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Carmelo Hernandez

ENG 1101

Kari Carter

15 April 2019

The War on Measles

Vaccines are by no means anyone’s best friend, but they play an important role in

maintaining our health. Many would argue that vaccines are actually the contrary though. One

very important vaccination is known as the measles, mumps, and rubella (MMR) vaccination and

it has been the center of attention for vaccination debates over the past twenty years. Some

would argue that the risk involved in receiving the MMR vaccine heavily outweigh the benefits.

Receiving the MMR vaccine is a personal choice, but not doing so may leave yourself and others

at risks for infection. It is essential for our society to enforce MMR vaccination if we intend to

maintain positive public health against the measles virus.

For the past 20 years, the World Health Organization (WHO) set a goal to eradicate the

measles virus. The WHO utilizes measles-containing vaccines (MCV) in order to do so. To

accomplish this goal, they set out to reach three milestones: maximize the national coverage of

the initial measles-containing vaccine (MCV1), reduce measles mortality, and reduce the number

of measles cases worldwide. The six WHO regions were closely monitored to measure the

coverage of MCV administration, measles incidences, and deaths caused from the virus. Over the

past 20 years the MVC1 vaccine coverage has increased by 13%. The better coverage of MVC1

showed a decrease of both measles incidence and deaths by roughly 83%. To put this in

perspective, the MMR vaccine has saved more than 21 million lives worldwide. This portion of

the study only concerned the initial MMR vaccination administration. When the WHO continued
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their study to include the supplementary MVC as well, the findings were even more positive than

the introduction of MCV1 (Daggbah 1323). This evidence would suggest that the MCV provides

adequate protection against the measles virus and reduces the number of infections and deaths

globally.

Recently there have been several measles outbreaks in the United States. Jaqueline K.

Olive and her colleagues conducted a study to find out what may be causing these sudden

outbreaks and identify potential risk factors. For this study, Olive et al hypothesized that measles

outbreaks could be related to non-medical exemptions (NME) for schools. NME exist for

children that have certain religious or philosophical beliefs that would prevent them from

receiving vaccinations. Olive found that eighteen states allowed philosophical NME and twelve

of the eighteen states allowed both religious and philosophical NME at the time of the study. The

groups of philosophical NMEs represents members of the Anti-Vaccination Movement in the

study. The study then focused on the percentage of children attending school with NMEs.

The study found that the percentage of NMEs directly correlated to chance of

measles outbreaks and that children with NMEs were 35 times more likely to contract

measles. This can be attributed to the correlation between NMEs and MMR vaccination

coverage. The study showed that there was a “significant inverse association” between

NME percentages and MMR vaccination coverage. According to Olive, “NMEs weaken

herd immunity that protects the population at large, particularly children who are unable

to get vaccinated for medical reasons,” and ideal herd immunity requires about 90-95%

vaccination coverage. Herd immunity is used to protect immunodeficient individuals

such as infants, elderly, cancer patients, and many others. When herd immunity is

weakened, it makes communities highly susceptible for a measles outbreak. Olive cites a
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good example of this weakened herd immunity can be seen in the measles outbreak in

Disneyland in 2014. Ever since the resurgence of measles, many of the states that allowed

NMEs have made stricter regulations and encouraged medical providers to educate their

patients. This study suggests that vaccine hesitant individuals pose a risk to public health

by refusing to have the MMR vaccine administered to themselves and their children, they

subsequently lower the herd immunity of their community and put immunodeficient

citizens at risk for infection.

So why are some parents refusing to vaccinate? With the overwhelming amount of

research that is available on the subject, it makes you wonder how the other side of the argument

justifies their position. There are several different stories from parents that choose to forego

immunization due to a medical complication. One common complaint is that vaccines like MMR

can cause behavioral disorders (autism spectrum disorder, bipolar disorder, ADHD) and

allergies. Another concern is that harmful toxins are injected into the body via vaccines. Others

have the theory that Big Pharma and medical providers are not revealing the entire truth behind

the dangers of vaccines in order to make a buck (Kluger 42). There is merit to be found in the

Anti-Vaccination movement to a certain degree. These parents are genuinely worried for the

safety of their children and are skeptical about information about MMR and other vaccines due

to conflicting information. “Even epidemiologists and school administrators agree that antivax

parents are motivated by nothing more than what they think is right - despite the science showing

they are wrong” (Kluger 42).

Susan Senator, a prolific author with several books concerning autism spectrum

disorder, recounts in an article from Psychology Today, her history as an anti-vaxxer. Her

second son was vaccinated and later developed autism. She began looking for answers as
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to how her son may have developed autism. This was about the time that she found an

article in an English medical journal called The Lancet (Senator).

