s strong suspicions are right regarding cause and causes of autism, legal actions against those corporations implicated would be staggering and possibly unprecedented in the history of world finance. Jeff was brilliant and had every reason to live. Although we’ve not been in touch in recent years I can not fathom that he checked himself out.” Others expressed their thanks for the miracles that Bradstreet had allegedly worked upon their autistic children, while quickly decrying his “murder.” “I will always remember how helpful his office in Melbourne Fl. was to my very ill autistic child,” Marla Peters wrote. “My daughter is now 19, she was 5 when we first went to his office. No one would help her with her gut pain but this group of Dr.s helped her and myself. Forever grateful and sad because his work was not done! May God have vengeance quickly on the evil doers who murdered him!” “One of the best doctors my son had in 21 years,” echoed Andrea Parker. “He did not kill himself! I simply don’t believe it at all. He was super religious and had an Autistic son himself. This looks really dirty to me.” Hotez said passions run high in the autism debate. He and his family have received angry messages and e-mails but never death threats, he said. And while he couldn’t comment about Bradstreet’s death, Hotez wondered if the homicide theories were, like vaccine conspiracies, half baked.

Why measles should be the thing that freaks politicians out

_This post has been updated._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Gov. Chris Christie's (R-N.J.) declaration on Monday that vaccinations against diseases like measles should incorporate a "balance" of parental concerns with public health recommendations met with a quick, often derisive response. It's easy to see why.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "Not every vaccine is created equal," Christie said, "and not every disease type is as great a public health threat as others." In short order, that comment was contrasted with Christie's forceful response to a possible Ebola case in his state. In that case, Christie mandated that Kaci Hickox be quarantined against her will -- suggesting that Christie feels that Ebola is a greater public health threat than the measles.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In West Africa, that's been true. In the United States, it has not, by a wide margin. According to data from the Centers for Disease Control, there were four cases of Ebola diagnosed in the United States last year. In contrast, there were 644 cases of measles. This year, a measles outbreak at Disneyland has pushed the number of cases in the country up quickly -- but no one else has contracted Ebola.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We've noted that one of the Ebola cases diagnosed in the U.S. died -- the first man to receive the diagnosis. Measles is less deadly than Ebola, but still deadly. In about two of 1,000 cases among children, the patient dies. Others suffer from less severe complications.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But the most salient comparison between the two is that measles, unlike Ebola, can largely be prevented through the use of vaccinations. Ebola transmissions can be kept in check through quarantines, yes, but measles was eradicated in the United States in 2000 thanks to the use of vaccinations and education programs. Now, in part thanks to parents opting to ignore public health advice, it's back.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _Update:_ A spokesperson for Christie issued a statement stating, in part, that "with a disease like measles there is no question kids should be vaccinated."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We've also updated the graphic to include data from the last three days of January. **RELATED** : **‘Get your kids vaccinated,’ Obama tells parents doubting ‘indisputable’ science**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Amid growing vaccination debate, measles continues to spread and is now in New York state**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **The Disneyland measles outbreak and the disgraced doctor who whipped up vaccination fear**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Anti-vaccine doctor revels in his notoriety**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Why this baby’s mom is so angry at the anti-vaxxers**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

The untold story of how today’s fight over vaccines has its roots in the American Revolution

Hours after California Governor Jerry Brown signed into law one of the strictest vaccination laws in the country, the backlash began. Comedian Jim Carrey unleashed a screed on Twitter denouncing the governor as a “corporate fascist,” and anti-vaccination groups began to scheme about how to take down the law.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Debates over public health and personal liberty can seem utterly of the moment in response to new and evolving threats -- an outbreak of measles at Disneyland this year triggered California politicians to put the law forward. **** And remember when the scary specter of Ebola triggered some politicians to implement mandatory quarantines for physicians and nurses who traveled to Africa to treat Ebola patients -- over the objections of public health experts?    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But a flashback to our nascent nation in the summer of 1776 -- when liberty was pretty much the topic of the day -- can reveal just how long the debate over government health policies has been running, and how the meaning of "freedom" has changed when it comes to access to preventive medicine. In Boston, the first Independence Day was preceded by inoculation day, when the Massachusetts general court abolished a ban on inoculating people against small pox. Only people who wanted to be inoculated or had already had the disease were allowed in the city. To leave the city before the inoculation period had ended, people needed the permission of a doctor or judge. "They posted guards at the entry to the towns. ...When the Declaration of Independence was first read in Boston, Abigail Adams was there with a whole bunch of people who were sick with smallpox," said Andrew Wehrman, a history professor at Central Michigan University. Two years earlier, 20 men in Marblehead brought torches and tar to burn down a new hospital -- not because of corporate fascists who were forcing them to get vaccines, but to protest the high-cost system that was shutting the poor out from access to small pox inoculations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In his forthcoming book, The Contagion of Liberty, Wehrman recounts how the expansion of inoculation was intertwined with the American Revolution itself. The freedom to inoculate was happily received in Boston, he wrote: "Ezekiel Price, a court official and insurance broker, declared, 'Liberty is given for to inoculate for the small-pox; many begin upon it this afternoon.' Hannah Winthrop, the wife of Harvard mathematics professor John Winthrop, described the scene: 'Boston has given up its Fears of an invasion & is busily employd in Communicating the Infection. ... Men Women & children eagerly crowding to inoculate is I think as modish as running away from the Troops of a barbarous George was the last year.'" The scientific consensus on the value of vaccines is clear: they are the medical innovation that – after clean water and hygiene – is one of the biggest boons to public health in human history. But strict laws such as California's (Mississippi and West Virginia have similar ones) can seem to some like an authoritarian scheme that threatens carefully guarded personal liberties. Even public health experts who unequivocally think that vaccination needs to be more widespread are unsure whether despite good intentions, the new law could backfire and have the unintended consequence of strengthening the anti-vaccination movement. “It may galvanize those parents who are sitting on the fence and unsure to be against vaccines,” said Daniel Salmon, deputy director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health. “If you look at the anti-vaccine groups in this country they’re actually pretty small. They’re loud, but they’re small. My concern is there are a lot of parents that have concerns, and my concern is it’s going to push [those] people in the wrong direction.” If anything, history teaches us that debates over public health and liberty predate government as we know it and are likely to rage on -- although no one expects any hospitals to be burnt down in 2015. Instead of mandatory vaccinations, Wehrman said U.S. medicine has largely been guided by an idea he traced to an influential medical textbook called Domestic Medicine, in which public health policies help reinforce "custom, which was the strongest of all laws. If you didn’t vaccinate, there would be enough pressure on you. Ostracism from the community would be enough." At the least, the situation in California might be seen as an experiment \-- when custom breaks down and outbreaks occur, what is the best solution? Will a strict new law mean more children will be vaccinated and measles declines, or will the anti-vaccine movement gain strength?    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Germany is battling a measles outbreak that is 10 times worse than the one in the U.S.

The United States has been shocked by a surge in measles cases with more than 100 incidents in January alone.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This, however, is much less worrisome than a current outbreak in Germany. While authorities there had hoped to completely eliminate the disease this year, 254 new cases emerged in January, primarily in Berlin. If we consider that the German population is only one fourth of the United States', the German measles surge was about 10 times worse than the one in the United States in January, relative to the total population.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There is one significant difference, though: The outbreak has raised little attention in Germany. Whereas measles has been high on the news agenda for weeks in the United States, in Germany, it has neither caused a debate about the alleged risks of vaccines nor has the outbreak been featured on front pages. The reason is simple: Germany has had even worse outbreaks over the past years. Experts, however, say that the risks of ignoring the upsurge would be significant. "The outbreak in Berlin is a sobering setback. In general, Germany's immunization rate is too low," Anette Siedler, the director of Germany's renowned Robert Koch Institute, was quoted as saying by German media.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But according to the World Health Organization, Germany already has one of the world's highest immunization rates among 1-year-olds with 97 percent -- compared to the United States with 91 percent. So where do all the new cases come from? German experts say that one third of all vaccinated German children either lack a sufficient immunization (which usually requires a second dose), or are vaccinated too late. **How could the recent outbreak spread so quickly?**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In fact, most of those who caught the virus were adults -- whereas official statistics only take into account children. Similar patterns have been observed in California, where the majority of those who caught the virus were adults as well. Particularly those born between 1970 and 1990 might have missed vaccination doses, due to a lack of stringent recommendations by public health officials at that time. What is worrisome is that the course of the disease is particularly serious for adults, although children are usually more likely to get infected.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The reasons for the lack of vaccinations in Germany are similar to the ones that are often mentioned in the United States: In both countries, **** measles seemed to have been "eliminated," and subsequently people started to "relax" about immunization. Contrary to developing countries, where the terrifying repercussions of measles outbreaks are still too visible to ignore, many in the United States or Germany have never been confronted with the disease. This makes them more susceptible for the ongoing debates about the safety of vaccinations that have prevented some parents from becoming vaccinated or ensuring that their children receive the necessary doses.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico What is different in Germany is that the cases have so far been limited to Berlin and Brandenburg, which is the state that surrounds Germany's capital. **Why the 1990s Yugoslav civil war might be to blame**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Local authorities in Germany first noticed a surge in infections last October among asylum seekers from Serbia as well as Bosnia and Herzegovina. One potential reason for the increase in cases could be the fact that the Yugoslav civil war in the 1990s interrupted vaccination programs in the areas from where the refugees have now fled. Overall, nearly all of those who got infected said they had not been vaccinated. Space to accommodate Germany's asylum seekers is rare and immigrants have complained that they are forced to live on little space -- a significant factor, considering that 90 percent of those without vaccination who come in contact with measles patients will catch the virus. Hence, the Robert Koch Institute has now recommended authorities to put a special emphasis on the vaccination of refugees who have fled Bosnia and Herzegovina.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Justin Lessler, an Assistant Epidemiology Professor at the Bloomberg School of Public Health, thinks that U.S. outbreaks could have similar origins. "There are several communities in the United States with close ties to countries with circulating measles and low vaccination rates, and these are certainly at risk. Since 2001, outbreaks in the US have been sparked by disease acquired in Romania, Kenya, Switzerland, and many more," Lessler told The Washington Post. To generally blame immigrants for the surge in measles cases would be misleading, though. Contrary to Germany and the United States, many countries in Africa or Latin America claim to have already successfully eliminated the virus. **RELATED:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Map: 113 countries have higher measles immunization rates than the U.S. for 1-year-olds    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Which states are the best (and worst) at vaccinating their kids

"Thank God for Mississippi," the old saying goes. The idea here being that no matter how badly things are in your state -- when it comes to health, or income, or education -- there's a good chance that you're still doing better than Mississippi, which holds the dubious distinction of ranking dead last among the states on a variety of well-being indicators.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But there is one health metric on which Mississippi does surprisingly well: vaccination rates. That's right: 74.6 percent of Mississippi toddlers have received the full complement of CDC-recommended vaccinations, putting it at number 12 among the states and well above the national average of 70.4 percent (for the curious, the full vaccine regimen consists of ≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, full series of Hib vaccine (≥3 or ≥4 doses, depending on product type), ≥3 doses of HepB, ≥1 dose of varicella vaccine, and ≥4 doses of PCV).    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Alabama usually accompanies Mississippi at the bottom of health rankings, but it does even better when it comes to vaccines -- 77 percent of toddlers there are completely covered. Overall, state-level vaccine rates buck the familiar trend of "south= bad, northeast and west = good" that we see on countless other health measures. New Hampshire kids are well-vaccinated, but Vermont and Maine kids less so. Mississippi comes in at #12 in the rankings, while just across the river Arkansas is dead-last. California, currently in the news for a large measles outbreak at Disneyland, is squarely middle-of-the-pack at number 30.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's tough to tease out demographic patterns behind vaccination rates. In California, some affluent areas have lower vaccination rates than the average. But looking at all 50 states, there's a small correlation between increased income and _increased_ vaccination. Some people maintain that vaccine skepticism is strongest on the left, but the data don't support that notion.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Some people who don't vaccinate their kids are hardcore anti-vaxxers. Some are simply "vaccine-hesitant." Some may not be getting immunized because they don't have health insurance coverage. As there are multiple drivers of lower vaccination rates, policy responses need to be multi-pronged as well.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California is taking an important first step addressing its vaccination issues by tightening the requirements for "personal belief exemptions" to state- required vaccines. Previously, all you had to do was fill out some paperwork. Now you need to consult a healthcare provider first. The change fully went into effect for the current calendar year, and already the state has seen a drop in the rate of personal belief exemptions filed.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

‘Not every vaccine is created equal.’ When politics and public-health outbreaks meet

