THE MEASLES IMMUNIZATION DEBACLE IN THE US AND THE AFRICAN PERSPECTIVE

Since the beginning of the year, the medical world has being awash with news of the latest measles outbreak in America. Many were shocked to hear that some American parents were refusing to get their children vaccinated against measles. Not very often do we hear news of such major failings in the Western world. That a major superpower has an outbreak of measles in contemporary times is unimaginable. Imagine an African tribesman in a remote African village without access to space technology launching a spacecraft to Mars! Or a neonate that can speak perfect Chinese at birth! It is that strange. Before judgment is passed on such a highly informed people, it is only fair to first examine the origin of this latest story.

The Official Story

The Centers for Disease Control and Prevention (CDC) claims that the “outbreak likely started from a traveler who became infected overseas with measles then visited an amusement park in California while infectious”. Since then, about 121 people across 17 states and Washington DC have been reported to have measles. 85% (103) have been linked to the initial case in December 2014. The CDC rushed to contain the outbreak and counseled vaccination to prevent a reoccurrence. Some politicians with (? African DNA) then decided to play “politricks” with the issue and shouted that parents had a right to prevent their children from being vaccinated! 

Hence, the debate started with the pro-vaccination guys trying to shout down the anti-vaccination guys; and the anti-vaccination guys shouting right back at them. What a titanic battle it has been since then with the different camps quoting scientific studies to support their claims. Last week, some parents were rumored to have organized so called “measles parties” in California. These parties are said to be willingly organized gatherings between healthy children and measles-infected children so that the non-infected and healthy children can get infected with the virus and acquire immunity. They prefer to give children the disease rather than the vaccine! This raises the question of how dangerous is this disease and how safe is the vaccine?

The Disease

Measles is considered one of the most contagious viral diseases on earth. A patient with measles can directly infect between 12-18 people while a patient with mumps can directly infect 4-7. A patient with measles can also infect a non-immune person up to 2hrs after the infected person has left a room. That is how contagious it is. It is also quite fatal. The World Health Organization (WHO) considers measles as one of the leading causes of death among children worldwide. In 2013 145,700 children died from measles alone. It also leads to disabilities like mental retardation, deafness and blindness. It causes complications like diarrhea, dehydration, pneumonia and encephalitis. It causes a rare but long term complication called Subacute Sclerosing Pan Encephalitis or SSPE. These are all well documented. There is presently no approved specific antiviral treatment for measles. So, one wonders why a loving parent will refuse to have his/her child vaccinated to protect the child from such harm. The answer may lie at the flipside of the coin; the measles vaccine.

The Vaccine

The measles vaccine is a live attenuated vaccine usually given before the 1^st birthday and between 6-8years. (The exact time of vaccination varies across countries). The vaccine can be given as a standalone injection or in combination with others e.g. the Measles, Mumps and Rubella vaccine or MMR. The measles vaccine was developed by Dr. John Franklin Enders who worked with Dr. Thomas C. Peebles at Children's Hospital Boston. According to Wikipedia, the first clinical trials of the measles vaccine were undertaken by David Morley at the Wesley Guild Hospital in Ilesha, Nigeria on his own children. The vaccine was then introduced to the US in 1963 and has since helped to reduce the incidence of measles from hundreds of thousands pre-1963 to barely less than 200 cases in 1997-2013. In fact the CDC declared measles eradicated from America in 2000. This feat was achieved through an excellent vaccination program that spanned four decades. But in 2014 there was a rise to 610 cases and 121 cases have been reported in January- February 2015 alone.

Before the worldwide drive for immunization began in 1980, measles caused approximately 2.6 million deaths annually. From 2000-2013, measles vaccination prevented about 15.6 million deaths. The vaccine though potent has certain drawbacks as well. The reported drawbacks of the vaccine are fever, injection site pain and, in rare cases, Thrombocytopenic purpura. There have also been reported cases of febrile seizures after vaccination. Serious side effects are extremely rare.

The Controversy

The present measles vaccination controversy was probably started in 1998, when a British gastroenterologist Andrew Wakefield published a study in The Lancet medical journal linking measles with autism. The study was later proved to be false and withdrawn by the reputable Journal in 2010. Dr Wakefield then had his medical license withdrawn because he was found to have received money ($675,000) from a lawyer who was suing the vaccine makers. Yet another study by Dr. Lee Hieb, an orthopaedic surgeon and past president of the Association of American Physicians and Surgeons stoked the Controversy fire even more. Her study showed that since 2005 there have been 86 deaths from the MMR vaccine – 68 of them children under the age of 3 years old. In addition the anti-vaccination guys have shouted to high heavens that the CDC has reported no case of death from measles in the last 12 years as against 108 cases of adverse reaction to the vaccine reported in the same period.

The burden of evidence though, seems to lie in favor of no association between measles and autism in particular. According to USA TODAY, fourteen scientific studies have found no link between measles vaccines and autism. Seven have found no link between autism and thimerosal, a preservative no longer used in childhood vaccines. And two studies have failed to find any link between autism and the number of vaccines a child gets. Several respected Medical bodies have also joined in the debate. The Centers for Disease Control and Prevention, the Institute of Medicine of the National Academy of Sciences, the UK National Health Service and the Cochrane Library review have all concluded that there is no evidence of a link between the MMR vaccine and autism.

How did the USA which previously hailed vaccination as a scientific miracle now come to regard it as a negative phenomenon? Why after several years of successfully fighting the virus will they say that their weapons are now dangerous?

Watch out for answers in my next post.