PHOTO: measles

ONE OF mankind’s most notable scientific and medical achievements was the discovery that vaccinating people with weakened or dead pathogens would stimulate their immune systems and protect them against the virulent form of the disease.

The first vaccine was created in 1796 by Edward Jenner, an English physician, who had observed that local milkmaids almost always caught cowpox, but never seemed to come down with the related, but far deadlier, smallpox. Acting on a hunch, Jenner injected a small amount of cowpox pus into James Phipps, a young neighbor boy, before exposing him to smallpox. Phipps did not get sick. In 1853, 30 years after Jenner’s death, England and Wales made smallpox vaccination compulsory.

In 1881, French chemist and microbiologist Louis Pasteur, who was the first to develop the germ theory of disease, created a vaccine for anthrax, and another one for rabies four years later.

In 1953, American medical researcher Dr. Jonas Salk announced that he had successfully created a vaccine against polio. A year later, Dr. Thomas Peebles at Boston Children’s Hospital isolated the measles virus, which was used to develop a measles vaccine the following decade.

Dr. Peebles, and the giants of science on whose shoulders he stood, would be absolutely horrified to learn that in 2019, 56 years after the measles vaccine first became available, anti-vaxxers would be holding measles parties—deliberately exposing their unvaccinated children to the deadly disease he had conquered in order to avoid the much lesser risk of complications from the vaccination itself, which is usually administered in conjunction with vaccines for mumps and rubella (MMR).

According to the Centers for Disease Control and Prevention, some 500,000 cases of measles were reported before the vaccination program began in 1963. Of those, “400 to 500 died, 48,000 were hospitalized, and 1,000 developed encephalitis (brain swelling) from measles. Since then, widespread use of measles vaccine has led to a greater than 99 percent reduction in measles cases compared with the pre-vaccine era.”

Between Jan. 1 and April 4 of this year, according to the CDC, “465 individual cases of measles have been confirmed in 19 states,” none of them in Virginia so far. “This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000.” Outbreaks in California, Washington, New York, New Jersey and Michigan were “linked to travelers who brought measles back from other countries.”

Epidemiologists have long warned that modern air travel is a perfect vector for pathogens like the measles virus to quickly spread across the globe. Ninety percent of unvaccinated people who come in contact with the virus get sick, posing an immediate danger to people with compromised immune systems, pregnant women, and infants under 12 months who are too young to be vaccinated.

Dr. Sarah Boggs, a board-certified pediatrician in infectious diseases at the University of Virginia, points out that, “Measles has one of the highest attack rates of any infectious disease that we know of. If you are unvaccinated and you are in a room with someone with measles, you are going to get it. It is very, very contagious.”

Vaccination has its risks, especially for a small group of individuals with life-threatening allergies, a history of seizures or weakened immune systems, which is why skipping it should be a decision made by parents in conjunction with their doctors. As of Jan. 2 of this year, 483 children and adults had received compensation for measles vaccination-related deaths and injuries from the U.S. Court of Claims, which administers the federal Vaccine Injury Compensation Program.

But that risk has to be weighed against the much larger risk to the public from unvaccinated individuals. In the event of an outbreak, the CDC recommends that “persons exempted from measles vaccination for medical, religious, or other reasons should be excluded from involved institutions in the outbreak area until 21 days after the onset of rash in the last case of measles.”

After declaring a public health emergency this week due to a months-long measles outbreak in his city, New York Mayor Bill de Blasio said that unvaccinated children living in affected Brooklyn zip codes “may not return to school or daycare for the duration of this outbreak. If you choose to not vaccinate, you will be fined [$1,000]. We have to protect our kids and our families.”

Fining people who refuse to vaccinate is going too far. Because of the small, but real risks involved, public health officials should never force anybody to vaccinate. People have the right to make that decision for themselves, based on their family and medical histories or religious beliefs.

But officials can and should restrict their access to public facilities during an outbreak, as per CDC recommendations. Nobody has the right to spread a potentially fatal, but preventable, disease to anybody else.