On Monday, the Centers for Disease Control and Prevention reported that the measles outbreak in the United States is getting worse, rather than better. This was one of two large measles-related stories to emerge as the work week got underway. The agency said that 102 cases of measles were confirmed in 14 states across the country in January, a number that in just one month topped the annual totals in nine of the last 13 years. Meanwhile, hundreds of other people are being monitored for possible exposure.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Most of the people who have gotten measles have not been vaccinated, which has prompted public-health officials to repeatedly stress the importance of vaccinations. “The best way to prevent measles is with vaccination,” Tom Frieden, director of the CDC, said Sunday on “Face the Nation.” Frieden pointed out that the vaccination rate in this country is very high — 92 percent — but because there are a number of people who could be susceptible to measles, it remains possible that we could see “a large outbreak in this country as a result,” he said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The other measles news that occurred Monday involved New Jersey Gov. Chris Christie — presidential aspirant, a self-described “tough when I have to be” politician — joining the ongoing debate over vaccinations and, very quickly, walking back his comments after they were widely criticized.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This is the second time recently that Christie has spoken out on a public-health problem and said something that directly contradicted what the public-health experts were advocating. Christie, who is at some point expected to announce he is seeking the Republican nomination for president, was in the United Kingdom when he discussed the vaccination issue. After noting that he and his wife have had their children vaccinated, Christie said: “It’s more important what you think as a parent than what you think as a public official. I also understand that parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.” Even if you didn’t follow the news on Monday — statement, criticism, clarification, sides taken, older statements dredged up, picture fully painted across media both social and traditional — you can already see the problem. His statement that parents should have “some measure of choice” runs against the accepted science backed by public-health experts, but it also contradicted the thinking of 70 percent of the American public; the only Americans inclined to like this line of thinking are younger Americans, and a majority of them still don’t agree.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In a statement released Monday after it was clear Christie’s remarks were not well received, his office said: “The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate.” It is unsurprising, if not a little dispiriting, that the reaction to an outbreak of a serious virus can transmogrify into yet another partisan, political issue, fodder for elected officials to make stern, authoritative statements that may counter the stern, authoritative statements made by public-health officials and experts, comments that can in turn be ground to dust in the gaffe machine that is our modern political system. Attention turned almost immediately to how this looked more than anything else. Was it a flub? Were people just overreacting because of a gotcha question? And hey, look, the comments came out just a day after President Obama, the man Christie hopes to succeed, was asked about the issue Sunday on NBC News and called the science “indisputable” when calling for parents to vaccinate their children.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Sen. Rand Paul (R-Ky.), another likely presidential candidate, chimed in Monday to say that “the state doesn’t own your children.” Former Secretary of State Hillary Clinton, who is expected to be the Democratic nominee next year, tweeted in support of vaccinations Monday night. Meanwhile, older comments from the 2008 presidential campaign reemerged, documenting that then-Senator Obama called the science “inconclusive,” though a spokesman had argued he was not speaking for himself in saying some people linked vaccinations and autism. [ **Note:** This paragraph was updated to reflect Paul and Clinton’s comments.]    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico This all leads to the worry that measles and vaccinations could become some sort of a political barometer — “If they’re for it, something must be wrong with it” — something we view through the same lens we tend to view everything, nowadays, something that gets wedged into whatever box is needed, until politicians on the stump are seen endlessly remarking, “I’m not an epidemiologist.” (So far, at least, that does not appear to be the case. The Pew Research Center notes that while more Republicans and independents than Democrats think parents should get to decide, a majority of all three groups disagree with this idea.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Christie also said that “not every vaccine is created equal, and not every disease type is as great a public health threat as others,” which makes one wonder which vaccinations, specifically, Christie thinks are superior or inferior to the measles vaccination. The latter half of his comment, though, is what warrants further consideration. When Christie says “not every disease type is as great a public health threat as others,” he is speaking mere months after his reaction to the arrival of Ebola in his neck of the woods. After a doctor in New York City was diagnosed with Ebola in October upon returning from West Africa, Christie and New York Gov. Andrew M. Cuomo (D) announced that medial aid workers who had responded to the epidemic were going to be quarantined upon returning to their states. This mandatory quarantine was unpopular with aid groups and medical experts, so both Christie and Cuomo backed away from the decision.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Christie, for his part, claimed at the time he had not reversed any decision. He also said that the CDC, which adopted stricter screening measures (but not quarantines), “don’t want to admit that we’re right and they were wrong,” adding, “I’m sorry about that.” The situation in New Jersey received more scrutiny than the one in New York because New Jersey had actually quarantined someone — Kaci Hickox, a nurse — despite her having no symptoms. Hickox and Christie then engaged in an argument through the media; she criticized Christie for placing her in a tent despite her lack of symptoms, and he said she was “obviously ill.” Ultimately, Hickox was released and allowed to go to Maine.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Ebola sparked considerable panic in the United States, a furor that included numerous politicians calling for a complete travel ban. As it turns out, only four people have been diagnosed in this country (one of whom died); no one has been diagnosed since October. Nearly 750 people have been diagnosed with measles in the country since the beginning of last year. The panic over Ebola subsided here, and attention turned to the next crisis, and on to the next one. Yet the same issues linger when it comes to politicians who have considerable pulpits being asked about public-health crises. What they say could be carried to a considerable audience, which gives the implication that what they say is merely one point of view to be contrasted with another, overshadowing figures like 92 percent and 70 percent. Until, of course, attention turns to the next crisis and the next potential flub.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Health officials warn of measles exposure in Maryland and the District

The Maryland Department of Health and Mental Hygiene is investigating a potential measles outbreak in portions of the Washington region after a patient admitted to Children’s National Medical Center in the District was diagnosed with the potentially deadly and highly contagious virus. The patient was diagnosed with measles on Friday but had been rendered medical aid in Maryland, including at Prince George’s Hospital Center, in the days before the diagnosis. The Maryland Department of Health, which is working with the health departments in the District and Prince George’s County, said it is informing people who were in certain locations in the District and Maryland about the diagnosis “out of an abundance of caution.” Most people in the United States are vaccinated against measles, so the exposure is considered a low risk. But for those who haven’t been vaccinated, the virus is extremely contagious, and 90 percent of people who are not immune can contract measles from being near a single infected person. The virus can live on a surface or hang in the air for as long as two hours after an infected person has coughed or sneezed. “Individuals who are concerned about possible exposure and vulnerability to measles should contact their primary health care provider or local health department before visiting a provider office or health care facility,” the Maryland Department of Health said in a statement. “Taking these steps reduces the chances of potentially exposing other people to measles.” The infected patient contracted measles outside the United States and developed symptoms upon returning, the department said. About the third to seventh day after being infected, a rash begins to appear on the face that will spread to the rest of the body, according to the Maryland health department. But it could take more than two weeks for someone to develop symptoms. Between May 8 and May 15, the patient was in public spaces in Prince George’s County and the District, including the Department of Social Services and Social Security buildings in Hyattsville. The measles patient was also in the Prince George’s Hospital Center Emergency Department and on May 9 rode the No. 12 public transit bus to and from Prince George’s Hospital Center. The patient has been in isolation since May 13. **— Perry Stein** Metro briefly suspended some service on the Green and Yellow lines Saturday while the fire department put out a small trash fire in the L’Enfant Plaza station. The D.C. fire department responded to reports of smoke at the station just before 2 p.m. and discovered a “very small smoldering trash fire” about 100 feet from the train platform, fire department spokesman Vito Maggiolo said. The fire was put out with a hand extinguisher and there were no injuries, according to Maggiolo. “There is no reason to believe it was anything nefarious,” he said. Metro tweeted that the incident prompted it to temporarily suspend service and offer shuttles between the Pentagon and Mount Vernon Square stations on the Yellow Line and between the Waterfront and Mount Vernon Square stations on the Green Line for a short time Saturday afternoon. **— Perry Stein** A 49-year-old man was fatally stabbed inside a Southwest Washington home early Saturday morning. Police say they responded to a report of a stabbing around 3:30 a.m. on the 100 block of Joliet Street SW. Inside the residence they found Derrick Roach suffering from a stab wound. D.C. Fire and EMS transported Roach to a hospital, where he was pronounced dead. Police have not made an arrest in the case and are offering a reward of up to $25,000 to anyone who can provide information that leads to the arrest and conviction of the person responsible. Anyone with information is asked to call police at 202-727-9099 or send a text to 50411. **— Perry Stein**

The Trump train is fueled by conspiracy

Watching the excellent documentary “Ebola in America: Epidemic of Fear” is to relive the confusion and controversies of the summer of 2014: the initial public health mistakes, the divided and unclear responsibilities, the hysterical coverage on cable TV. But it is the political role played by Republicans and conservatives that stands out, and not in a good way. At every stage, elements of the right made a reasonable, science-based response to Ebola more difficult. Against the advice of the Centers for Disease Control and Prevention (CDC), New Jersey Gov. Chris Christie quarantined a nurse returning from West Africa who had tested negative for the disease. Some conservative media outlets spread false information about the disease to exaggerate an impression of public health incompetence. But it was Donald Trump who led the opposition. He tweeted: “The U.S. must immediately stop all flights from EBOLA infected countries or the plague will start and spread inside our ‘borders.’ Act fast!” And: “Ebola is much easier to transmit than the CDC and government representatives are admitting.” Health officials were not lying. Travel to and from West Africa was essential for medical personnel and aid workers to defeat the disease at its point of origin. Trump’s ban would have made Ebola materially more likely to spread beyond control. What kind of politics is ascendant in the United States? A distrust of institutions that borders on conspiratorial. Here is Trump again: “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes — AUTISM.” And: “I am being proven right about massive vaccinations — the doctors lied.” And: “So many people who have children with autism have thanked me — amazing response. They know far better than fudged up reports!” Lying doctors. Fudged reports. It would all be disturbing — if it were not conspiratorial nonsense. No connection has ever been demonstrated between vaccinations and autism. And this particular nonsense is potentially deadly. Trump is undermining a consensus for vaccination that builds up “herd immunity” and saves the lives of children. Who else is plotting against us — I mean, other than public health officials and your local pediatrician? Well, the Mexican government, because “they send the bad ones over because they don’t want to pay for them.” And how does Trump know the “cunning” Mexicans are purposely exporting criminals? Because some unspecified “Border Patrol people” told him. Even more disturbingly, there are the “thousands and thousands” of Muslims in New Jersey who Trump claims celebrated the Twin Towers collapsing. For proof of this, he linked to an article at the Infowars website, run by Alex Jones, who has famously argued that the U.S. government was behind the 9/11 attacks. Trump has pledged that, if he is elected, “you will find out who really knocked down the World Trade Center.” And then there are the black criminals who are responsible, according to a Trump retweet, for 81 percent of homicides against whites. Except that this turned out to be a racist myth from a white supremacist source. And then there is the death of justice Antonin Scalia. “They say they found a pillow on his face,” responded Trump, “which is a pretty unusual place to find a pillow.” Does Trump really believe that liberals may have ordered a hit on a Supreme Court justice? Who knows? We do know he finds such ideas useful. Trump emerged in conservative circles by questioning Barack Obama’s citizenship, and thus the legality of his presidency. This required the existence of a conspiracy to hide the circumstances of Obama’s birth. “They cannot believe what they’re finding,” he said of “people that have been studying it.” Having actually discovered nothing, Trump doubled down on a deception. As a leader, Trump has succeeded by appealing to stereotypes and ugly hatreds that most American leaders have struggled to repress and contain. His political universe consists of deceptive experts, of scheming, of criminal Mexicans, of lying politicians and bureaucrats and of disloyal Muslims. Asked to repudiate David Duke and the Ku Klux Klan, Trump hesitated, later claiming a “bad earpiece.” Asked to repudiate the vicious anti-Semitism of some of his followers, Trump responded, “I don’t have a message to the fans.” Wouldn’t want to offend “the fans.” This is not flirting with the fringes; it is French-kissing them. Every Republican official endorsing Trump should know: This is the company he keeps. This is the company you now keep. _Read more fromMichael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook _. **Read more here:** Michael Gerson: Conservatives make a deal with the devil Anne Applebaum: Donald Trump’s campaign of conspiracy theories Jonathan Capehart: Unfit for the Oval Office Paul Waldman: Minority voters will know the GOP by the company it keeps

Why pediatricians care so much about the Supreme Court’s birth control case

For the second time in two years, the Supreme Court justices tangled over a question about personal beliefs and birth control: Must employers who are religiously opposed to it cover it in their health plans? A prominent group of pediatricians hopes the answer will be yes. Erecting hurdles to the pill, in this case, could jeopardize the health of America’s children, said Benard Dreyer, president of the the American Academy of Pediatrics. It could even encourage the next Disneyland measles outbreak.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The link, he acknowledges, isn’t immediately obvious. “There’s no discernible difference between a religious objection to contraception and a religious objection to a vaccine,” said Dreyer, also a pediatrics professor at New York University. "If [the Supreme Court] entitles an employer to be totally exempt from contraceptive coverage, it would presumably allow an employer to do the same for vaccination coverage.” In other words, a church-run school that condemns intrauterine devices, for example, could more easily say it won’t fund a chickenpox vaccine. And a low- income worker, unsure of how to find another expense-free avenue or come up with the $94 to pay for the vaccine, might have trouble getting that shot for their first-grader.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Religious resistance to vaccinations in American law can be traced back to the British Vaccination Act of 1898, which provided a “conscience clause” to allow exemptions to the mandatory smallpox vaccination. Most states already allow parents to reject vaccinations for their kids for nonmedical reasons. Some offer “personal belief” exemptions, while others allow for a religious exemption.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Though some people simply don’t like vaccines — one prominent Baltimore Rabbi called them a hoax — only two religions have close to an official negative stance on them: Christian Scientists, who pray first to treat illnesses, and members of the Dutch Reformed Church, who worry the shots could affect their relationship with God.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The case before the court Wednesday, _Zubik v. Burwell_ , mirrors 2014’s _Burwell v. Hobby Lobby Stores_ , which said that forcing family-owned corporations to pay for birth-control coverage violated the Religious Freedom Restoration Act of 1993.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On Wednesday, the justices heard arguments on what the government has offered as a compromise: Religious colleges and advocacy groups will not have to pay for the drugs they oppose. Instead, such groups could inform the government that, because of religious reasons, they’re opting out — and public money would go to cover the cost. But the petitioners, including East Texas Baptist University and Denver’s Little Sisters of the Poor, argued that allowing birth control to be covered under their plans, regardless of who’s footing the bill, implicates them in sin. Providing their information to the government, they say, makes them complicit. Supreme Court Justice Anthony M. Kennedy, the case’s likely swing vote, appeared to side with the challengers. He told Solicitor General Donald B. Verrilli Jr. that the government seemed to be “hijacking” their insurance plans. Instead, he said, the administration should offer an alternative that does not involve the organizations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Justice Sonia Sotomayor disagreed with Kennedy’s logic. If everyone who said laws violated their beliefs chose not to follow them, she said, “how will we ever have a government that functions?” Under the Affordable Care Act, insurance plans on the individual and company level must fully cover vaccines, just like contraceptives. The law has technically ended out-of-pocket pay for these “preventive services,” though not all pharmacists and insurers have yet complied.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The American Academy of Pediatrics, which represents roughly 64,000 physicians who treat children, filed an amicus brief earlier this year, urging the court to consider “effects far beyond the facts of this case.” (The organization files briefs when the court considers family-related cases, Dreyer said.)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Future objectors,” the document reads, “could prevent children from obtaining critical, life-saving preventive care.” **More on Wonkblog:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The odd thing Justice Kennedy noticed about abortions in Texas    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Why Republicans are pushing for over-the-counter birth control    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Why pregnant women in Mississippi keep dying    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Trump energizes the anti-vaccine movement in Texas

