Vaccines: It’s a Small World After All

The World Health Organization reported in a press release today some striking numbers.

Approximately 6500 cases of measles among 30 countries in Europe.  From just the start of this year.  That’s less than 4 months.

Take those 6500 cases and imagine the number of contacts each individual has and the possibility of spread.  This is infectious disease.  This is why public health matters.  And this is why vaccination is such a hot topic.  On one hand, to vaccinate or not feels intensely personal.  And yet, we are all members of a world-wide community and the decision not to vaccinate does translate into public health risks, not just personal health.

Our lives are intersecting at a greater pace than ever before.  People will continue to travel, move, explore, and connect.

It’s a small world after all.  All the more so in the world of infectious disease.

There was a recent outbreak of measles in Minnesota. Fifteen confirmed cases of measles:  thirteen of them were linked to a case acquired in Kenya, one was acquired in Florida, and another was acquired in India.  The patients ranged in age from as young as 4 months old to 51 years old.  Five of them were too young to get the measles vaccine (given at 1 year old), six of them were old enough for the vaccine but had not received it, one did have the vaccine, and three others had unknown vaccine status.

When young children get measles, they are at much greater risk for complications.  A severe complication associated with measles is subacute sclerosing panencephalitis.  I saw one case of it during my years in training and it was devastating.   I will not forget it.

“Outbreaks and the further spread of measles are likely to continue so long as people remain unimmunized or do not get immunized on time according to the routine immunization schedule. An increase in international travel during the Easter holidays will further increase the risk of exportation and importation of measles.” (WHO/Europe)

About one year ago, British researcher Andrew Wakefield was stripped of his medical license and his ability to practice medicine.  His 1998 publication in The Lancet, which claimed to link the Measles-Mumps-Rubella vaccine to autistic enterocolitis and autism, was proven to be a fraud.  Information was falsified.  Financial gain was evident.  The Lancet fully retracted the publication.  Nevertheless, the harm has already been done and that can’t be retracted as easily.  One paper started a seed of fear.  That fear has only grown, and despite the continued reassurance that no link has been verified between the MMR vaccine and autism, that fear continues to grow and lead to other fears.

This is not just about who is right or wrong.  I understand the fear that parents face.  I don’t doubt it nor do I sneer at it simply because it doesn’t fit my perspective.  But I do feel the tragedy in this.  Parents who desire to do what’s right for their children.  Doctors who also desire to do what’s right for all children — yours, mine, and the community at large.  It is a big mess complicated by lots of hurtful emotions.  The trust has been broken.  The gap in communication creates a palpable tension.  It points to the current frailty of the doctor-patient relationship which undermines health care on all levels, even if the vaccine controversy were to resolve.

I don’t assume to have any great ideas on how to create new bridges between parent and doctor.  I can only start with one family at a time, doing my best to listen and acknowledge the fears, but continue to encourage and reassure.

Because it’s a small world after all.  We can’t afford to grow distant when we are so close.

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One thought on “Vaccines: It’s a Small World After All

  1. Pingback: Cursing Toddlers « One Family Table

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