By: Anna Christou
With 50 confirmed cases of measles, Washington is in a state of emergency, and the disease has spread to other states as well: California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, and Texas have each reported at least one case of measles this year. Measles is an extremely contagious, airborne disease caused by a virus that spreads from person to person through coughing and sneezing. The Mayo Clinic states that measles is usually characterized by a fever, sore throat, and a skin rash; within days, it can escalate to severe complications, such as pneumonia and encephalitis, which is the swelling of the brain. Measles can be prevented through the measles, mumps, and rubella (MMR) vaccine, which is generally given in two doses—the first at around 12 months old and the second between 4 and 6 years old—and is 97% effective. Implementing the MMR vaccination program in 1963 led to a 99% reduction in the number of measles cases in the United States. Measles cases continued to decline thereafter, however, starting in 2017, the rate of measles began to increase for the first time since the advent of the vaccination, in large part due to the anti-vaccination movement. In particular, anti-vaccination is linked to this year’s outbreak.
According to the World Health Organization, vaccination, in general, prevents 2 to 3 million deaths every year and has the potential to prevent millions more if vaccination becomes more widespread. Vaccines prepare the body to fight a pathogen by activating the immune system. The immune system, which is in charge of protecting the body from infection, recognizes unhealthy cells that have entered the body and activates a response. Specifically, it releases a variety of white blood cells, including T cells and B cells, which travel to the site of the foreign invader. Both T and B cells develop a way to “remember” the invader in order to more efficiently fight the infection if the body is re-exposed. In addition, B cells secrete antibodies, which are proteins produced by blood cells that neutralize pathogens by latching onto them and thus effectively removing them from the body. On the other hand, T cells also directly kill microbes. Vaccines expose a person to a small amount of the virus—this activates the immune response and teaches the body, particularly the T and B cells, to develop a memory for a pathogen. That way, if a person is re-exposed to the virus, the T and B cells will more efficiently and effectively mount an immune response that protects the body.
However, many people with access and the ability to receive vaccines are reluctant to get vaccinated for a variety of reasons, including thinking that vaccines are unsafe and linked to autism; that acquiring immunity naturally is more effective; and that they will be protected by herd immunity.
The modern-day anti-vaccination movement began in 1998, when Andrew Wakefield, an English doctor, published a paper asserting that there was a link between the MMR vaccine and autism, spurring fear in many and receiving a significant amount of media attention. However, this theory has been completely disproven: the data has been proved to be unreliable and false, and numerous other studies have been conducted and have shown that there is no relationship between vaccines and autism. In particular, medical records have shown that the children did not show symptoms of autism, or if they did, this was not due to receiving vaccines, as they had already shown signs of autism before the study.
Another common concern is that the vaccine will overwhelm the immune system or even lead to the person contracting that disease. In reality, despite being exposed to the virus, one cannot get sick from the vaccine, because only a dead or a weakened version of the virus is injected into the body. Some people might experience a minor reaction to vaccines, such as a fever or rash, but this is not a reaction to an active virus but just the presence of a foreign pathogen.
In addition, some people have personal beliefs that building immunity naturally is more effective than receiving a vaccine. They think that if they contract the disease and survive, then they will be protected in the future. However, the problem with this philosophy is that in order to build immunity naturally, one has to contract the disease, which as described above, has very severe symptoms and complications and can pose a risk to others, as well.
Finally, many people think that they will be protected if everyone else is vaccinated, misinterpreting the concept of herd immunity, which is the idea that an entire community is protected from a disease if immunity rates are sufficiently high. Specifically, as diseases spread amongst people in a community, if enough people are vaccinated, then the diseases will be less likely to spread. This, in theory, protects people who are not vaccinated. However, herd immunity only works when immunity rates are very high—close to 95%. That way, only the small unvaccinated cohort of the population, namely the immunocompromised patients who cannot be vaccinated or newborns who are not old enough to receive the vaccine, will be protected. However, if people with healthy immune systems and no allergies to vaccines decide to not become vaccinated and less than 95% of the population is immune, then those who are unvaccinated have a higher risk of contracting the disease. But, if everyone who is able to get vaccinated does so, then not only will the immunocompromised be protected but those who have been vaccinated will also be even safer, as the overall spread of the disease—and risk of contracting it— will be low.
As a result, especially given the link between anti-vaccination and the recent measles outbreak, it is very important to refute the anti-vaccination movement and spread of misinformation. Healthcare officials have started to draw attention to this issue: for example, the World Health Organization listed vaccine hesitancy as one of the top ten threats to global health in 2019. Realizing that vaccines do not make people sick, do not cause autism, and are far more effective and safe than trying to develop immunity naturally, is a step towards ensuring that people who can get vaccinated, do get vaccinated.