AUSTIN — The group of 40 people gathered at a popular burger and fish taco restaurant in San Antonio listened eagerly to the latest news about the anti- vaccine fight taking place in the Texas legislature. Some mothers in the group had stopped immunizing their young children because of doubts about vaccine safety. Heads nodded as the woman giving the statehouse update warned that vaccine advocates wanted to “chip away” at parents’ right to choose. But she also had encouraging news. “We have 30 champions in that statehouse,” boasted Jackie Schlegel, executive director of Texans for Vaccine Choice. “Last session, we had two.” Now they also have one in the White House. President Trump’s embrace of discredited theories linking vaccines to autism has energized the anti-vaccine movement. Once fringe, the movement is becoming more popular, raising doubts about basic childhood health care among politically and geographically diverse groups. Public health experts warn that this growing movement is threatening one of the most successful **** medical innovations of modern times. Globally, vaccines prevent the deaths of about 2.5 million children every year, but deadly diseases such as measles and whooping cough still circulate in populations where enough people are unvaccinated. In San Antonio, 80 miles southwest of the state capital, Texans for Vaccine Choice convened a happy hour to encourage attendees to get more involved politically. The event was among dozens of outreach events the group has hosted across the state. The relatively new group has boosted its profile, aided by a savvy social-media strategy, and now leads a contentious fight over vaccines that is gearing up in the current legislative session. The battle comes at a time when increasing numbers of Texas parents are choosing not to immunize their children because of “personal beliefs.” Measles was eliminated in the United States more than 15 years ago, but the highly contagious disease has made a return in recent years, including in Texas, in part because of parents refusing to vaccinate their children. **** A 2013 outbreak in Texas infected 21 people, many of them unvaccinated children. The modern anti-vaccine movement is based on a fraud. A study published almost 20 years ago purported to show a link between childhood vaccines and autism. The data was later found to be falsified, and the study was retracted. Scores of large-scale, long-term studies from around the world since then have proved that there is no connection between vaccines and autism. But the suspicion lingers. Its strongest form is a stubborn conspiracy theory that doctors, scientists, federal health agencies, vaccine-makers and the worldwide public health community are hiding the truth and are knowingly harming children. A leading conspiracy theorist is Andrew Wakefield, author of the 1998 study that needlessly triggered the first fears. (The medical journal BMJ, in a 2011 review of the debacle, described the paper as “fatally flawed both scientifically and ethically.”) Wakefield’s Twitter handle identifies him as a doctor, but his medical license has been revoked. The British native now lives in Austin, where he is active in the state and national anti-vaccine movement. Trump has met with Wakefield, who attended an inaugural ball and told supporters afterward that he had received “tremendous support” for his efforts and hoped to have more meetings with the president. Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development, predicts that 2017 could be the year the anti-vaccination movement gains ascendancy in the United States. Texas could lead the way, he said, because some public schools are dangerously close to the threshold at which measles outbreaks can be expected. A third of students at some private schools are unvaccinated. “We’re losing the battle,” Hotez said. Although the anti-vaccine movement has been strong in other states, including California, Oregon, Washington and Colorado, experts say the effort in Texas is among the most organized and politically active. “It’s a great example of an issue that has a targeted, small minority but an intense minority who are willing to mobilize and engage in direct action,” **** said Mark Jones, a political science professor at Rice University in Houston. The vast majority of parents in Texas and across the country vaccinate their children. Most people have never had to think much about this basic preventive-medicine practice. But now immunization advocates are realizing that they can’t let vaccine critics go unchallenged, saying they need voices other than scientists and experts to make the case. They are recruiting teachers and grass-roots groups to explain how immunization protects families and communities. Jinny Suh, 39, runs one such group, Immunize Texas , from her Austin home, where she lives with her husband and two young sons. Their house is about three miles from the Austin Waldorf School, a private school where 158 students — more than 40 percent of the school population — are unvaccinated, and tuition costs more than $14,000 a year. Suh worries about the risk that the school’s unvaccinated children pose to her 4-month-old, who is too young to be immunized. “I’m sure there are people I go to the grocery store with and go to the park with” who have unimmunized children, she said. “This is a public hazard. You can’t see germs.” Those who oppose vaccination are driven by fear, even though it is misguided, and that fear drives passion, she said. But parents who support vaccination “need to step up our passion and speak up for science — and for children,” she said. States set their own day-care and school vaccination requirements. Students in Texas are required to receive seven vaccinations before they attend school, unless their families file an exemption. In Texas, the number of school-age children who are not vaccinated has soared since 2003, when the state expanded its exemption criteria to include reasons of conscience. Personal-belief exemptions increased from 2,314 in the 2003-2004 school year to 44,716 in 2015-2016. Overall statewide vaccination rates remain high — over 98 percent. But in some parts of Texas, vaccine coverage is slipping below the 90 to 95 percent level that experts say is needed to prevent an outbreak. Many private schools, including in the Austin area, have the highest rates of unvaccinated children, exceeding 20 percent. Wakefield has stoked parents’ unfounded fears about vaccines, even though his study was withdrawn and Britain’s General Medical Council stripped him of his medical license in 2010. In a brief phone interview, Wakefield said he had not spoken to Trump since last summer. He declined to say how he was invited to an inaugural ball. “Better to say nothing at this stage,” he said. Wakefield said he was heading to Europe to promote “Vaxxed,” the movie he directed and co- wrote in which he defends the debunked link between the measles, mumps and rubella vaccine and autism. Texans for Vaccine Choice has sponsored showings of the film and promotes it on its Facebook page. One part of the anti-vaccine movement’s message is that vaccine-preventable diseases aren’t dangerous if people get modern medical care. But that’s a myth, and the failure to vaccinate can be catastrophic. Texas health data shows a steady uptick in diseases such as pertussis and mumps in recent years. A recent mumps outbreak in Johnson County, southwest of Dallas, sickened at least 167 people, mostly students. In 2013, Texas experienced the largest outbreak of whooping cough, or pertussis, since 1959: nearly 4,000 cases. Five newborns who were too young to be vaccinated died. Although anti-vaccine groups are gaining momentum in Texas, other states have shown that they can be fought. In 2015, California passed one of the strictest vaccine requirement laws in the country, mandating that almost all schoolchildren be fully vaccinated to go to school. Exemptions are allowed only for documented medical conditions. The law was sparked by a 2014-2015 measles outbreak that started at Disneyland in California, where a single unvaccinated child with measles led to the infections of 131 people. A Texas lawmaker tried to pass a similar bill during the legislative session in 2015. (Texas’s legislature meets every other year.) “It was clear common sense,” recalled Republican Rep. Jason Villalba, a Dallas lawyer. Mumps was resurgent in the state, including in his district, and his youngest child wasn’t old enough to be immunized. The bill never made it out of committee. But it sparked a huge reaction and was the reason Schlegel and about 20 other mothers formed Texans for Vaccine Choice. The group claimed “that I was a mad scientist, stripping liberties from parents,” Villalba recalled. He said Texas lawmakers are not likely to pass any legislation that could be viewed as government intrusion into parents’ rights. He is not planning to take up the fight against nonmedical exemptions again — unless there is a measles outbreak. In the current legislative session, no bills have been filed to eliminate the personal-belief exemptions. In fact, vaccine opponents have introduced a bill to simplify the exemption process. But pro-vaccine advocates are expected to try to change the law and give parents the right to know the number of unimmunized children at individual schools, information that’s not readily available now. One bill already introduced would require parents to complete an online education course before seeking a vaccine exemption. Another would make it easier for teenagers to get vaccinated against cancer-causing human papillomavirus (HPV). The bills’ sponsor, Republican Rep. Sarah Davis, a Houston lawyer whose district is home to some of Texas’s most well-known hospitals, said the bills are common-sense legislation that would better protect children. “The more active the anti-vaxxers have become, the more that other members start to question whether vaccines are controversial, and most legislators are not wanting to make waves,” she said. People on both sides of the vaccine issue are lobbying lawmakers and their staffs, and activity is sure to intensify before the session, which began Jan. 10, ends in May. Vaccines aren’t a standard conservative or liberal issue. In many parts of the country, pockets of unimmunized children tend to be in white, upper-middle-class neighborhoods, including in Austin, said Anna Dragsbaek, who heads the Immunization Partnership, a Houston-based immunization advocacy group. One particularly strong strain of anti-vaccine rhetoric in Texas is libertarian and anti-government. **** Texans for Vaccine Choice receives help and expertise from “friendly” lawmakers and groups such as Empower Texans, said Jonathan Stickland, a tea party Republican representative from Tarrant County and a key supporter. Political experts consider Empower Texans the state’s most sophisticated and influential conservative organization. “Our message resonates with people,” said Schlegel, 37, in a brief interview after a day of meetings at the Capitol. “Texans value parental rights,” she said. “We have a message of liberty. We have a message of choice.” Schlegel has an assistant who helps coordinate her schedule. The group has a director of state policy. Its Facebook page posts regular updates on Schlegel’s meetings with lawmakers. The group hands out sophisticated, glossy materials — in red, white and blue — to lawmakers. The packets, with business cards tucked inside, lay out the group’s positions, the bills it supports and the ones it opposes. One leaflet describes “the lack of safety testing” and “questionable ingredients” in vaccines. (To be clear, vaccines and their ingredients are some of the most carefully tested medical interventions in history.) Another calls the current recommended schedule of vaccines “one of the most aggressive and bloated of ANY other nation on the planet.” When the group recently sought volunteers on Facebook for “engagement days” at the state Capitol this month and in March, one woman said she wanted to help but was concerned she didn’t know enough about vaccines. Don’t worry, she was told. “Very little talk about vaccines and a LOT of talk about parental rights and CHOICE.” The American Academy of Pediatrics and 350 other medical, professional and advocacy groups recently wrote a letter to Trump expressing “unequivocal support” for vaccines’ safety and endorsing the recommended schedule. The letter has links to more than 40 major studies on safety and effectiveness. But immunization advocates like Suh say it’s hard to counter the passion of her opponents. Most people consider vaccinations to be such a basic part of life, like clean drinking water, that it’s hard to motivate them to take time to show up at lawmakers’ offices. “We’re completely outgunned,” said Suh, adding there are only about a dozen members whom she can call on to show up for events. Immunize Texas is part of the Immunization Project. Suh often writes emails and posts to the group’s Facebook account from her cellphone while caring for her two sons. She juggles her immunization advocacy, a mostly volunteer gig, with other businesses she runs from home. To present herself and other mothers as the face of vaccine advocates, she and Jessica Cleary-Kemp, seven months pregnant and mother of a 13-year-old and a 2-year-old, met recently with several lawmakers. One was J.D. Sheffield, a Republican state representative who sought during the last session to require individual schools to provide immunization exemption data. Suh jiggled her son on her lap while Cleary’s son played a game on an iPad. It’s not yet clear whether Sheffield or another lawmaker will introduce the bill this session. But they all agreed it will be a controversial issue. To help get their social-media message out, Suh may need to redo the logo for the group’s website. Buttons and T-shirts are another idea. But first, she needs to be better prepared for the next face-to-face meetings. “People kept asking for business cards,” she said. “So we need to get some.” Alice Crites contributed to this report from Washington, and Eva Ruth Moravec contributed from San Antonio.

