The current measles situation is a preventable tragedy. To understand the situation, it is important to understand “herd immunity”. Imagine a room of 100 people, like a movie theater, airport terminal, or busy waiting room. Imagine a person walks into the left side of the room with a contagious virus. On the right side of the room is a patient with a compromised immune system who could die if they get the disease that just walked into the room. Herd immunity is what stops that virus from getting to the right side of the room. The virus wants its next victim, and it wants to keep moving from host to host to host. If the three or four people around the ill person are immune to the virus, it may never reach the person on the right side of the room that is vulnerable to the virus. But, if the virus can find one person who is susceptible, it moves forward, and if there are enough susceptible people, will make its way to the person on the right side of the room who could die from the illness.
Why does this matter? Because for measles we used to have herd immunity so that measles was essentially eliminated in the United States. How did that happen? We had an amazingly effective vaccine, in fact one of our best vaccines, called the MMR vaccine. That vaccine works so good that after 2 doses 97/100 people are completely immune to measles. Think about that - 97%. That success rate is extremely rare in medicine. If I told you I had a chemotherapy that would cure your cancer 97% of the time, you would think that was a miracle. And why did we have herd immunity? Because at the time, people trusted their doctors and the internet wasn’t a resource of bogus information. To have herd immunity you need 95% of people vaccinated. We had that. Now we do not. When my parents took me to get my MMR in 1975, the conversation likely went like this:
Dr Kobler: “Measles kills 2.6 million children a year before the MMR vaccine came out in 1971. The side effects are rare, but you could get a mild fever or rash. Would you like to get the vaccine today?”
Mrs. Fisher: “Of course, that seems like a weird question.” (My mom was very blunt; she also loved and trusted Dr. Kobler).
The worldwide use of this vaccine has caused deaths to fall from 2.6 million kids a year to 122 thousand kids a year, most of them in poor countries who have a difficult time getting kids their vaccines due to war, poor government structure, or extreme poverty.
The US has abundant resources, but now our vaccination rate is in the high 80s. Often this is due to the conversation going like this:
Dr. Fisher: “1 year olds get a MMR vaccine that can cause fever or rash in a week, but if that happens it is completely safe. Are you okay with me ordering the vaccine?”
Parent: “I have to do my research.”
“I heard it causes autism.”
The problem is what may seem like research is really just looking through tons of unverified opinions and sometimes lies on the internet. The other issue is that even when you find reputable studies on the internet, most parents don’t have the extensive background in science and medicine to interpret the studies. I have much more training in understanding these studies and interpreting the results and I promise that we do that with your child’s best interest at heart.
What does that mean? That means if we have a measles outbreak in Indiana, unvaccinated kids will get measles. Some of them will die. Some of those who die or get hospitalized will be families that made a “personal decision” to not get the vaccine, but some of those that die will be infants whose parents want the vaccine, but they were too young to receive it. Meaning, they will die because other people's “personal decision” decreased herd immunity to the point of letting the virus spread and kill infants that otherwise should not have been exposed if 95% of the population had been vaccinated. I don’t believe this is a personal decision, anymore than I believe stopping at red lights is a personal decision. Getting vaccinated is a moral obligation that we do to protect our friends, neighbors, first responders, and susceptible people in our communities that may not be as healthy as ourselves.
Herd immunity is part of the reason our office only takes care of vaccinated patients. We feel obligated to protect your children, our staff, and our staff’s children, and therefore we require vaccination to be part of Fisher Pediatrics.
What can we do to protect ourselves? Measles is one of the most contagious germs on the planet. If a measles patient is in a room, they can pass it to someone who walks into that room for up to 2 hours after they have left! I would make sure my daycare/childcare requires MMR vaccines, and would transfer my child if possible if they do not. I would also avoid traveling to states that are actively seeing measles if I have a baby under 12 months who is not vaccinated. If you have to go to a state with measles, then please call our office if your child is 6 months or older to discuss getting a measles vaccine early. It doesn’t replace the one you will get at 1 and 4 years old, but it will offer some protection.
Until next time, good luck parenting,
Dr. William J. Fisher
Fisher Pediatrics
317 861 7125
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