There are 136 cases of measles in Quebec. The disease is spreading fast considering that this outbreak was allegedly caused by a single returnee from a Disney vacation where the outbreak started. Like a run away freight train, measles will jump person to person and eventually make it here. Is my son who had a heart transplant and can't be vaccinated protected? I sure hope so. If you don't want to vaccinate, don't. But when measles is out there, an airborne illness that is so easily spread, please keep your child home. Don't make choices for my child too.
As someone who has had both leukemia and measles as an indirect result of chemotherapy, I'm a firm believer in Western medicine (though I do enjoy organic kale juice from time to time). Watching the vaccination furor from afar, I've been thinking about the connection between this debate and the two First Nations girls from Ontario who opted to have "natural" therapies to treat their Acute Lymphoblastic Leukemia instead of proven chemotherapies.
In Canada, health care is a provincial responsibility. So, the provincial ministries of health draw up the vaccination schedules. You'll find slight variations in the different schedules. Some provinces may adopt new vaccines sooner than others. Or, a vaccine may target a different strain of a particular bug, reflecting what's circulating locally.
Every day when I see patients in my surgical clinic, some are offered a procedure to help them feel better. Whether it is a minor surgery like a tonsillectomy, or something larger scale such as tumor resection, I have a full discussion with the patient regarding the benefits and risks of doing "something." Each time I go over the common minor risks of an intervention and the exceedingly rare, but potentially very serious risks that can occur. I also review with them the risks of doing "nothing" - of what may happen if they don't have surgery. Vaccination is no different.
A few months ago I described three major epidemics around child health in Canada today, when there are in fact four. I failed to mention the equally important epidemic of misinformation, which has been described well here and while this is certainly applicable to the issue of vaccine hesitancy, it doesn't describe the entire picture.
I got a measles vaccine booster shot this week because I needed to be sure I couldn't bring harm to my community. And I mean that literally, as measles has now arrived in my Toronto neighbourhood. The proximity of measles also prompted me to start poking around the Toronto Star's interactive map of Immunization Exemptions in Toronto's Schools and what I found sadly didn't surprise me -- alternative schools host scary percentages of unvaccinated kids. Unfortunately, anyone in Ontario can get a vaccine exemption.
With each new outbreak, measles gains more ground for a permanent return. The virus becomes present year-round and causes seasonal infection like the cold and the flu. Every January to April dozens if not hundreds of people will become infected leaving public health officials with little option than to accept the future is a return to a dark past.
Last week in Berlin more than 15 countries pledged over US$7.5 billion to buy vaccines for the children of the world's poorest countries for the next five years. While this is great news for the millions of children living in the 73 countries supported by Gavi, there were other big winners: the pharmaceutical companies that benefit from the soaring vaccine prices they charge for vaccines worldwide.
Past generations of professional hockey players were never at risk of mumps outbreaks. Today's players are, and tomorrow's will be, along with adults generally. These outbreaks -- which the media portray as coming out of the blue -- don't surprise anyone in medical circles who has been paying attention.
In 1934 and 1935, two polio vaccines were prematurely employed in large-scale trials with disastrous results. The vaccines, given to 17,000 children in Canada and the U.S., killed six and paralyzed a dozen others, the deaths and paralyses typically involving paralysis in the inoculated arm rather than in the legs, as was more normal. So traumatic was this experience -- to both the public and the research establishment -- that it would take another two decades before another polio vaccine would be brought to market.
Merck now faces federal charges of fraud from the whistleblowers, a vaccine competitor and doctors in New Jersey and New York. Merck could also need to defend itself in Congress: The staff of representative Bill Posey (R-Fla) -- a longstanding critic of the CDC interested in an alleged link between vaccines and autism -- is now reviewing some 1,000 documents that the CDC whistleblower turned over to them.
The recent outbreaks of measles in Canada and the United States came as a shock to many public health experts but they wouldn't have to Dr. Gregory Poland, one of the world's most admired, most advanced thinkers in the field of vaccinology. The measles vaccine has failed, he explained two years ago in a prescient paper.
Drinking and driving is a choice -- however, it's an illegal choice because drunk drivers might kill themselves or, even worse, kill others who didn't have a say in the matter. But at least I've never heard of any drunk drivers justifying their actions by arguing that people die in car accidents not involving alcohol, too. That's the anti-vaccine rationale some parents are using to justify bringing back potentially deadly diseases and putting their children and others at risk, including infants, the elderly and people with immunodeficiencies or on chemotherapy.
The information war over vaccination is an obvious reflection of this fear. Public health has had its hands full during this war, but has failed to really counter the misinformation in vaccine hesitant communities. We are in desperate need for a new message, and a group of high school students from California have made one in a most spectacular way. Despite the myth-makers, the spin addicts, and the conspiracy nuts, cigarette use has gone down, climate science has become even more exact, and vaccines have been shown to be both safe and effective.
In the case of measles, the introduction and widespread use of the vaccine should have allowed us to put our fears away and look forward to a measles-free world. But now that future is at risk. The reasons are varied and will be explored over the coming years but in the meantime, the best way to be prepared is to be informed.