Anti-vaccine activists spark a state’s worst measles outbreak in decades

The young mother started getting advice early on from friends in the close-knit Somali immigrant community here. Don’t let your children get the vaccine for measles, mumps and rubella — it causes autism, they said. Suaado Salah listened. And this spring, her 3-year-old boy and 18-month-old girl contracted measles in Minnesota’s largest outbreak of the highly infectious and potentially deadly disease in nearly three decades. Her daughter, who had a rash, high fever and cough, was hospitalized for four nights and needed intravenous fluids and oxygen. “I thought: ‘I’m in America. I thought I’m in a safe place and my kids will never get sick in that disease,’ ” said Salah, 26, who has lived in Minnesota for more than a decade. Growing up in Somalia, she’d had measles as a child. A sister died of the disease at age 3. Salah no longer believes that the MMR vaccine triggers autism, a discredited theory that spread rapidly through the local Somali community, fanned by meetings organized by anti-vaccine groups. The activists repeatedly invited Andrew Wakefield, the founder of the modern anti-vaccine movement, to talk to worried parents. Immunization rates plummeted, and last month the first cases of measles appeared. Soon there was a full-blown outbreak, one of the starkest consequences of an intensifying anti-vaccine movement in the United States and around the world that has gained traction in part by targeting specific communities. “It’s remarkable to come in and talk to a population that’s vulnerable and marginalized and who doesn’t necessarily have the capacity for advocacy for themselves, and to take advantage of that,” said Siman Nuurali, a Somali American clinician who coordinates the care of medically complex patients at Children’s Hospitals and Clinics of Minnesota. “It’s abhorrent.” Although extensive research has disproved any relationship between vaccines and autism, the fear has become entrenched in the community. “I don’t know if we will be able to dig out on our own,” Nuurali said. Anti-vaccine activists defend their position and their role, saying they merely provided information to parents. “The Somalis had decided themselves that they were particularly concerned,” Wakefield said last week. “I was responding to that.” He maintained that he bears no fault for what is happening within the community. “I don’t feel responsible at all,” he said. MMR vaccination rates among U.S.-born children of Somali descent used to be higher than among other children in Minnesota. But the rates plummeted from 92 percent in 2004 to 42 percent in 2014, state health department data shows, well below the threshold of 92 to 94 percent needed to protect a community against measles. Wakefield, a British activist who now lives in Texas, visited Minneapolis at least three times in 2010 and 2011 to meet privately with Somali parents of autistic children, according to local anti-vaccine activists. Wakefield’s prominence stems from a 1998 study he authored that claimed to show a link between the vaccine and autism. The study was later identified as fraudulent and was retracted by the medical journal that published it, and his medical license was revoked. The current outbreak was identified in early April. As of Friday, there were 44 cases, all but two occurring in people who were not vaccinated and all but one in children 10 or younger. Nearly all have been from the Somali American community in Hennepin County. A fourth of the patients have been hospitalized. Because of the dangerously low vaccination rates and the disease’s extreme infectiousness, more cases are expected in the weeks ahead. Measles, which remains endemic in many parts of the world, was eliminated in the United States at the start of this century. It reappeared several years ago as more people — many wealthier, more educated and white — began refusing to vaccinate their children or delaying those shots. The ramifications already have been significant. A 2014-2015 measles outbreak infected 147 people in seven states and spread to Mexico and Canada. In California, high school students were sent home because of infected classmates. One patient who was unknowingly infectious visited a hospital and exposed dozens of pregnant women and babies, including those in the neonatal intensive care unit. Another adult patient was hospitalized and on a breathing machine for three weeks. Federal guidelines typically recommend that children get the first vaccine dose at 12 to 15 months of age and the second when they are 4 to 6 years old. The combination is 97 percent effective in preventing the viral disease, which can cause pneumonia, brain swelling, deafness and, in rare instances, death. State health officials are now recommending doses for babies as young as 6 months if there is concern for ongoing measles exposure. Minnesota’s Somali community is the largest in the country. The roots of the outbreak there date to 2008, when parents raised concerns that their children were disproportionately affected by autism spectrum disorder. A limited survey by the state health department the following year found an unexpectedly high number of Somali children in a preschool autism program. But a University of Minnesota study found that Somali children were about as likely as white children to be identified with autism, although they were more likely to have intellectual disabilities. Around that time, health-care providers began receiving reports of parents refusing the MMR vaccine. As parents sought to learn more about the disorder, they came across websites of anti-   vaccine groups. And activists from those groups started showing up at community health meetings and distributing pamphlets, recalled Lynn Bahta, a longtime state health department nurse who has worked with Somali nurses to counter MMR vaccine resistance within the community. At one 2011 gathering featuring Wakefield, Bahta recalled, an armed guard barred her, other public health officials and reporters from attending. Fear of autism runs so deep in the Somali community that parents whose children have recently come down with measles insist that measles is preferable to risking autism. One father, who did not want his family identified to protect its privacy, sat helplessly by his daughter’s bed at Children’s Minnesota hospital last week as she struggled to breathe during coughing fits. The 23-month-old was on an IV for fluids and had repeatedly pulled out the oxygen tube in her nose. Her older brother, almost 4, endured a milder bout. Neither had received the MMR vaccine. The children now have antibodies to protect against measles, but they still need the vaccine to prevent mumps and rubella. Their father, who is 33 and studying mechanical engineering while working as a mechanic, wants to wait. His worry: autism. A colleague has a son “who is mute.” “I would hold off until she’s 3 . . . or until she fluently starts talking,” he said. His wife no longer harbors doubts, however. As soon as both children are well, she said, “they are going to get the shot.” The pervasive mistrust was evident Sunday night during a meeting, sponsored by several anti-vaccine groups, that drew a mostly Somali crowd of 90 to a Somali-owned restaurant here. Patti Carroll, a member of the Vaccine Safety Council of Minnesota, described its goal as giving parents more information, including about their right to refuse to vaccinate. People have been “bullied big-time” by doctors and public health officials, she said. The presentation by anti-vaccine activist Mark Blaxill drew cheers and applause. Blaxill, a Boston businessman whose adult daughter has autism, played down the threat of measles and played up local autism rates. “When you hear people from the state public health department saying there is no risk, that [vaccines] are safe, this is the sort of thing that should cause you to be skeptical,” Blaxill said. Two pediatricians in the audience stepped up to a microphone to denounce the claims. “I am very concerned, especially in the midst of a measles outbreak, to have folks come into a community impacted by this disease and start talking about links between MMR and autism,” said Andrew Kiragu, interim chief of pediatrics at Hennepin Medical Center in Minneapolis. “This is a travesty.” He and the other doctors were interrupted by boos and yelling. “For God’s sake, I want to know if vaccines are safe!” Sahra Osman shouted. She has a nearly adult son who received an autism diagnosis when he was 3. “My people are suffering! We’re not ignorant. I read a lot. I know a lot. I educate myself. . . . You don’t know what you are talking about.” While scores of studies from around the world have shown conclusively that vaccines do not cause autism, that is often not a satisfactory answer for Somali American parents. They say that if science can explain that vaccines do not cause autism, science should be able to say what _does._ But researchers don’t really know. A growing body of evidence suggests that brain differences associated with autism may be found early in infancy — well before children receive most vaccines. Other studies have found that alterations in brain-cell development related to autism may occur before birth. There are some genetic risk factors for autism, and advanced parental age has been associated with the condition. Meanwhile, the ongoing spread of the anti-vaccine message is making it harder to control the burgeoning number of measles cases. The groups continue advising parents, “in the middle of their crisis,” on how to opt out of vaccines, said pediatric nurse practitioner Patsy Stinchfield, an infection-control expert leading the outbreak response at Children’s Minnesota. That message is “exactly the opposite of what clinicians and public health officials are urging, which is to get vaccinated as soon as possible.” Staffers at her hospital have been working round-the-clock to vaccinate hundreds of people who may have been exposed; an MMR dose given within 72 hours of exposure can prevent measles. When their two sick children are well, Suaado Salah and her husband, Tahlil Wehlie, plan to talk to friends and acquaintances to spread the word that the anti-vaccine groups are wrong and that all youngsters should get immunized. “Because when the kids get sick, it’s going to affect everybody. It’s not going to affect only the family who have the sick kid,” she said. “They make sick for everybody. That’s when you wake up and say, ‘Okay, what happened?’ ” But she understands the apprehension that fed the outbreak. With a parent whose child has autism, she said, “it’s something that you’re looking for an answer for how it happened and what happened to your kid.” Alice Crites in Washington and Emily Sohn in Minneapolis contributed to this report.

Why a few unvaccinated children are an even bigger threat than you think

The measles outbreak traced back to Disneyland has spread to 14 states, with as many as 102 cases reported. Media outlets are highlighting the rise of anti-vaccination sentiments. Scientists are expressing their dismay at people who reject sound medical advice and put their families and communities in harm’s way.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Measles was considered eliminated in the United States in 2000. But if the first month of 2015 is any indication, this year will easily beat the record number of measles cases recorded in 2014.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The narrative during this outbreak, or any measles outbreak really, is that measles is a highly transmissible disease. So transmissible in fact that 90 percent to 95 percent of people must be vaccinated in order to protect the entire population, or achieve what is called herd immunity.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico That is partly true. Measles is highly transmissible, not least because people can be contagious days before symptoms develop. But there are three problems with this line of reasoning about vaccination rates. First, the numbers are based on calculations that assume a world of random mixing. Second, the vaccination coverage is not a perfect measure of immunity in the population. Third, and most problematic in my view, it gives people a seemingly scientific justification for not getting vaccinated – after all, if not everyone needs to get vaccinated in order to attain herd immunity, can it really be so bad if I opt out of it? **What exactly is herd immunity?**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Let’s look at the concept of herd immunity first. The basic idea is that a group (the “herd”) can avoid exposure to a disease by ensuring that enough people are immune so that no sustained chains of transmission can be established. This protects an entire population, especially those who are too young or too sick to be vaccinated. But how many people need to be immune to achieve this?    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In order to calculate the number of people who need to be immune for herd immunity to be effective, we need to know how many people will get infected, on average, by an infectious person. Imagine that a newly infected person will on average pass on the disease to two other people. Those two will each infect another two people, who will themselves pass it on, and so on, resulting in the classical pattern of an exponentially growing outbreak. In order to stop the growth in the number of transmissions, we need to ensure that each individual case causes, on average, less than one new infection. So, let’s say that one case leads on average to two more infections, but instead we want that number to be less than one. That means at least 50 percent of the population needs to be immune, so that at most, only one of the two people who might have been infected by an individual will be. **How many people need to get vaccinated to achieve herd immunity?**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico So, how do we calculate what fraction of a population needs to be immune to reach herd immunity? First, we need to know what the reproduction number, or _R_ , is. That’s how many new cases a single case of an infection will cause.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Imagine that you are infected in a completely susceptible population, and you pass on the infection to five other people (ie _R=5_ ). In order to prevent an outbreak, at least four out of those five people, or 80 percent of the population in general, should be immune. Put differently, 20 percent of the population may remain individually susceptible, but the population would still remain protected.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico So if you can estimate the reproduction number for a given disease, you can calculate the fraction of the population that needs to be immune in order to attain herd immunity. For influenza and Ebola, the number R is about two. For polio and smallpox, it is around five to eight. But for measles it is much higher, somewhere between 10 and 20. And because of that, the goal for measles vaccination coverage is typically around 90 percent to 95 percent of a population. But there’s a problem with this calculation. **The population is not random**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The assumption underlying the calculation for herd immunity is that people are mixing randomly, and that vaccination is distributed equally among the population. But that is not true. As the Disneyland measles outbreak has demonstrated, there are communities whose members are much more likely to refuse vaccination than others.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Geographically, vaccination coverage is highly variable on the level of states, counties, and even schools. We’re fairly certain that opinions and sentiments about vaccination can spread in communities, which may in turn lead to polarized communities with respect to vaccination.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico And media messages, especially from social media, may make the problem worse. When we analyzed data from Twitter about sentiments on the influenza H1N1 vaccine during the swine flu pandemic in 2009, we found that negative sentiments were more contagious than positive sentiments, and that positive messages may even have back-fired, triggering more negative responses.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico And in measles outbreak after measles outbreak, we find that the vast majority of cases occurred in communities that had vaccination coverages that were way below average.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The sad truth is this: as long as there are communities that harbor strong negative views about vaccination, there will be outbreaks of vaccine-preventable diseases in those communities. These outbreaks will happen even if the population as a whole has achieved the vaccination coverage considered sufficient for herd immunity. If negative vaccination sentiments become more popular in the rest of the population as well, we may start to see more sustained transmission chains. Once those chains are sufficiently frequent to connect under-vaccinated communities, we may again be in a situation of endemic measles. The solution often proposed is that we should do a better job of convincing people that vaccines are safe. I’m all for it. But I would also suggest that we should stop basing our vaccination policies on models that made sense in a world of constrained vaccine supply, and aim for 100 percent vaccination coverage among those who can get vaccinated. This would also solve another problem, often glanced over: There are many people who cannot get vaccinated for medical reasons, either because they are too young, or because they have other conditions that prevent them from acquiring immunity through vaccination. Herd immunity against measles requires that 90 percent to 95 percent of the _entire_ population are immune, whereas vaccination coverage is measured as the percentage vaccinated of the _target_ population – which only includes people who are eligible for vaccination. This means that to achieve 95 percent immunity in the population for measles, vaccination coverage needs to be higher than 95 percent. This is the scientific argument for a public health policy that aims at 100 percent vaccination coverage.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico More importantly, there is an ethical argument to be made for the goal of 100 percent vaccination coverage. It sends the right message. Everyone who can get vaccinated, should get vaccinated – not only to protect themselves, but to protect those who can’t, through herd immunity. _This article was originally published onThe Conversation. Read the original article._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Even in 2015, the public doesn’t trust scientists    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Listen up, guys: You should get the HPV vaccine, too    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Sorry, Jenny McCarthy: Grownups need vaccinations    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Mississippi is the Best State in America

The measles outbreak that has spread from California to Arizona and beyond has renewed debate over whether parents should be required to vaccinate their children. Medical professionals almost unanimously agree that doing so prevents the spread of dangerous diseases with little or no risk, while parents on the left and the right are concerned about autism and big- government interference.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In Mississippi, the debate has long been settled. Since the 1970s, the state has required parents to vaccinate any child attending public or private schools, and it’s very difficult for anyone to claim an exemption . The state Supreme Court ruled in 1979 that religious exemptions violated the state constitution, and Mississippi is one of 32 states that don’t allow exemptions for philosophical reasons.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The result: A stunning 99.7 percent of the 45,719 Mississippi kindergartners had received the measles, mumps and rubella vaccine, as well as the diphtheria, tetanus toxoids and pertussis vaccine, according to an October report from the Centers for Disease Control and Prevention.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Mississippi hasn’t had a case of measles since 1992, according to Thomas E. Dobbs III, the state epidemiologist. In the United States, there were about 60 cases of measles, on average, each year between 2001 and 2011, though there were 644 cases reported in 2014, according to the CDC. North Carolina, Utah and Hawaii were the only other states where more than 98 percent of children had gotten the MMR vaccine. At the bottom of the pile, fewer than nine in 10 children had received the MMR vaccine in Arkansas, Idaho, Kansas, Maine, Pennsylvania, Washington and the District of Columbia. In Colorado, just 81.7 percent of kindergartners had received MMR shots, the lowest rate in the country. Read the full story here.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