In 1998 The Lancet issued an article discussing a link between the MMR vaccination and

chronic colitis and developmental disorders. This article pointed out in particular that the MMR

vaccination was linked to autism. The article continues on to describe how the study was

conducted:- “Fudenburg noted that 15 of 20 autistic children, the first symptoms developed

within a week of vaccination” (Wakefield et al 640). This is the primary evidence that the anti-

vaccination groups have accepted as the truth. However later studies found that the information

in Wakefield’s article was heavily flawed and misconstrued. In Wakefield’s study, he reported

that he used twelve randomly selected children. Wakefield’s article was brought into question

because of the relatively small sample size. Even so, no other agency was able to recreate

Wakefield’s results with similar conditions or a link between autism and vaccines. It was later

discovered that the children used in the study were carefully selected to tailor the results of the

test. Furthermore, Wakefield and his colleagues research was funded by lawyers with pending

lawsuits against vaccine manufacturers. After this evidence was discovered, the Lancet was

required to retract the article. But at this point the damage had already been done. Tens of

thousands people trusted this article and it resulted in one of the worst measles outbreaks in

English history. However, there are still anti-vaccination groups that believe that Wakefield’s

study is accurate even after the retraction (Eggertson). This single article sparked an enormous

debate and is the reason measles is more of a threat to our society.

The individuals that oppose vaccines are not unintelligent. It is quite the contrary.

Many members of the Anti-Vaccination movement are well-educated and make a decent

living. But with little scientific evidence supporting anti-vaccination, it is difficult to

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justify why this is the best course of action. Kluger notes that antivax individuals who are

wealthier and more educated gradually start to believe that they can control everything

and remove the risk themselves. Susan Senator eventually started to see that Wakefield’s

study in The Lancet was wrong and allowed her third son to receive vaccination. Senator

describes that she slowly started to accept that the information she had received was

wrong (Senator).

Following Jaqueline Olive’s study on NME rate compared to MMR vaccination

rate, several states started to impose stricter legislation for getting an NME in conjunction

with increasing the availability of vaccinations. There will be a more thorough saturation

of information if the public had educational programs available. The biggest

responsibility will fall on medical providers to educate every patient and illustrate the

dangers of not receiving the MMR vaccine. Increased vaccination rates and reduced risk

of measles outbreaks will follow if communities engage in more targeted education and

require providers to provide education to vaccine hesitant patients and parents against

continuing NMEs (Olive et al).

You may not be the biggest fan of vaccines, but the undeniable truth is that they

are important to maintaining good health. The WHO will keep striving everyday to reach

their goal of eradicating the measles virus. Until the Earth is completely rid of all

infection, we will need the vaccinations to keep society healthy by maintaining herd

immunity. Even if there are those that still believe the evidence Wakefield published or

some other outlandish theory, MMR vaccination needs to be a priority. If medical

providers and other health agencies band together to increase public awareness and
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educate them on the MMR vaccine, we will live in a healthier society potentially rid of

the measles virus. So do the responsible thing and go get your shots.

Works Cited:

Dabbagh, Alya, et al. “Progress towards Regional Measles Elimination - Worldwide, 2000-

2017.” Weekly Epidemiological Record, vol. 93, no. 48, Nov. 2018, pp. 649–660.

Academic Search Complete,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=a9h&AN=133296604&site=ehost-live.

Eggertson, Laura. “Lancet Retracts 12-year-old Article Linking Autism to MMR Vaccines.”

National Center for Biotechnology Information, 4 February 2010,

www.ncbi.nlm.nih.gov/pmc/articles/PMC2831678. doi:10.1503/cmaj.109-3179

Kluger, Jeffrey. “Who’s Afraid of a Little Vaccine?” TIME Magazine, vol. 184, no. 13, Oct.

2014, pp. 40–43. Academic Search Complete,

sinclair.ohionet.org:80/login?url=https://search.ebscohost.com/login.aspx?direct=true&d

b=a9h&AN=98516496&site=ehost-live.

Olive, Jacqueline K., et al. “The State of the Antivaccine Movement in the United States: A

Focused Examination of Nonmedical Exemptions in States and Counties.” PLoS

Medicine, vol. 15, no. 6, June 2018, pp. 1–10. Academic Search Complete,

doi:10.1371/journal.pmed.1002578. Accessed 20 Mar. 2019

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Senator, Susan. "Why I Was an Anti-vaxxer." 24 August 2018. Psychology Today, 24 August

2018 www.psychologytoday.com/us/blog/all-families-are-not-alike/201808/why-i-was-

anti-vaxxer

Wakefield, A J, et al. “Ileal-lymphoid-nodular Hyperplasia, Non-specific Colitis, and Pervasive

Developmental Disorder in Children.” The Lancet, vol. 351, no. 640, 28 Febuary 1998,

www.thelancet.com/action/showPdf?pii=S0140-6736%2897%2911096-0. 29 March

2018.