Measles | The Magpie Gazette

Vaccination Nation

June 13, 2021 Vita Historia

“What made eradication possible was a really good vaccine and political support. There was a real incentive to do it. You don’t ask a cow if it wants to be vaccinated. You just do it.”
— Ron DeHaven, former CEO of the American Veterinary Medical Association, speaking about the eradication of rinderpest, a cattle disease related to the measles virus.

Rinderpest and smallpox are the only two infectious diseases that have been eradicated around the world. Smallpox is the only disease to be eradicated that infects only people. Eradication of other infectious diseases, like COVID-19 for one, is unlikely because there are alternate hosts in the animal population, and while it may be feasible to vaccinate domesticated animals such as cows to the point of herd immunity, it is unrealistic to think the same can be done for wild animals.

Ruins of 19th-Century Smallpox Hospital - Roosevelt Island - New York City - USA - 01 (41147019525)

Ruins of the Smallpox Hospital built in the 19th century on Roosevelt Island in New York City. Photo by Flickr user Adam Jones.

Cows have another favorable trait in reaching herd immunity besides being easily available for their shots, which is that they don’t subscribe to bizarre, illogical, and unscientific conspiracy theories egging them on to refuse vaccinations, if that was a possibility for them. Rinderpest, like its cousin infecting humans, the measles virus, is among the most contagious diseases on the planet, and the more contagious a disease is, the higher the percentage of a susceptible population must be vaccinated in order to achieve herd immunity. For measles and rinderpest, that’s over 90 percent.

Smallpox is – was – in the middle of the scale as far as its contagious qualities, but among the deadliest at around 30 percent fatalities. Influenza, with notable exceptions throughout history, such as the 1918-19 Spanish Flu outbreak, is at the lower end of the scale for both contagiousness and deadliness. COVID-19, like the other Severe Acute Respiratory Syndrome (SARS) viruses to which it’s related, is higher up the scale for contagiousness than the annual flu, but it is nowhere near as deadly as smallpox, though deadliness as always is strongly affected by a victim’s socioeconomic circumstances. The poor, as always in any affliction, die in droves, while the better off have access to the best care and are less likely to be infected in the first place.

One by one through the nineteenth and twentieth centuries, diseases that had killed hundreds of millions over thousands of years were brought under control with vaccines and other public health measures, such as better sanitation. There have always been people of skeptical of the effectiveness of vaccines or suspicious of the motives of the medical people, often affiliated in one way or another with a government entity, who administered the vaccines. The difference in then from now is that before about 1980 evidence of a world without vaccines was still readily available to everyone, rich and poor, living in the industrialized northern hemisphere or in the largely agricultural southern hemisphere.

In 1947, when the threat of disfigurement or death from smallpox was still very real to everyone, the citizens of New York City lined up for blocks to receive vaccinations in order to stem a possible outbreak.

Today, people in richer countries no longer see the effects of smallpox at all, and rarely do they see the effects of less disfiguring, less deadly diseases like measles. If COVID-19 were to leave visible scars on those who suffered and survived, instead of just the internal scars it does leave, one wonders if at least some of the people ready to dismiss the seriousness of the disease and the severity of the outbreak would be as obstinate about complying with public health measures.

If there were still children crippled by polio in every neighborhood, would there still be people who are more willing to believe an insane theory about vaccines they read in their Facebook “news” feeds than the scientific fact of once rampaging infections brought to heel in the past two hundred years? No doubt there will always be some hard cases who can’t be reached through reason, no matter what. The amount of the U.S. population vaccinated against COVID-19 is currently about 43 percent, and it needs to be over 70 percent to reach herd immunity. It will be best to cross that threshold before cold weather sets in again, forcing people back indoors. If it’s not, then COVID-19, a disease that will likely never be eradicated, only controlled, could surge once more, making this summer of relative freedom appear in retrospect like a fool’s paradise.
— Vita

Health American Veterinary Medical Association, Animals, Cattle, Conspiracy Theories, COVID-19, Cows, Diseases, Facebook, Influenza, Measles, New York City, People, Polio, Poor People, Public Health, Rich People, Rinderpest, Ron DeHaven, Roosevelt Island, Severe Acute Respiratory Syndrome (SARS), Smallpox, Smallpox Hospital, Spanish Flu, United States, Vaccines, Viruses

Everyone Has an Opinion

February 10, 2019 Vita Historia

The measles outbreak in Clark County, in the southwestern corner of the state of Washington, across the Columbia River from Portland, Oregon, has brought national attention to the beliefs of people who do not get some or all vaccinations for one reason or another, because vaccination rates in Clark County are far below the national average. The term many have come to apply to these people is “anti-vaxxer”, though it unfairly lumps everyone together, including people who are less against vaccines as they are for personal liberty, or who object on religious grounds. Since vaccination is a public health issue, however, the reasons for not getting vaccinated do not matter as much as the effects.