In 2013, measles killed more kids than car accidents or AIDS

Measles killed 82,100 children under age 5 in 2013, ranking the disease at No. 7 on the list of the top causes of child death, according to recent statistics from the Global Burden of Disease study published in the Lancet. Lower respiratory infections like pneumonia were the number one killer, followed by malaria, diarrhea, nutritional deficiencies, congenital defects and meningitis. More small children died from measles in 2013 than died from drowning, road injuries or aids.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Here in the United States, we have the luxury of signing up for "personal belief exemptions" from vaccine requirements and indulging vaccine skeptics in their unfounded beliefs about the "dangers" posed by measles vaccines. Currently there are 113 countries that can boast better measles vaccination rates than the United States. The only reason this is possible, of course, is the incredible effectiveness of vaccines at eradicating diseases like measles.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But these numbers serve as a stark reminder that in the developing world, where measles kills roughly 225 children each day, the situation is quite different. Children under 5 make up more than half of the 145,000 deaths attributed to the disease annually. In some particularly impoverished and malnourished areas, the disease has a fatality rate of 10 percent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico According to the World Health Organization, it costs about a dollar to immunize a child against measles. But a single case of the disease here in the United States costs about $11,000 to treat. Not a bad return on investment.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Ebola vaccine shown to be ‘highly protective’ against deadly virus in major trial

Although the current outbreak has been contained, health officials fear the deadly pathogen could come back and have been racing to develop new ways to stop it should that scenario unfold. The new study, led by the World Health Organization, was based in a coastal region of Guinea known as Basse-Guinee. The vaccine showed 100 percent efficacy in protecting those who got it. More than 11,800 people participated in the trial. “While these compelling results come too late for those who lost their lives during West Africa’s Ebola epidemic, they show that when the next Ebola outbreak hits, we will not be defenseless,” Marie-Paule Kieny, the study's lead author and WHO assistant director general for health systems, said in announcing the results. When preliminary findings were unveiled in July 2015, WHO Director General Margaret Chan called the vaccine a potential “game-changer.” Guinea was one of three West African nations hit hardest by Ebola beginning in 2014. Researchers are running two parallel studies of the same vaccine in Sierra Leone and Liberia, the other epicenter countries. The vaccine used in the study, known as rVSV-ZEBOV and licensed by Merck, involves just a single shot. Both the U.S. Food and Drug Administration and the European Medicines Agency have designated it for streamlined regulatory approval. A number of other vaccines — developed by GlaxoSmithKline and the Beijing Institute of Biotechnology, among other groups — also have shown promise and are advancing in human trials.   At the beginning of the trial, which took place in 2015 when the virus was still actively spreading in the region, the rings were randomly divided into two groups. One was to get the vaccine immediately and the other after a three-week delay. When the first results showed that the vaccine was working, everyone was offered it immediately. Those 18 and older got it initially, then children older than 6. The results were striking: In the group of 5,837 people who received the vaccine immediately, there were zero Ebola cases. In the other group, which included those who got a delayed vaccination as well as those who were never vaccinated, there were 23 cases. Kieny and research team members from Guinea’s Health Ministry and other international partners also noted that vaccination appeared to create a type of “herd immunity” that indirectly protected people who had not been vaccinated. But more research will be needed to confirm this theory, they said. Two serious adverse events were reported after vaccination, with one participant spiking a fever and another suffering an allergic reaction. Everyone else either reported no side effects or very mild ones such as headache, fatigue and muscle pain. No effects were long term. Despite researchers' caution that more studies are needed to confirm the vaccine's safety for children and other vulnerable groups, such as individuals with HIV, they already are making plans to accelerate its rollout should future trials further confirm safety and effectiveness. Merck has committed to having 300,000 emergency doses available soon and to submit the licensing application to regulatory authorities by the end of 2017. In a commentary piece — optimistically titled “First Ebola virus vaccine to protect human beings?" — virologist Thomas Geisbert of the University of Texas wrote that the study data were so strong that it seemed likely that the vaccine “probably contributed to controlling the 2013–16 outbreak of Ebola virus disease in Guinea." As encouraged as he seemed by the study, Geisbert also raised a number of questions. Researchers still don't know whether the vaccine is long-lasting, he said, asking, “Is it still protective, for example, 2-3 years after the vaccination?” He also noted that safety questions came up in the early testing. Still, he wrote, “After 40 years we appear to now have an effective vaccine for Ebola virus disease to build upon.”

You can blame CNN (and the news media) if childhood vaccinations go down

There were a lot of half-truths and out-right falsehoods peddled at CNN’s Republican debate Wednesday night, but perhaps the most damaging among them was the assertion by Donald Trump that childhood vaccinations cause autism, and others’ skepticism about the safety of the vaccine schedule set out by the American Academy of Pediatrics. It was particularly galling watching two physicians who are president candidates, Ben Carson and Rand Paul, pander when they clearly know better.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Those who saw the vaccine exchange during the debate will rightly castigate the Republican field for their refusal to stand up for medical science consensus. But CNN’s role in raising the issue in the first place should not be overlooked. If CNN, and other media, continues on the course of unprecedented politicization of vaccine safety by treating it as a campaign issue, the societal consensus on the safety and efficacy of vaccines may be eroded at tremendous cost. Here’s why. We are fortunate to have a rather broad societal consensus on the efficacy and safety of childhood vaccinations. For all the attention that the anti-vaxxer movement has generated, vaccination rates for measles, mumps and rubella (MMR) remain above the 90 percent target in almost all states. Increasing resistance to vaccinations, while deeply troubling, has remained largely localized.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Further, as Kahan and others have noted, there are no striking partisan or ideological differences in vaccine attitudes. Notwithstanding the quackery on stage at the GOP debate on Wednesday, Republican voters are just as likely to believe in vaccine safety as Democrats, at least for now. That may change if party elites become polarized on the issue, and if this is communicated to the mass public through the national press.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico We fear that it might happen because something similar transpired with attitudes about global warming. In a paper we recently presented at the annual meeting of the American Political Science Association, we looked at the role mainstream media plays in promoting pseudo-scientific attitudes on several issues, such as global warming and childhood vaccinations. We fear that the story of global warming polarization should serve as a cautionary tale of how the media and the political establishment choose to proceed on vaccinations.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico So far the coverage of vaccinations has been reasonable, despite what we might intuitively infer from the rise of the anti-vaxxer movement. We know this because we gathered coverage of childhood vaccinations in the New York Times, The Washington Post, and USA Today, and constructed a keyword-based dictionary to capture cues from parties and party leaders, as well as experts using Lexicoder for automated content analysis.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The figure below shows that coverage of vaccines has increased since the bogus Wakefield study purportedly linked vaccines to autism. Salience has increased modestly, but politicization hasn’t. As the right panel shows, references to experts dominate coverage, and party cues have fallen to below 10 percent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Do note that until recently, party elites were in consensus on vaccines. While some cues were present in the press, these did not have the potential to polarize the public. We fear that if party elites continue to polarize, the cues present in the press could begin to undermine the societal consensus on childhood vaccinations. Why are we reasonably sure this is the case? Because we have seen this movie before, with global warming. Climate scientists and others in the academic community have been at a loss as to why it has been so difficult to mobilize a societal consensus to take serious action in tackling global warming. The issue is polarized, with Republicans, particularly the most educated, being steadfastly against the scientific consensus. This fact has helped maintain a narrative in the press that Republicans and conservatives are inherently anti-science.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The narrative, however plausible on its face, ignores the fact conservative leaders in other countries got on board to deal with global warming (Margaret Thatcher and David Cameron, for example), and more importantly, over-time dynamics in the United States. Republican elites moved into a much more entrenched stance against dealing with global warming, and Republican voters became more skeptical over time. We gathered polls on global warming attitudes going back to 1992 from the Roper database, and constructed a climate skepticism “mood” measure using James Stimson’s WCalc software. The results are shown below in the furthest left panel.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Widespread polarization on global warming was not inevitable. As the left panel of the figure above demonstrates, skepticism has gradually crept upwards since 1992, almost certainly concentrated among Republican voters (for more details, please see our conference paper).    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Two periods in particular are worthy of note: a steady increase in skepticism between 1992 and 2000, and a steep increase after 2006. Why did this occur? In all likelihood, an important contributor was a steep increase in the politicization of coverage, and the issue’s increased salience over time. Republican voters were persuaded by Republican and Democratic elites whose stances on the issue were increasingly available in coverage. As we show in the center panel above, media attention on global warming skyrocketed after 2006, while the panel on the right shows coverage has gotten increasingly politicized. Parties and party leaders were hardly mentioned in the 1980s — now they are featured in over half of stories on global warming. The period of increasing climate skepticism between 1992 and 2000 shown above corresponds with a period of relentless increases in the politicization of coverage, and increasing skepticism after 2007 may well be linked to a massive increase in coverage that made politicized coverage ever more available to Republican voters. We believe the media played a critical role in polarizing the American public on climate change with potentially disastrous consequences in the future. Interest groups pressured Republican elites to reject action on climate change, and elite cues filtered through the press to erode Republican support of climate science. We fear we may begin to witness a similar dynamic on vaccines. Republican elites are increasingly voicing skepticism of the medical science consensus. The media sees this as fitting a pre-established narrative that Republicans are hostile to science, and thus CNN asked the GOP field a question about vaccines in front of a record breaking national audience of 23 million people.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It would not be surprising if Democratic elites leap at this opportunity to solidify their own science-based credentials and make it a campaign issue, particularly if someone like Donald Trump wins the Republican nomination. These cues are then communicated to the public through the press, and we may be off to the polarization races. Even a slight erosion in public support for vaccines may cause tremendous damage. We need at least 90 percent of parents to vaccinate their kids, not 60 percent or even 80. We should definitely be critical about Republican leaders pandering to vaccine truther-ism, but we should be equally critical of CNN for making this an issue in the first place. If we value our societal consensus on vaccines, we must recognize that it’s potentially fragile, and that the best way to maintain it is to keep the issue out of the Republican primaries and out of the 2016 presidential election. _Eric Merkley and Dominik Stecula are PhD students in political science at the University of British Columbia._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

‘Daily Show’s’ Jon Stewart chides CNN for (excellent) measles simulation

It’s become a predictable part of our media echosphere: CNN deploys some high-tech device to illustrate a phenomenon in the news, and “The Daily Show’s” Jon Stewart skewers the network. Witness CNN’s coverage of the ongoing measles outbreak. In his segment titled “Les Measlesrables,” Stewart commended CNN senior medical correspondent Elizabeth Cohen for a description of measles’ communicability on Monday night: “If I had measles, I walked into a room, and then I walked out, and you walked into that room two hours later, you could get measles if you had not been vaccinated,” Cohen told host Anderson Cooper. Stewart rejoined, “You’re just going to sit there and tell us the information using clear, easy-to-understand ‘words’? CNN, you’ve changed. Now I’m going to count to three, and if I don’t see some unnecessary hologram of measles floating through an airplane, I’m going to flip my [bleep].” Sure enough, what followed was a clip of CNNer Tom Foreman in a simulated airplane, sitting in a row in the front part of the aircraft. “If I were seated on a plane like this and somebody way in the back sneezed,” says Foreman in the demonstration, “the truth is, that virus now could travel in sort of invisible clouds of microdroplets all the way up to where I am seated here.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “And those microdroplets can infect me, they can land on surfaces and I can touch them and they can infect me,” says Foreman. Stewart had fun with it all, invoking “Snakes on a Plane,” among other riffs.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Satirize all you want, Stewart, but the CNN-Foreman-airborne-measles moment is precisely the sort of value added that a well-funded cable TV outlet should bring to an issue as pressing as measles. The CDC capably describes the threat from this menace: “The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. Measles virus can remain infectious on surfaces and in the air for up to two hours after an infected person leaves an area.” Yet those words don’t even approach the power and simplicity of CNN’s simulation.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Measles outbreak in Minnesota surpasses last year’s total for the entire country

