Measles

Measles: Putting the Hysteria into Perspective

Growing up I thought the prevention of measles was simple - you vaccinate. Everyone did it, I did it, I had no reason to question it. It wasn't until I was plunged into parenthood with little ones depending on me that I took the time to seriously read up on the topic. There was a different opinion floating around every corner so I decided to get some definitive answers by looking at the medical research. The problem I found was the further I dug into the research, the more problematic and unsettling the topic became.

Vaccines... they don't work quite how you think
One of the more startling revelations the research revealed was that most vaccines, including the measles vaccine, don’t protect against contracting infection but will often reduce or prevent symptoms of infection [1-7].
"Many vaccines are primarily intended to prevent disease and do not necessarily protect against infection." - Andre et al. World Health Organization, 2008 [7]
Andre et al go on to state that just two vaccines, the HPV and Hep A vaccine, may have the ability to prevent infection.

This fact is NOT widely known, not only because it's virtually never mentioned publicly, but also because medical terminology can be a little deceiving. When we read that "vaccines prevent disease" we equate the word "disease" with "infection", but that's not the case in medical literature. "Disease" is defined as a state causing symptoms of ill health, however you can easily have an infection without symptoms of ill health. Disease and infection are two very different terms.

So, we can say that vaccines prevent disease, because they can (though not always) prevent the symptoms of ill health, yet they commonly don't stop infection or its transmission. We can also say that vaccines can prevent the spread of the disease, because without symptoms such as coughing the infection is less likely to spread, though it is still present in saliva and nasal secretions.

Disease prevent is NOT just about vaccines
The big issue I have with the current strong push for measles vaccination (and all vaccination), is that it's just one of the methods that reduces the symptoms (and therefore spread, of infection). There are many, many more methods of disease prevention besides vaccination that are proven in medical literature.

Breastfeeding is one such highly underrated disease prevention method that stands out. It is shown in studies to dramatically reduce the rate of symptomatic infection in babies [8]. The protection is known to continue against certain types of infections for up to 10 years [9].

But it doesn't stop there. Breastfed children are...

5 times less likely to have more than 1 illness.
*compared to infants exclusively formula fed for 5 months.

16 times less likely to have 3 or more illnesses.
*compared to infants exclusively formula fed for 5 months.

5 times less likely to need hospitalization.
*compared to formula fed babies for the first 6 months of life.

6 times less likely to be hospitalized due to infection.
*compared to formula fed babies for the first 6 months of life.

5 times less likely to have gastrointestinal illness.
*when compared to infants exclusively formula fed for the first 13 weeks of life.
*any infection of the digestive tract caused by bacteria, viruses, or parasites.

4 times less likely to have necrotising enterocolitis.
*compared to formula fed preterm infants.
*necrotising enterocolitis is a condition where portions of the bowel undergo tissue death, it has a death rate of 20-30%.

4 times less likely to have diarrhoeal disease.
*compared to infants breastfed for 6 months or more.

4 times less likely to be hospitalized for lower respiratory tract diseases.
* compared to infants formula fed for 4 or more months
* lower respiratory tract diseases include bronchiolitis, asthma, bronchitis, pneumonia, empyema, and infections due to specific agents (eg, respiratory syncytial virus).

4 times less likely to have pneumococcal disease.
*compared to formula fed infants.
*pneumococcal disease is a bacterial infection that can present as pneumonia, bacteremia, meningitis, middle ear infection, and sinusitis.

3 times less likely to have ear infections.
* compared to infants exclusively formula fed for six months.

2 times less likely to have conjunctivitis.
* compared to infants exclusively formula fed for six months.

7 times less likely to have thrush.
* compared to infants exclusively formula fed for six months.

(See this post for stats related to not breastfeeding and a list of references.)

Those are some serious stats showing breastfeeding has the ability to prevent not just one, but a multitude of illnesses, and without the risk of side effects.

Why the hysteria over MMR?
With that in mind, let’s look at the recent MMR vaccine publicity. The measles rates are within a normal range compared to recent years [10], there have been no measles associated deaths, and measles is well known to be a benign illness in most individuals [11]. Yet the current measles hysteria seems even worse than the recent Ebola scare.We have articles calling for non-vaccinating parents to be sued if their child infects another child, to be put in jail, their children taken away and forcibly vaccinated, and addresses of non-vaccinators to be made public. Then there's the vitriol spewed through social media with commenters labelling non-vaccinators child abusers, vile monsters, and ignorant science-deniers, along with threats of violence and death.

Are we enforcing a double standard on parents?
Let's pretend that treating non-vaccinating parents this way is acceptable for a moment (it's not). If this is the way we've decided as a society to treat parents who choose not to adopt specific disease prevention methods for their children, tell me where are the witch hunts calling for parents who refuse to breastfeed to be sued if their child infects another child, for non-breastfeeders to be put in jail, their children taken away and forcibly breastfed, or addresses of non-breastfeeders to be made public?

We know that breastfeeding reduces a myriad of infections, including pneumococcal disease which can progress to dreaded meningitis [12]. We're not talking about a little possible benefit, we're talking about real, tangible prevention of disease and death through breastfeeding. Studies show breastfed babies are 5 times less likely to be hospitalized for infection - we are talking about the prevention of hospitalization for thousands of babies [13].

Parents have been prosecuted for not vaccinating their child who consequently died from a "vaccine preventable disease" [14]. Should the same be done to parents who refuse to breastfeed, whose child consequently dies from a "breastmilk preventable disease"?