The history of the differing reasons for vaccine opposition goes back to the introduction of the smallpox vaccine, primarily by Edward Jenner, in the late eighteenth and early nineteenth centuries in England. The idea that to combat a disease a person should voluntarily introduce a weakened form of it into his or her body ran counter to reason. Vaccination methods of the time were far cruder than today, and since sterilization of wounds and bandages were little understood, infection often followed upon vaccination. The alternative was death or disfigurement from a full force smallpox infestation, and some religious folks actually expressed preference for that because it was “God’s will.”

In Merawi, Ethiopia, a mother holds her nine month old child in preparation for a measles vaccination. One in ten children across Ethiopia do not live to see their fifth birthday, with many dying of preventable diseases like measles, pneumonia, malaria, and diarrhea. British aid has helped double immunization rates across Ethiopia in recent years by funding medicines, equipment, and training for doctors and nurses. Photo by Pete Lewis for the United Kingdom Department for International Development (DFID).

Measles world map-Deaths per million persons-WHO2012

World Health Organization (WHO) 2012 estimated deaths due to measles per million persons, with bright yellow at 0, dark red at 74-850, and shades of ocher from light to dark ranging from 1-73. Gray areas indicate statistics not available. Map by Chris55.

Those who didn’t object to vaccination on grounds of cutting into a healthy body and introducing a light case of the disease or a bad case of infection, or of meddling in God’s will, objected to the perceived unnaturalness of the procedure since the vaccine ultimately came from cows infected with cowpox. To those people, introduction into the human body of something from an animal was unwholesome, even dangerous. Never mind that people do the same thing all the time when they eat meat, presumably from animals and not from other people, without the ill effects these folks foresaw, such as taking on the traits of animal whose parts were introduced directly into human flesh. On the other hand, perhaps they were taking the dictum “you are what you eat” to a logical extreme somehow unimpeded by the process of digestion.

It is probably best not to overload these viewpoints with the rigors of logic. People have their opinions, and they often do not bother to make the distinction between opinions and facts. The fact is that through vaccination programs, smallpox has been eradicated worldwide since the middle of the twentieth century, roughly 150 years after introduction of the vaccine. Similarly, measles in the United States disappeared around the turn of this century after nearly 50 years of vaccinations. About the time measles was going away in this country, in 1998 a doctor in England, Andrew Wakefield, published a report in the English medical journal The Lancet linking the MMR (Measles, Mumps, and Rubella) vaccine to autism and bowel disorders, and though the findings in the report and Dr. Wakefield himself were soon repudiated by the majority of other medical professionals, some anti-vaxxers latched onto the link with autism and have been running with it ever since, regardless of the lack of evidence to support the link.

Centers for Disease Control and Prevention (CDC) statistics on U.S. measles cases (not deaths). Chart by 2over0.

The problem with anti-vaxxers of one stripe or another running with opinions mistaken for their own version of the facts is that vaccinations are needed most by vulnerable populations such as the very young, the very old, and people with suppressed immune systems. Infants cannot be vaccinated against measles at all. Many of these vulnerable people are in the position of having decisions made for them by responsible adults. In the case of children, that would be their parents, who of course have the best interest of their children at heart. The difficult point to get across to those parents is that in a public health issue involving communicable diseases, their decision not to vaccinate their children affects not only their children, but those other most vulnerable members of the greater society as well. Public health is a commons, shared by all, like clean water and clean air, and the tragedy of the commons is that a relatively few people making selfish decisions based on ill-informed opinions can have a ripple effect on everyone else. Personal liberty is a fine and noble ideal, but when it leads to poisoning of the commons then quarantine is the only option, either self-imposed or involuntary.
— Vita

Health Andrew Wakefield, Anti-Vaxxers, Autism, Bowel Disorders, British, Centers for Disease Control and Prevention (CDC), Clark County, Columbia River, Department for International Development (DFID), Edward Jenner, England, English, Ethiopia, Measles, Merawi, MMR (Measles Mumps and Rubella) Vaccine, Oregon, Portland, Public Health, Quarantine, Smallpox, The Commons, The Lancet, United Kingdom, United States, Vaccination, Vaccines, Washington (state), World Health Organization (WHO)