Minnesota’s measles outbreak has exceeded the total number of cases reported in the entire United States last year, with no sign of slowing. Health officials worry that the holy month of Ramadan, which began Friday night and brings Muslims together in prayer and festivities, will accelerate the spread of the highly infectious and potentially deadly disease, which is plaguing the close-knit Somali American community. Minnesota health officials are working closely with faith leaders in an unprecedented effort to spread the message that parents should get their children vaccinated and keep them home if they show symptoms of the disease. It’s the first time imams in the United States have taken such an active role in a public health crisis, health officials and Somali Americans said. The imams are up against the anti-vaccine movement, which in recent years has targeted the Somali American community with misinformation linking the measles-mumps-rubella vaccine to autism, a claim that extensive research has disproved. Somali American children in Minnesota had a vaccination rate of 92 percent in 2004, higher than the state average, but that rate has dropped to 42 percent, leaving children vulnerable to disease. Faith leaders and health professionals need to work side by side, said Sharif Mohamed, who has been the imam of his mosque in Minneapolis for nearly 20 years. “The imams emphasize the role of the parent and the role of faith to keep people safe from any disease — not just yourself, but the entire community and also the state — so people have to be responsible citizens and do their part,” he said. “Health professionals can focus on the linkage between the vaccine and the measles. I think we can win the battle.” Health officials say there have been at least 8,250 exposures in day-care centers, schools, hospitals and clinics. As of June 1, there were 73 confirmed cases, the Minnesota department of health announced, most of them in unvaccinated preschool children. A significant number have been hospitalized. Last year, the United States recorded 70 measles cases. Although the largest number of cases are in the Somali American community, the disease has begun to spread to the broader community through the Minneapolis public school system, infecting six white children. Unfounded fears about vaccines have circulated among some in the white community for decades. “It’s white, middle-class parents who have made a decision not to vaccinate and feel very strongly about that choice,” said Kris Ehresmann, director of infectious disease epidemiology at the Minnesota Department of Health. The outbreak in Minnesota has been fueled by local and national anti-vaccine groups that organized meetings in the Somali community. Andrew Wakefield, the founder of the modern anti-vaccine movement, visited Minneapolis at least three times in recent years to talk to parents. At one meeting, during a smaller measles outbreak in 2011 that also affected Somali children, he downplayed the severity of measles, according to a health official. In an interview, Wakefield, whose falsified 1998 study purported to link vaccines to autism, has said he feels no responsibility for the current measles outbreak. At least 50 children have been treated at Children’s Hospitals and Clinics of Minnesota, and 20 have been hospitalized, staying an average of five days, said Patsy Stinchfield, who oversees infection control at Children’s. Some of the children are suffering severe dehydration because their mouths are so sore that they can’t drink or swallow, she said. One child was hospitalized for 17 days. Some children who were discharged had to return to the hospital because of continuing respiratory problems. “We don’t see a plateauing,” Stinchfield said. “We’ve geared up for working on this through the summer.” But there have been some encouraging signs. Since the outbreak began in early April, there has been a surge in vaccinations as parents have seen firsthand the severity of the disease. Statewide, the number of measles-mumps-rubella vaccine doses given before the outbreak was about 2,700 per week. Since the outbreak started, the health department has seen as many as 9,700 doses given in a week. For ethnic Somali children between 2 and 13 years old, the department typically administered about 30 doses a week before the outbreak. That number began to rise after the outbreak started and reached more than 500 doses a week at the end of April and early May, Ehresmann said. Despite the worst measles outbreak in the state in nearly 30 years, anti- vaccine groups have stepped up efforts to spread their message there. At a recent community forum in Minneapolis about the MMR vaccine, an anti-vaccine advocate handed out printouts that claimed the vaccine can cause permanent brain damage and death, according to a Public Radio International report. “When you have an open community meeting, that does allow a forum for the anti-vaccine groups to come and continue to present their misinformation,” Ehresmann said. Health department officials in Columbus, Ohio, and Seattle, home to other large Somali American communities, worry that the disease or misinformation or both could spread to their areas. They have increased outreach, adding education forums and programs to air on Somali-language television. “There is a strong oral tradition in the Somali community, and Somalis in Minnesota have shared the message from the anti-vaccine groups with the community in the Seattle area, so there has been indirect influence from these groups,” said Libby Page, who manages the immunization program for Seattle and King County. According to the Washington State Department of Health, only 65 percent of infants born to Somali families in 2013 had received one or more doses of MMR by 23 months, even though federal guidelines recommend that vaccinations begin at 12 to 18 months. Columbus’s Somali community of 50,000 to 60,000 people is second only to that concentrated in Minneapolis, with about 90,000. There is much travel between the two communities for family gatherings, such as weddings and graduations, as well as for Ramadan. The most important message will come from imams, the most trusted community leaders, health officials say. Clinicians from Children’s Minnesota and Hennepin County Medical Center are working with a group of 30 imams and mosque executive directors who are eager to participate. During the group’s monthly dinner meeting in late May at the Dar Al-Farooq mosque in suburban Minneapolis, faith leaders sat at tables covered in white tablecloths and listened intently as clinicians explained that there is no medicine for measles. They showed photos of Somali children covered in rashes, as well as a chart illustrating the drop in MMR immunization rates. Clinicians also described the characteristics of autism. The condition is often recognized at the age of 12 to 18 months — around the time the first dose of MMR is recommended. The timing is coincidental, but still makes some families incorrectly assume the vaccine caused autism. (In fact, brain abnormalities associated with autism have been detected much earlier and may emerge during fetal development.) “They were really listening,” said Stinchfield, who led the presentation. “You could hear a pin drop.” Several imams stood up to talk. Some spoke with great passion about their responsibility to make sure children in their community and the broader one do not die of a preventable disease. “They very much shared our sense of urgency about this topic,” Stinchfield said. “They very much confirmed they are allies with us. We are going to work together.” Some of the actions under consideration include suggestions for messaging during each night of Ramadan, immunization clinics at individual mosques, education forums to explain how the measles virus spreads, and sessions about autism. For imams such as Mohamed, who is partnering with the Minnesota health department, that additional information will give faith leaders a stronger voice to battle falsehoods. “I think we will at least reduce the attack from the groups with anti-vaccine message,” he said. “They had a very loud voice. But they didn’t get a group of strong imams. We will have impact.”

Best state in America: Mississippi, for vaccination rates

_Reid Wilson is the author ofRead In, The Post’s morning tipsheet on politics. Read more from Outlook and follow our updates on Facebook and Twitter._ The measles outbreak that has spread from California to Arizona and beyond has renewed debate over whether parents should be required to vaccinate their children. Medical professionals almost unanimously agree that doing so prevents the spread of dangerous diseases with little or no risk, while some parents on the left and the right are concerned about autism and big- government interference. In Mississippi, the debate has long been settled. Since the 1970s, the state has required parents to vaccinate any child attending public or private schools, and it’s very difficult for anyone to claim an exemption . The state Supreme Court ruled in 1979 that religious exemptions violated the state constitution, and Mississippi is one of 32 states that don’t allow exemptions for philosophical reasons. The result: A stunning 99.7 percent of the 45,719 Mississippi kindergartners had received the measles, mumps and rubella vaccine, as well as the diphtheria, tetanus toxoids and pertussis vaccine, according to an October report from the Centers for Disease Control and Prevention. Mississippi hasn’t had a case of measles since 1992, according to Thomas E. Dobbs III, the state epidemiologist. In the United States, there were about 60 cases of measles, on average, each year between 2001 and 2011,  though there were 644 cases reported in 2014, according to the CDC. “The vast majority of Mississippians support the need for immunizations, so we do have a good historical relationship with our providers and the vast majority of our parents,” Dobbs said in an interview. North Carolina, Utah and Hawaii were the only other states where more than 98 percent of children had gotten the MMR vaccine. At the bottom of the pile, fewer than nine in 10 children had received the MMR vaccine in Arkansas, Idaho, Kansas, Maine, Pennsylvania, Washington and the District of Columbia. In Colorado, just 81.7 percent of kindergartners had received MMR shots, the lowest rate in the country. Skepticism has found its way into Mississippi, however. Dobbs said that the number of medical exemptions — 135 in 2014 — has more than doubled in recent years. This week, legislators fended off another attempt to allow religious and philosophical exemptions. Holding a firm line on those exemptions has kept nasty outbreaks out of Mississippi schools. Efforts to roll back similar exemptions elsewhere could be a real shot in the arm to other states. Read more from Outlook and follow our updates on Facebook and Twitter.

Why is there a measles outbreak?

There has been an outbreak of measles in the United States for the past two months. During this time, you may have read about the outbreak or overheard your parents talking about it. KidsPost thought it would help to explain what’s going on. **What is measles?** Measles is a viral infection that used to be a common childhood disease in the United States. Before the measles vaccine was given to American children in 1963, there were about 500,000 cases and 450 deaths reported each year. In the past 10 years, there have been an average of 60 cases of measles each year. Compare that to the 20 million cases that occur worldwide each year. **Is measles serious?** Most kids who get measles are sick for seven to 10 days. It begins with the symptoms of a cold: runny nose, cough, sore throat, conjunctivitis (pink eye) and fever. After a few days, a red, blotchy rash starts on the face and spreads all over the body. Serious complications include dehydration, pneumonia or an inflammation of the brain called encephalitis. **Is measles contagious?** When the Ebola scare hit last summer, one of the things doctors told people is that Ebola, while serious, is not highly contagious. The reason for this is because you can’t catch Ebola unless you come in direct contact with the bodily fluids of someone who has the infection. Health officials reassured the public that Ebola was not airborne. That means you can’t catch it from breathing the same air as someone who has the infection. But measles is one of the most contagious viruses known to science. People with measles can spread the infection for four days before the onset of the rash and four days after. (That means people are contagious before they know they have measles.) Not only is measles spread through airborne exposure, but the virus can remain in the air for two hours after an infected person has left the area. **How is measles treated?** Like most viral infections, there is no specific treatment for measles. If someone gets the infection, he is treated with rest, fluids and fever medication. In some cases, people are hospitalized because they developed a complication of the disease. **When did the current outbreak begin?** The outbreak began in December and was linked to Disneyland in Anaheim, California. It’s presumed that the original patient entered the United States from another country. The infection spread rapidly to people who had not been immunized against it. To date, more than 120 confirmed cases have been reported in 17 states and the District of Columbia. **Are you at risk for catching the infection?** Most children receive two measles shots. The first is usually given between 12 months and 15 months. The second is usually given between ages 4 and 6. Vaccines aren’t completely effective, but if you’ve had both measles vaccines, your chances of becoming infected after being exposed to the virus are less than 2 percent. **Why have so many people come down with measles?** Over the past two decades, some parents have become concerned that vaccines are more dangerous than the diseases they prevent. Many scientific studies have shown this isn’t true, but some people are still reluctant to give their children shots. Most states require children to be vaccinated against measles and other diseases to attend school. The reason for this policy is simple. The more people who are vaccinated, the less likely an outbreak will occur. This process is called herd immunity. Each jurisdiction has its own rules about mandatory vaccinations. Some, such as Maryland, have a very strict policy about immunizing students. But all states other than Mississippi and West Virginia allow parents not to vaccinate their children because of the family’s religious beliefs. Nineteen states also allow parents that option if the vaccinations are against their personal beliefs. **Why are some people upset about the outbreak?** Because there is a vaccine for measles, it is a preventable disease. And the way to prevent the spread of the disease is to keep most of the population immunized against the virus. However, some children can’t get the vaccine because they have cancer, other diseases that weaken their immune system or they are too young. If parents choose not to vaccinate their children, it puts others at risk. That’s why some people are upset about what’s taking place. **— Howard J. Bennett  **

Where are all the anti-vaxxers?

What did I think was going to happen? Two weeks ago, I posted a question about vaccines on Facebook. To nobody’s surprise— except, perhaps, my own since I must have been in denial la-la land to post something about vaccines on Facebook and think it could remain civil—it got ugly pretty quickly. It had been about a month since the Disneyland measles outbreak and the media was on fire with talks about “anti-vaxxers.” Yet, I had never met one (or at least I thought I had never met one. It turns out there was one extremely nearby.) I wrote this: “Where are the parents who don’t vaccinate their kids? Please message me. It’s not for an article or even a conversation about it. I’m just super curious who you are since there’s all this buzz and I’ve literally never talked to anyone who told me they don’t vaccinate. But statistically that can’t be accurate, right? Especially since I’ve lived in hippie towns Takoma Park, Md., and Portland, Ore., with kids.” I’m 32 with two young daughters. My Facebook page is basically a fertility explosion of ultrasound images and newborn announcements. We are the demographic with some of the fiercest opinions about vaccination because we are the ones making the decisions, about our babies, right now. Ignore the part about it not being for an article; I was assigned to write it up for this blog after the fact. I later asked permission to use everybody’s comments. By saying that it wouldn’t be for publication and that people could message me privately, I was trying to grant these mysterious anti-vaxxers anonymity. The social stigma is largely what fascinated me in the first place. I am very pro-vaccination based on research I did reporting health and science articles for The Washington Post. I think they’re one of the most terrific medical accomplishments of modern times. I felt grateful for vaccines even when I had to see my infant daughters get up to four shots in one check-up, and even when one of those shots gave my oldest daughter a fever and a rash all over her torso that left both of us miserable for a few days. Because you know what’s worse than that? Real measles. Polio. Pertussis. And about half a dozen other illnesses that I am lucky to not know anything about. The comments came in a few flavors. There were the people telling me where to find anti-vaxxers. They suggested California, Ashland, Ore., and Ravalli County, Montana. And then the people offering anecdotes about their acquaintances who don’t vaccinate their children. The one I appreciated the most came from a woman who grew up before the measles vaccine was introduced and “the kid across the alley got measles and the complications he faced made him deaf for life.” And the one that hit me the hardest was from our own nanny, who said that there are “a TON of unvaccinated children running around” a coffee shop in our neighborhood, including the owner’s four young ones. Even after knowing that, my 1 1/2 year old and I went to a kiddie concert at that coffee shop a few days later. I felt vaguely suspicious of the parents (and children), even though of course there’s no way to tell who is vaccinated or not. My girls have had their shots so it doesn’t worry me to take them there. But since babies can’t get the MMR (measles, mumps, rubella) shot until they turn 1 year old, I probably would not go there if I had an infant and that would be disappointing. That’s where I get mad about this, by the way– when I think about vulnerable infants at risk because of somebody else’s misinformed objections.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico After someone on my Facebook page finally came forward and said they don’t vaccinate their kids, the comments turned to debunking the link between vaccines and autism, the need for scientific literacy and being a responsible citizen. Then, someone else came forward as an anti-vaxxer: My half-sister. “I’ve heard of tiny babies getting 4 whopping vaccinations in one sitting!!! Super bad! Also tiny babies [sic] bodies aren’t prepared to handle those. I’d be that parent that opts out of vaccines for religious reasons if I had a baby. Just saying. I’ve also read a lot about the link to autism—vaccinating before age 2.” Gulp. Guess what topic I won’t ever bring up at family birthday parties or the Thanksgiving table. She is only a hypothetical anti-vaxxer since she doesn’t have any children. I found her opinion frustrating and ill-informed, not to mention awkward, now that we were having this debate in a quasi-public space. Both of my daughters—her nieces—got “4 whopping vaccinations in one sitting,” after all. Despite my anger, I realized there was only way I could respond: “Agree to disagree.” _Rachel Saslow is a former reporter for The Washington Post who now lives in Oregon with her husband and two vaccinated daughters._    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Like On Parenting on Facebookfor more essays, advice and news. **    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico _You might also be interested in:_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Why parental sleep deprivation needs to be taken seriously    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico How to teach children about consent at a young age (hint: it’s never too early)    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Here’s why we have to stop labeling our boys, too    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Michael Gerson: The enduring benefits of vaccination

