One of the infectious diseases we studied so far is the highly contagious measles. Measles are caused by a single-stranded enveloped RNA paramyxovirus that replicates in the respiratory tract. I was intrigued to learn that measles have re-emerged as global concern with thousands of deaths in the past several years. In the article, “Measles: An Overview of a Re-Emerging Disease in Children and Immunocompromised Patients,” written by Misin et al., explains that despite the availability of safe and effective vaccinations, in recent years, hundreds of thousands of new measles cases were reported worldwide, which resulted in thousands of deaths from measles. Additionally, in 2017, global measles cases spiked, causing the death of 110,000 people, mostly children under the age of 5 years and immunocompromised adults. The increase in measles incidence is speculated to be caused by the ongoing refusal of vaccination coverage.
Measles is especially dangerous because it can lead to complications involving almost all organs and systems. Measles destroys the epithelium, favoring bacterial superinfections. The measles vaccines are attenuated viral vaccines that replicate within the host to induce protective immunity. However, in order to achieve protective efficacy, or herd immunity, we need a level of immunity within the entire population. More precisely, to obtain her immunity for measles we require vaccination coverage ranging from 93% to 95% with two doses of measles vaccine. If parents opt out of vaccinating their children then those numbers drop significantly and we see the trend of re-emergence of the disease in the population. Nevertheless, the choice these select small minority of parents that opt out of vaccination protocols endanger the lives and health of their own children and, crucially, others as well, at risk.
This phenomenon of herd immunity is especially useful in the community because there are always some in any society who cannot, or will not, be immun-ized. Reasons vary but include people that cannot be vaccinated for medical reasons, such as immunocompromised, pregnant, etc, or because they are too young since some vaccines are attenuated and require a developed immune system to offer protection. Also, some may be poor and lack access to healthcare. Therefore, it is vital to establish and maintain that community immunity to protect the population at large. Although all states have laws to impose vaccination requirements, some still find loopholes to avoid this requirement. Theses loopholes include religious affiliations, moral and philosophical objections and other conscientious exemptions. Unfortunately, it’s taking some devastating new outbreaks to open that dialogue again and converting some to be vaccine believers. More policies are being implemented to reduce the number of non-medical exemptions that are issued in hopes of minimize further outbreaks. I think that it is nice that we live in a society with liberal “free choices” but I feel that when those “free choices” impose a significant risk to those who have not made similar choices then it’s infringing on other people’s free rights. At the end of the day, who should have the final authority on who has priority to impose their free right? The person exposing others to risk, or the person being exposed? Obviously, legislature is only one means to combat these issues but maybe continual educational campaign could be beneficial to help further demystify the fears of vaccination and help move this discussion forward.
Microbiology and You 