Adopting pro-vax rhetoric we could conclude non-breastfed kids are a threat to our children, and the rest of the community. They are more likely to carry disease, they could infect vulnerable newborns, elderly folks, or chronically ill patients. They should not be allowed to go to daycare or preschool, or at least must be sent home when there is an outbreak. Doctors who don’t enforce mandatory breastfeeding for their patients should lose their licence. In fact, anyone who advocates that breastfeeding shouldn’t be mandatory should be publicly shamed. Parents who don’t breastfeed are irresponsible, neglectful, stupid, and anti-science. They literally want to their child to die. (Yes, these are word-for-word comparisons of pro-vax rhetoric.)

Sounds hideous when you attack mothers about not breastfeeding doesn’t it? Something like propaganda spread by a dictatorship.
Dictatorship, form of government in which one person or a small group possesses absolute power without effective constitutional limitations… Dictators usually resort to force or fraud to gain despotic political power, which they maintain through the use of intimidation, terror, and the suppression of basic civil liberties. They may also employ techniques of mass propaganda in order to sustain their public support.”
- Encyclopaedia Britannica 
Propaganda, dissemination of information—facts, arguments, rumours, half-truths, or lies—to influence public opinion.”
- Encyclopaedia Britannica
While we’re at it…
Bullying, intentional harm-doing or harassment that is directed toward vulnerable targets and typically repeated. Bullying encompasses a wide range of malicious aggressive behaviours, including physical violence, verbal mockery, threats, ostracism, and rumours spread either orally or by other means of communication, such as the Internet.”
- Encyclopaedia Britannica

How do you think someone who couldn’t breastfeed would feel hearing the above statements? Imagine breastfeeding (like vaccines) did have major risks, and a parent had a child who severely reacted to breastmilk resulting in permanent brain damage. The family doctor refused to admit that the breastmilk caused the reaction and insisted the child continue to be breastfed. How scared do you think the parent would feel when faced with the possibility of mandatory breastfeeding? How heartbroken and disillusioned do you think she would feel hearing someone call her “neglectful” or “stupid”?

These tactics - whether used against those who don't breastfeed or don't vaccinate - are cruel, unfair, and unethical.

Disease prevention is a lifestyle
There’s plenty of analogies that can be used for vaccination besides breastfeeding...
  • avoiding people when sick
  • washing hands
  • not sharing drinks or food
  • eating a healthy diet
  • getting enough exercise
  • not smoking
  • not drinking alcohol
All of these life style choices are shown in studies to have a profound impact on the immune system. Best of all these don’t carry the risks that vaccination does.

Why are these factors not gaining more attention in the fight against not just communicable disease but all disease? Why is the public not rabidly demanding that others be forced to adopt these lifestyle changes like they are for vaccination? After all if people don’t avoid others when sick, don’t wash hands, share food and drink with others, eat an unhealthy diet, get no exercise, chain smoke, and binge drink, they could well become a cesspool of disease - in theory they are a risk to the public. 

So why the double standard when it comes to vaccination?

Protecting individual choice
At the end of the day we do have a responsibility to try to prevent disease in our community. But it must be recognized that there is more than one way to prevent disease - vaccination is not our only hope. The combination of prevention methods that is right for one person may be wrong for someone else. Insisting that we know what is right for others is naïve, arrogant, and dismissive of individual variability. Medicine has never been a "one size fits all" regime.

As "safe" as vaccines have been touted, we can never guarantee the benefit outweighs the risk for someone else. It won't be us (or the doctor or the pharmaceutical company) paying the price if the vaccine backfires, it will be the individual. Given the seriousness of possible consequences and lack of vaccine safety testing/monitoring, the choice to vaccinate MUST remain with the individual.


Sources:

1. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model. Jason M. Warfel et al. doi: 10.1073/pnas.1314688110

2. Estimated susceptibility to asymptomatic secondary immune response against measles in late convalescent and vaccinated persons. Damien B, et al. J Med Virol. 1998 Sep;56(1):85-90. PMID: 9700638

3. Investigation of a measles outbreak in a fully vaccinated school population including serum studies before and after revaccination. Matson DO et al. Pediatr Infect Dis J. 1993 Apr;12(4):292-9. PMID: 8483623

4. Nonclassic measles infections in an immune population exposed to measles during a college bus trip. Helfand RF et al. J Med Virol. 1998 Dec;56(4):337-41. PMID: 9829639

5. Vaccination against measles: a neverending story.
Koert J Stittelaar et al. Expert Rev. Vaccines 1(2), 151–159 (2002).

6. Endpoints in vaccine trials.
Michael G Hudgens, et al. Statistical Methods in Medical Research 2004; 13: 1^26

7. Vaccination greatly reduces disease, disability, death and inequity worldwide.
FE Andre et al. Bulletin of the World Health Organization, Feb 2008, Vol 86, Number 2, 81-160

8. Outcomes of Breastfeeding
Ginna Wall, MN, IBCLC, February 2013

9. Protective effect of breastfeeding: an ecologic study of Haemophilus influenzae meningitis and breastfeeding in a Swedish population. Silfverdal SA et al. Int J Epidemiol. 1999 Feb;28(1):152-6. PMID: 10195681

10. Notifiable Diseases and Mortality Tables
MMWR / February 13, 2015 / Vol. 64 / No. 5

11. Measles, CDC Pinkbook

12. Risk of Formula Feeding
Natural Mama NZ

13. Infectious disease hospitalizations among infants in the United States.
Yorita KL et al. Pediatrics. 2008 Feb;121(2):244-52.

14. The anti-vaccine couple facing prison over the death of their toddler from meningitis
Michael E. Miller Friday 18 March 2016 16:29 GMT