Recently I wrote about a type of scientific denialism — often practiced by religious people — that cheats children out of the wonders of modern cosmology and encourages unnecessary religious doubt. But there is another sort of scientific skepticism — often displayed by affluent and educated parents — that withholds routine childhood vaccinations and encourages unnecessary disease. These should be kept in proportion. The belief that human beings walked with dinosaurs is wrong. The belief that vaccinations cause autism or brain damage is wrong and dangerous. In the latter case (as in the former), the scientific argument is not merely lopsided but single-sided. Like any medicine, vaccines have a very small risk of serious side effects, which doctors are trained to identify. But the association of the measles vaccination with autism has been entirely discredited. Childhood vaccinations do not involve dangerous levels of toxins and do not compromise the immune system. And vaccinations prevent a range of diseases — chickenpox, diphtheria, measles, mumps, pertussis, polio, rotavirus, rubella, tetanus — that used to routinely hospitalize, disable or kill children. In most health matters, defying medical authority mainly has individual consequences. Those who believe that cancer can be treated with coffee enemas are only killing themselves. But communicable diseases are different. Some people can’t be immunized for medical reasons, or their protective response to a vaccine is weak. They depend on the immunity of others to avoid infection. Immunization rates north of 90 percent are usually required to protect the whole herd. This means that if even a small portion of the herd refuses vaccination, the risks rise for everyone. Epidemiology grants marginal groups the power to do great harm. The United States generally has rates of immunization in the high 80s or low 90s. In some places, however, the rate dips lower, making it easier for an infected traveler (for example) to cause an outbreak. Recent examples can be found in Orange County, Calif., and New York City. The problem is even worse in Britain (where the immunization rate for measles is only about 80 percent) and in other parts of Europe. Those who resist vaccination are a varied group. The parents of autistic children seek and deserve an explanation. Unfortunately, vaccination is not the answer. Other “non-conformists” are a subset of home-schoolers, distrustful of government mandates and intent on the right to keep and bear viruses. A larger number of resisters are committed to an organic, chemical-free, natural lifestyle. This is attractive, except in the case of diseases in which the “natural” state — through most of history and still in much of the world — has been massive infant and child suffering and death. The achievements of science in this area are highly artificial — and thank goodness. The ability to opt out of vaccinations (other than for diagnosed medical problems) is often miscast as a matter of parental choice, leading to a proliferation of state exemptions for vague religious and philosophic reasons. What could be wrong with choice? A lot, when you are choosing to endanger your neighbors. Vaccination — in a little-used but useful term — is a social responsibility. It is a duty we owe each other as members of a community. Opting out should be difficult and burdensome. And there is no parental right to send a purposely unvaccinated child to public school, exposing other children to unnecessary risk. Resistance to immunization is not new. In the late 1700s, some believed that the smallpox vaccine could turn people into cows. Today, however, there would be 1,000 Web sites alleging a sinister connection between Big Pharma and Big Dairy. The problem of vaccine denialism is closely tied to the problem of information and authority in the digital age. People prone to skepticism can cover themselves with layers of pseudo-science and conspiracy theories that thicken and harden like papier mache. On medical issues, the United States needs not more sources of questionable information but more trust in knowledgeable authority. The Centers for Disease Control and Prevention, the American Academy of Pediatrics and your local pediatrician are not lying about immunization. Many Web sites are. The seriousness of this discussion must somehow reflect the seriousness of the stakes. Vaccine denialism is not the equivalent of advocating for diaper-free children or sleeping in the family bed. During the lifetimes of American children born from 1994 to 2013, according to the CDC, childhood vaccinations will prevent an estimated 21 million hospitalizations and 732,000 deaths. This is miraculous but not natural. _Read more fromMichael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook _. **Read more about this issue:** Alexandra Petri: The one problem with that Jenny McCarthy Twitter backlash Seth Mnookin: An early cure for parents’ vaccine panic Sandra G. Boodman: Inside the vaccine-autism scare

Scientific experimentation, debate and selflessness on the way to today’s vaccines

_Susan Okie is a physician, a former Washington Post science reporter and editor, and a clinical assistant professor of family medicine at Georgetown University School of Medicine._ Growing up in the 1950s and ’60s, I suffered through chicken pox and measles, like millions of other American kids, and I belonged to the first generation to receive the brand-new polio vaccines in national campaigns. My parents had friends permanently paralyzed by polio; the mother of a schoolmate gave birth to a baby who was deaf, nearly blind and suffering a severe intellectual disability from rubella (“German measles”) contracted during pregnancy. Within a half-century, vaccines have made these and other once-common viral diseases so rare in the United States that doctors being trained today may never see cases of them, and some parents worry more about the small or hypothetical risks of vaccinating children than about the risks of leaving them unprotected. It takes events such as the 2015 measles outbreak among visitors to Disneyland in California or the recent emergence of the Zika virus — so dangerous to the brain of a developing fetus — to remind us not to take our freedom from infectious diseases for granted. In this meticulously researched history of the high-stakes race to develop effective vaccines against polio, rubella, rabies and other viruses, science writer and physician Meredith Wadman tells the story of these near-miraculous medical achievements of the post-World War II era. “The Vaccine Race” also details the risks posed by some of the early products — risks that arose, in part, because to make the vaccines, researchers first had to invent techniques for growing viruses such as polio or rubella in living cells, without knowing what other viruses those host cells might harbor. Even when a courageous government scientist, Bernice Eddy, and colleagues showed that monkey cells used to produce the Salk polio vaccine and other vaccines contained a virus, SV40, that could cause malignant changes in human cells, government officials at first discounted the evidence and allowed such vaccines to remain on the market. By 1963, when the federal Division of Biologics Standards began to require that polio vaccines be free of SV40, 98 million Americans had received the Salk vaccine, indisputably preventing tens of thousands of cases of paralysis from polio. But between 10 million and 30 million of them may have received a dose contaminated by the SV40 virus. Whether such exposure increased their likelihood of developing cancer remains uncertain. The Institute of Medicine “concluded in 2002 that although studies that followed vaccine recipients over the decades provide no evidence of increased cancer risk, these studies were ‘sufficiently flawed’ that the question . . . couldn’t be answered,” Wadman writes. Early vaccines against viral diseases were designed to stimulate the immune system by giving the recipient either a dead or a weakened version of the virus they were meant to protect against. In live-virus vaccines, choosing the right strength and strain of the virus was a challenge. If it was too strong, the vaccine might cause full-blown cases of the illness; if too weak, it might not produce lasting immunity. Live-virus vaccines are used today to protect against certain infections, including measles, mumps, rubella and chicken pox. Newer vaccines against some other diseases are genetically engineered to contain only proteins from the coat of the virus. Thus, they cannot cause the infection. The only sure way to measure how well an experimental vaccine will work is by testing it in groups of people likely to be exposed to the disease. “Vaccinology, I would say that it’s not rocket science. It’s a lot harder than rocket science,” Alan Schmaljohn, a University of Maryland virologist, remarked in 2014. In the postwar decades, researchers and drug companies competed intensely to be the first to license vaccines against certain diseases. The need was urgent. Polio paralyzed an average of 15,000 Americans each year. Rubella epidemics occurred every few years and were devastating for women infected during pregnancy: The nationwide epidemic of 1964-65 caused about 6,250 miscarriages or stillbirths, 2,100 deaths among newborns, and 20,000 cases of congenital birth defects. An additional 5,000 pregnant women obtained abortions after contracting rubella. Rabies, considered the most deadly of all infections in humans, was on the rise in wild animals in the early 1960s, and the existing vaccines for people bitten by infected animals were dangerous or insufficient. At the time, government standards on the ethics of human research were rudimentary to nonexistent. As Wadman describes, vaccines were tested in circumstances shocking to a reader today. Experimental vaccines were given to newborn or premature babies, to prisoners, and to mentally or physically disabled residents of institutions, often without the consent of patients or parents, and with minimal institutional oversight. The first humans to receive a live polio vaccine, in 1950, were 20 intellectually disabled children at Letchworth Village, an institution in rural New York. Its director reportedly sought parental permission because, he said, “I realized we would never get official permission from the state.” Babies born to women imprisoned at Clinton State Farms in New Jersey were given an experimental polio vaccine over a five-year period in the late 1950s. The prison’s popular female warden and medical director “were extremely helpful in obtaining permission” from the mothers, the researchers later noted. Wadman relates this fascinating history as lived by a handful of scientists at the center of it all, especially Leonard Hayflick, an indefatigable cell biologist who refined techniques for growing, maintaining and infecting human cells with viruses to make safer, better vaccines, and Stanley Plotkin, a pediatrician and vaccinologist who studied the rubella virus and developed a safe, highly protective vaccine against it. Hayflick reasoned that cells taken from human fetuses, which are protected from most infections (though not rubella) in the womb, would probably be free of viruses and thus far less risky than animal cells for vaccine production. Through connections in Sweden, he obtained fresh tissue from aborted fetuses, including, in 1963, lung tissue from the normal fetus of a Swedish woman referred to as Mrs. X. The cultured lung cells gave rise to a cell line called WI-38 — vigorous, healthy and virus-free. It became the preferred cell line for making many new vaccines and is still used today. Eventually, as biology became big business, the ampoules of frozen WI-38 founder cells proved a valuable commodity, sparking an ugly tug-of-war over their ownership among Hayflick; his longtime boss, Hilary Koprowski of Philadelphia’s Wistar Institute; and officials at the National Institutes of Health. Wadman traces the twists in this colorful dispute with admirable balance, conveying the strengths and the failings of Hayflick and her other characters. Plotkin used Hayflick’s WI-38 cells to grow a weakened strain of rubella virus that he needed to make his vaccine. The strain he chose came from the infected kidney cells of another fetus, one whose mother had undergone an abortion after contracting rubella during pregnancy. Thus, the protection from disease conferred by Plotkin’s rubella vaccine, and by other vaccines made using WI-38 cells, is directly linked to the use of these cells from aborted fetuses. “I am moved by the intimate interaction between the WI-38 cells and the hundreds of millions of people who have benefited from . . . vaccines made using them,” Wadman writes. “When they are vaccinated, they are literally, physically connected to Mrs. X’s fetus.” Although debate continues over the use of fetal tissue in research, it is legal in the United States and is contributing to scientists’ understanding of numerous diseases, as well as development of new treatments. At almost 400 pages of text plus abundant endnotes, this book is so rich in scientific anecdotes, historical detail and quirky characters that I can’t do it justice in a short review. Wadman conjures the wizardry of Hayflick’s cell laboratory; the brick vastness of long-gone Philadelphia General Hospital, which cared for the city’s workers and poor; the medical acumen of Australian eye surgeon Norman McAlister Gregg, who first made the connection between pregnant women with rubella and babies born blind. She conveys the era’s no-holds-barred approach to science, as well as the altruism of individual scientists and doctors at a time when no one had yet thought of patenting a gene or a living cell. Her dissection of the role played by abortion in vaccine development provides valuable context for understanding today’s abortion politics, and her chapter on the stirrings of entrepreneurship among biologists and universities is an enlightening primer on the birth of the biotech industry. By Meredith Wadman Viking. 436 pp. $30

Amid growing vaccination debate, measles continues to spread and is now in New York state

Health officials announced that a college student diagnosed with measles recently traveled across New York on a train, potentially exposing untold numbers of travelers to the virus, according to news reports. The infected individual, a student at Bard College, boarded a a 1:20 p.m. Sunday Amtrak train from New York City’s Penn Station to Rhinecliff, N.Y., according to ABC News. The train stopped in Albany before traveling on to Niagara Falls, ABC reported.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Anyone traveling on Amtrak train #283 from Penn Station in NYC to Albany on January 25, 2015, and who is not immune to measles or not sure of their measles immunity, should contact their primary care physician if they become ill with fever,” the New York State Department of Health said in a statement, according to the Associated Press. Three New York state residents — one in Dutchess County and two in New York City — have been diagnosed with measles so far this year, ABC reported. New York requires that college students taking six credits or more show proof of immunity to measles, according to university guidelines.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “At Bard College, medical forms show that a student’s immunity to the disease must be documented, but they don’t state whether exemptions are allowed,” according to ABC. After notifying students and faculty of the measles case, Bard College, with the help of Dutchess County Department of Health, held a measles vaccination clinic for anyone on campus who has not been vaccinated against measles, according to ABC.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “In order to prevent the spread of illness, DOH is advising individuals who may have been exposed and who have symptoms consistent with measles to call their health care providers or a local emergency room BEFORE going for care. This will help to prevent others at these facilities from being exposed to the illness,” the Health Department said, according to the AP.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The latest measles outbreak has infected more than 100 people across 14 states, according to Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases. Fifty-eight of those cases, according to the California Department of Public Health, are traceable to an outbreak at Disneyland and another theme park in Southern California that began in late December and now has spread to six other states, including Utah, Washington, Oregon and Colorado. The outbreak has generated sometimes fierce criticism of people who, for personal reasons or because they mistrust the vaccine, choose not to have their children immunized and prompted at least two school systems in California to ban unvaccinated students from school. RELATED: 2015 U.S. measles outbreak already at 84 cases, more than in a typical year    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On Friday, White House spokesman Josh Earnest said President Obama believes decisions for vaccinating children should remain in parents hands, but noted that he also thinks the public should heed the advice of public health professionals, according to Reuters.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I’m not going stand up here and dispense medical advice,” Earnest said, according to the AP. “But I am going to suggest that the president’s view is that people should evaluate this for themselves, with a bias toward good science and toward the advice of our public health professionals, who are trained to offer us exactly this kind of advice.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico RELATED: Amid measles outbreak, anti-vaccine doctor revels in his notoriety    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

More than 350 organizations write Trump to endorse current vaccines’ safety

More than 350 organizations, including leading U.S. medical, advocacy and professional organizations, have sent a letter to President Trump expressing their “unequivocal support for the safety of vaccines.”  “Vaccines protect the health of children and adults and save lives,” the letter opens. “Vaccines have been part of the fabric of our society for decades and are one of the most significant medical innovations of our time.” It continues: “Claims that vaccines are unsafe when administered according to expert recommendations have been disproven by a robust body of medical literature.” The letter was sent to Trump on Tuesday. Organizations that signed on represent families, providers, researchers, patients and consumers. They include the American Medical Association, the advocacy group Autism Speaks and major children’s and disability groups such as the Children’s Defense Fund, Easter Seals and the March of Dimes.  The letter calls vaccines the safest and most cost-effective way of preventing disease, disability and death. It notes that the United States is still experiencing outbreaks of vaccine-preventable illness, disability and death, such as the 2014-2015 measles outbreak that began at Disneyland and the sharp spike of pertussis, or whooping cough, in 2012. The organizations wrote that they would welcome a meeting with Trump “to share the robust, extensive, scientific evidence” supporting vaccine safety and effectiveness. After just over a page of text, the letter continues for 26 additional pages to list all the national and state-based groups that signed as well as a summary of more than 40 studies on vaccine safety.

