Among Mickey Mouse ears and roller coasters, a dangerous measles virus slithered through Disneyland on December 17-20, 2014. The source of the virus is unknown, but a according to the CDC, a calculated 170 people have been diagnosed with the disease between January 1 and February 27 of this year, with 125 of the cases being linked to the Disneyland outbreak.
This year’s rising occurrence of the disease is an oddity that defies scientific developments in recent history. With the advent of the measles vaccine in 1968, the number of annual reported cases has significantly diminished; by 2000, a strong vaccination program of two doses of the vaccine had proven effective, and the CDC deemed the disease eliminated.
Yet the recent outbreak has caused the disease to resurface, instigating havoc among Americans. Parents are beginning to vaccinate their previously unvaccinated children, and schools have forced unvaccinated children to stay home until the outbreak has been contained. The start of outbreak probably stems from a traveler who carried it from another country, but the culprit of its proliferation in America, many claim, is unvaccinated citizens; and it is this population of unvaccinated citizens that have spurred a national debate that extends beyond the walls of the vaccine itself.
Back in 1998, an article in a medical journal was published that linked vaccines to autism. British doctor Andrew Wakefield studied a mere twelve subjects who were injected with the measles, mumps, rubella, or MMR vaccine. He contended that the inoculation causes the immune system to steer off its regular path, triggering issues in the digestive tract and eventually in the brain. His study was immediately discredited due to insufficient evidence and the medical journal even removed his manuscript from the publication. Yet his paper instilled fear in many, and parents decided not to vaccinate their children altogether.
Dr. Wakefield still speaks out in support of his findings and celebrities those such as Jenny McCarthy, who attributes her son’s autism to his receiving the vaccination. Others avoid vaccinations for personal reasons, and thereby gain exemption from school-mandated vaccine requirements. Some feel that they can attain immunity from diseases without vaccinations, and still others maintain that a healthy lifestyle can replace the need for vaccinations altogether.
Clyde Haberman of the New York Times suggests that anti-vaccinators maintain their position because disease is not often experienced as often as it used to be, unlike the years before vaccines. “You might as well be protecting against aliens — these are things they’ve never seen,” says Seth Mnookin, writer and professor at the Massachusetts Institute of Technology in the Times article.
Those who support vaccinations fear that these pockets of unvaccinated people have prevented what is called herd immunity. Before vaccines, almost nobody was immune to measles, and a diseased patient could transmit the disease to up eighteen people. Those eighteen people would each go on to infect another eighteen people, resulting in three hundred twenty four people contracting the disease in a matter of a few days. One person becoming sick could then dangerously spiral into an epidemic.
However, once vaccines were created and the rate of use rose significantly, only a few of those eighteen people would present the disease because the rest would be immune. Furthermore, if at least seventeen of those eighteen people, or ninety four percent, were immune to the virus, then the original patient would infect only one other person and herd immunity would be established.
But with the anti-vaccination movement, herd immunity is not complete and therefore allows for the spread of the virus. Once a person contracts the disease, they are contagious for four days before the tell-tale rash appears and for four days afterwards. It can be spread easily by a simple cough or a sneeze—and it even remains in the air for up to two hours after an infected subject releases the virus from their body. This poses a danger to babies too young to be vaccinated, those who medically cannot be vaccinated, like those who are allergic to certain ingredients, and especially to the immunocompromised.
This concept of societal responsibility is a prominent argument given by supporters of vaccination. Take six-year-old Rhett Krawit of California, for example, who endured leukemia for four years, and has since been declared in remission. His immune system is too low for him to be immunized, and it also makes for a high probability that he will contract the measles virus. His family is advocating for more people to be vaccinated, but ultimately if even one unvaccinated person in his community becomes sick, Rhett can be exposed and infected.
Adjunct Assistant Professor of Philosophy Herb Leventer at Stern College says that the choice not to vaccinate one’s children is not merely a personal choice; rather, it is a choice that has consequences for others as well. In American society, he states, “we recognize that every individual is also imbedded in our society, which has a claim on him to act as a responsible citizen.” This means vaccinating one’s children. By vaccinating her children, a parent fulfills her societal “obligation to do her part to prevent other children from getting measles from her child, and, [if she does not vaccinate her children, she] does wrong to see the situation as simply her choice to accept possible measles for her child in exchange for avoiding possible autism for her child.”
Prompted by the measles scare, several doctors have begun to discuss banning unvaccinated children from their medical practice. Parents fear that while sitting in the waiting room, unvaccinated patients may be carrying the measles virus and can transmit it to their babies or immunocompromised children. In a survey of five hundred pediatric medical practices done by the Physicians Computer Company, it was found that fifty-four percent of the offices will not treat children whose parents do not fulfill the vaccine requirement of the practice.
In an interview with CBS news, pediatrician Dr. Margeret Van Blerk laments that parents want her to take care of their children, but then show distrust when they opt not to comply with her vaccine requirements that are in place to protect other patients. Dr. Van Blerk says, “As a physician, we take the Hippocratic Oath, and it’s first to do no harm. And by bringing patients in who are not vaccinated, I think we’re harming our other patients who depend on us to keep them healthy.”
Other physicians reject this argument and maintain that unvaccinated children should not be banned from medical practices. Logistically, it may leave unvaccinated children without a primary care physicians, because they may be unable to find a new pediatrician who will accept them. Also, banning unvaccinated children from medical practices is not a solution to the measles epidemic, avers Dr. Kenneth Bromberg of the American Academy of Pediatrics. Children can be protected from the disease in other ways, he says, such as making separate office hours for unvaccinated children. Moreover, these physicians claim that it is unreasonable to refuse to treat patients solely on the basis that they are not vaccinated.
Professor Leventer comments that such a decision on the part of pediatricians is unethical because “it was the parent, not the child who refused the vaccine, so why punish the child?” Professor Leventer also notes that upon entering the pediatrician’s office, a child can contract any one of the illnesses floating in the air that result from the sneezes and coughs of all sick children sitting in the waiting room, just as easily as they can catch a disease from an unvaccinated child.
As we enter into March, the measles chaos has calmed down, but the debate over vaccinations and the implications of unvaccinated children still remains, and many questions hover. If a person has a runny nose, do they have a societal responsibility to remain isolated in their home until their symptoms subside? Does a doctor have at all a right to refuse treatment to any patient? And, how do we, as a part of a community, find a balance between protecting ourselves and protecting others?