Déjà vu. In the winter of 2015 in both the U.S. and Canada, and now again in 2019, an outbreak of measles is underway, setting loose what seems like an endless discussion about immunization. On one side are spokespeople for public health, urging people to check their immunization status. On the other side are impassioned individuals and some organized anti-immunization crusaders.
In 2015 on the CBC I heard a discussion that pitted public health officials against a woman who claimed she had done her research, showing that serious adverse events were common in routine immunization.
What she called research was actually chats she had with other people who were against immunization. She also brought up as evidence the long ago discredited research that falsely claimed a link between measles and autism.
When the interviewer pointed out that her choice not to immunize her children was reducing “herd immunity” and thereby putting others, including immuno-compromised children and adults, at risk of preventable diseases, she replied that she was sorry about that.
When the interviewer pointed out that the source of recent outbreaks were certain religious communities and other groups that were against immunization, she replied that they had a right to their beliefs and that in the end it was about “freedom of choice.”
Why the debate? Immunization campaigns have been so successful that the public no longer has personal experience with the diseases that have been prevented, including diphtheria, whooping cough, tetanus, polio, and certain types of meningitis and ear infections.
In the very recent past it was usual for the public to have had direct experience with these diseases. The public knew of U.S. President Franklin Delano Roosevelt’s post-polio much diminished state. It is remarkable to think that FDR was so much weakened from the disease that if he had died a little earlier from the disease, the Second World War might have been lost.
I had all the classical childhood diseases. I still remember spending a week in a dark room with measles. I recall high fever, nightmares and what must have been delirium, severe light sensitivity, and a seizure, as well.
Lacking experience with measles, many in the public think of measles a nothing more than a fever and rash. In fact, it is a severe respiratory disease including bronchopneumonia, ear infections, sensitivity to light, invasion of the brain often severe enough to cause encephalitis and at times permanent brain damage – yes, and by the way, there is also a rash.
Today we think of measles as a minor illness. We are unaware of the serious multisystem consequences.
Before the MMR (measles, mumps and rubella) vaccine was approved in 1963, almost everyone got measles by the age of 18. In Canada, there were 300,000 cases of measles every year. After the vaccine, that number fell to less than 20.
In recent years there have been a few hundred cases after travellers brought the virus back to Canada. In unimmunized populations, one in five children are hospitalized with measles and one in 1,000 die.
The very success of immunizations has allowed those who deny the efficacy of immunizations, or who have issues with modern medicine, to find a receptive audience.
These deniers distrust doctors and science, sometimes with good reason. They allow their own personal “freedom” to do what they please with their bodies to trump the public good.
Important vaccine side effects do occur but their frequency is many orders of magnitude less than the frequency of major complications and death from the diseases they prevent.
Unless we reach those who distrust modern approaches to the prevention of disease, it is clear that the gains of the past are in danger of being lost, and diseases that were eliminated are at risk of reappearing.
The earth is not flat. The climate is warming. Vaccines work and have eliminated diseases that we hope never to see again.
– Dr. Michael C. Klein, author of Dissident Doctor: Catching Babies and Challenging the Medical Status Quo (Douglas and McIntyre, 2018), lives in Roberts Creek.