Va. health officials report second confirmed measles case, warn of potential exposures

Health officials are expanding an investigation into potential measles exposures in Virginia, the District of Columbia and Maryland between May 11 and May 15 after a second case of the disease was recently confirmed. The announcement Wednesday by the Virginia Department of Health followed a May 6 warning of possible exposures in Loudoun and Fairfax counties. Officials said a second case of measles was recently verified in a person who had close contact with the patient who sparked the initial investigation. Health officials across the region are trying to identify people who might have been exposed to the more recent measles case, according to Lorrie Andrew-Spear, spokesperson for the Virginia Health Department. For those who might have been exposed on May 15, officials said that there could still be time for preventive treatment, which is especially critical for high-risk individuals such as pregnant women, infants and those with compromised immune systems. The treatment must be administered May 21 to be effective. Officials urge anyone who believes they might be affected to call 877-275-8343 as soon as possible. Those who have received at least one dose of the measles, mumps and rubella (MMR) vaccine in the past face a very low risk of being infected from any exposure, according to David Goodfriend, a doctor with the Loudoun County Health Department. The disease is easily preventable through the vaccine, which is recommended in two doses for most people, with the first dose given at age 12 to 15 months and the second prior to kindergarten, officials said. But for anyone who has not received a dose of the vaccine, exposure to the highly contagious virus could lead to infection. Listed below are the dates, times and locations of the potential exposure sites associated with the second confirmed case of measles: Officials from the Centers for Disease Control and Prevention last month reported the biggest measles outbreak since 1996, with 129 people infected across 13 states in the United States. Doctors, parents and community residents were urged to look for any sign of the potentially deadly respiratory disease. Measles generally affects young children, according to health officials, and early symptoms include a fever of more than 101 degrees, a runny nose, watery eyes and a cough. The second stage of the illness generally appears around the third to seventh day, when a distinctive red rash appears on the face and spreads over the entire body, officials said. Based on the most recent dates of possible exposure, health officials said that anyone who became infected with the measles virus could develop symptoms as late as June 5. Anyone who develops symptoms is asked to isolate themselves in their homes to limit exposure to others, contact a primary health-care provider, and alert the doctor to the possibility of measles exposure.

Measles cases are spreading, despite high vaccination rates. What’s going on?

It’s now official: Measles cases in the United States are at their  highest level  since 2000, when the disease was  declared eliminated — meaning that regular, year-round transmission had been interrupted.  Five hundred fourteen cases have been reported this year — more than double the previous high, in 2011 — and the number is expected to continue to climb. The measles vaccine is among the most effective, and the vast majority of Americans have either had the measles (and are therefore immune to a second case) or have been vaccinated against it. So why are so many people being infected? One big reason is vaccine refusals: The overwhelming majority of current infections occur in unvaccinated people, most of whom declined the injections for religious, philosophical or personal reasons, according to the Centers for Disease Control and Prevention. But 10 percent of the cases occurred in vaccinated individuals. Even worse, a case study published in February about a woman dubbed “Measles Mary” described a scenario that scientists had not known was possible: In 2011, the 22-year- old New York theater worker, who had been vaccinated, not only contracted the disease but also passed it along to four others, two of whom had also been vaccinated. While this was very rare — it was the first documented case of a vaccinated person passing measles along to others — the case illustrates how the disease can pose a threat even to those who have had their measles vaccine. What’s going on? Briefly, there are two ways vaccines can fail. To understand them, it helps first to understand how vaccines work. Vaccines are made from a deactivated or weakened piece of a   disease-causing pathogen — a virus or bacterium. When the vaccine is introduced into your body, it tricks your immune system into thinking it’s the real deal. The immune system ramps up and creates antibodies, which remain in your system until the day the real pathogen arrives . . . and then BAM! The disease is dead on arrival. That process — the body’s generating antibodies in response to a vaccine — is called seroconversion. But sometimes the person getting the vaccine does not seroconvert: Antibodies are not created, and the person is not protected. This is the first way vaccines can fail, and it happens about 5 percent of the time with the MMR (measles, mumps and rubella) vaccine. That’s the reason for the second shot in the MMR series: After getting it, an additional 3 to 4 percent of people seroconvert, leaving 1 to 2 percent unprotected. Parents who don’t want to vaccinate their kids may ask, “Why does it matter to you that my kids aren’t vaccinated if yours are?” The reason is that an unvaccinated child is more likely to catch a disease and then pass it on to others, including to someone who has been vaccinated but — because of failed seroconversion — is not fully protected. So if vaccines can fail right off the bat, why bother with them? Well, they fail in only a small percentage of the population. Seat belts don’t prevent death 100 percent of the time, and life jackets don’t prevent drowning 100 percent of the time, but they do reduce the risk of death; that’s why we use vaccines — for risk reduction, not risk elimination. But if a person seroconverts after the first MMR shot, does he need the second? The short answer is yes: Most of the time, it’s a good idea. For one thing, a person may seroconvert for the measles but not the mumps or rubella after the first MMR dose. Even if a blood draw to check antibody concentration after the first shot reveals the person has high enough levels to protect against measles, mumps and rubella, the second dose may further increase those concentrations, acting like a booster. And having high concentrations may be good later on because of the second way vaccines can fail: the passage of time. As a successfully vaccinated person ages, the concentration of antibodies decreases, causing immunity to wane. The best known recent example of this is the pertussis vaccine introduced in the 1990s, which waned more quickly than its predecessor vaccine and is partly responsible for the increase in U.S. cases of pertussis, or whooping cough, over the past decade. Waning immunity is the reason for vaccine boosters. (The immunity provided by having caught an infection can also decrease over time.) The initial series of vaccine shots, such as the five on the childhood immunization schedule for DTaP (diphtheria, tetanus and pertussis), provide initial immunity at the highest efficacy possible. Then boosters, such as the Tdap (the adult version of DTaP), are given to strengthen a person’s immunity after it has probably waned. In the case of Measles Mary, the vaccine failure was a result of waning. Researchers already knew that some people don’t seroconvert after contracting measles, but Mary had evidence of antibodies, so failed seroconversion wasn’t the problem. The problem was that her antibodies had waned, making her both susceptible to catching the disease and, apparently, capable of passing it on. This finding is important, but it’s also notable that this occurrence is so rare — so far — that it merited a case study in the medical literature. It’s not the waning antibodies to measles that caught scientists off guard; it’s the fact that she was able to pass on the infection despite having antibodies. It’s the first time since the measles vaccine became available in 1963 that this process has been documented. What this finding means remains to be seen. Because the measles vaccine has been around only about 50 years, scientists don’t know if it can last a lifetime. The Measles Mary case implies not. In fact, since this woman was so young, it implies the vaccine’s effectiveness may wear off in some rare cases in just a couple of decades. Until about six or seven years ago, waning immunity to measles would not have been a major concern. That’s because the United States had high levels of what is called herd immunity —  meaning so many people are vaccinated that a disease has trouble spreading because there are few unprotected people left to pass it along. Not only does herd immunity protect those who are too young, too sick or too immuno-compromised to be vaccinated, it also protects those who have been vaccinated and think they’re protected but actually aren’t. Herd immunity meant that even the measles cases introduced into the United States from abroad wouldn’t travel far. But the recent string of outbreaks spans the country — New York City,  California, Seattle, Massachusetts, Dallas — and they will continue if immunization levels remain low enough to let the disease spread. If the case of Measles Mary indicates that waning immunity from the vaccine is more widespread, the situation may become even more dangerous unless vaccination rates pick up again. Haelle is a freelance science writer. Related: U.S. measles outbreak sets record Potential measles exposure in Virginia, Maryland and D.C.

Not a strong argument for vaccination

I count myself among those who are confused about the reasons some parents choose not to vaccinate their children against childhood diseases such as measles. But the Wonkblog excerpt [news, Jan. 23], “Clusters of vaccine foes foster spread of illness,” did nothing to persuade me to rally with those who believe in the necessity of vaccination. For one thing, of the 34 people who contracted measles and whose vaccination status was known, five were fully vaccinated. What was the status of the others (partially vaccinated, vaccinated in the distant past or totally unvaccinated) and what were their ages? Furthermore, unlike the climate change and evolution deniers who either have limited information or have arguments based on religious beliefs, the anti-vaxxers, as the article called them, are people who generally are pro-science and highly educated, who have high incomes and who have studied this issue carefully before coming to the conclusion that the risk to their children is greater than the slim possibility of contracting a childhood disease that many in my generation had with little or no residual consequences. ****Ray Evert** , McLean**

Local digest: A roundup of D.C.-area news briefs

A case of measles has been confirmed in the District, a spokesman for Mayor Muriel E. Bowser (D) said Tuesday. Michael Czin, the spokesman, said in an e-mail that the case is linked to international travel, not to an outbreak that is believed to have started at Disneyland in California and now totals more than 100 cases. Czin called the District case “isolated,” but he said that the Bowser administration is monitoring the situation and that everyone, especially young children, should be vaccinated against the disease. D.C. Department of Health officials did not respond to requests for information about the current case. The National Zoo said Tuesday that it plans to employ special security-screening measures during especially busy periods that coincide with area school systems’ spring breaks. The measures will include bag checks and restrictions on the influx of visitors on extremely crowded days, the zoo said. It said the measures are similar to those used at other Smithsonian sites. Last year, an Easter Monday shooting near the zoo wounded a 16-year-old and an 18-year-old from Prince George’s County. The attack involved an encounter between members of rival gangs, police said. A 14-year-old pleaded guilty in September to the shooting and was placed under the supervision of the District’s youth correctional agency until he turns 18. **— Michael E. Ruane** President Obama’s proposed transportation budget for the fiscal year that starts Oct. 1 includes $100 million in federal aid to build a light-rail Purple Line in the Maryland suburbs, even though state support for the project remains uncertain. The money would be part of the $900 million in federal construction funds that the Maryland Transit Administration is seeking to build a light-rail line between Montgomery and Prince George’s counties. But the state won’t receive federal construction funds until it secures a “full funding grant agreement” with the Federal Transit Administration, an official said. Whether the state will pursue the federal money under Gov. Larry Hogan (R) remains unclear because Hogan has not said whether he intends to continue O’Malley’s transit plans. **— Katherine Shaver**

Protecting Virginians

Virginia’s General Assembly is poised to act on legislation to protect against meningococcal meningitis, a particularly deadly and almost always destructive set of infections. The proposed law would require vaccination against this disease for entry into middle school and a booster in high school. Despite significant strides in promoting vaccination and a mandate at the collegiate level in Virginia, meningococcal meningitis, which describes different strains of bacterial meningitis, is still very much a threat. From recent meningitis outbreaks at Georgetown University to a death in Russell County, this fast-moving and often tragically misdiagnosed disease continues to inflict the same devastation it brought my family almost six years ago, when we lost my son. There is no question vaccination is the most effective way to prevent bacterial meningitis. According to the Centers for Disease Control and Prevention, vaccinations have significantly reduced the incidence rate, which dropped by 31 percent from 1998 through 2007. However, more than 4,000 cases of bacterial meningitis are reported each year in the United States, and 500 of these cases result in death. Those numbers may, in fact, be higher because not all cases are diagnosed accurately. Even though this childhood vaccination legislation is a significant step forward, it is also important to remember that the disease can strike anyone, regardless of age. My son, Michael Sean Hodges, was 44 when bacterial meningitis ended his life in little more than two days. After coming down on a Wednesday with a severe, migraine-like headache that only worsened, he went to the emergency room that Friday. My normally unshakable son was in tears from the pain. Still, even though he exhibited the known signs of meningitis, he was misdiagnosed with a “raging sinus infection” and sent home against his will. After a couple of hours at home, he became unresponsive and was transported back to the hospital. There, the emergency room physician tentatively diagnosed him with meningitis. Michael was flown to the trauma center, where just hours later his brain swelled beyond any chance of recovery. At 10:30 that evening, just two days after his symptoms started, he was declared brain-dead. I found myself standing in the neurological intensive care unit by my son’s side as the machines that worked to keep him alive were removed. Bacterial meningitis can strike anyone. Through my work with the National Meningitis Association, I have met people of all ages who were infected: a man of 65, a good friend who contracted it in his mid-40s, another friend who was stricken when she was just 9 months old. Everyone is susceptible to the assault of bacterial meningitis. Even with swift treatment, the CDC estimates that between 10 and 14 percent of those diagnosed will die from the disease. When the diagnoses are delayed, even for a short period, the fatality rate climbs to more than 20 percent. At least 19 percent of those who survive the disease will face permanent consequences, including deafness, blindness, organ failure, brain damage and the loss of limbs. While Virginia lawmakers should act on this legislation to ensure children are protected against bacterial meningitis, people of all ages should get the vaccine. Vaccination is the best weapon against bacterial meningitis, and it’s one that we all need to have. **Read more about this issue:** Gal Adam Spinrad: I used to be a vaccine skeptic; now I’m a believer Michael Gerson: Vaccines and what we owe our neighbors Michael Gerson: The enduring benefits of vaccination