Vaccines, Outbreaks, and Personal Choice: Measles by the Numbers | St. Louis Public Radio

Vaccines, Outbreaks, and Personal Choice: Measles by the Numbers

Feb 6, 2015

Measles has not reached the St. Louis area this year, but that hasn’t kept it from stoking fears.  

Local public health officials are encouraging parents to make sure their children’s vaccinations are up-to-date by checking with their individual health providers. With worries that last month’s outbreak in Disneyland could continue to spread, officials in Illinois are investigating the source of five infants diagnosed with measles at a day care center outside Chicago.

Though Illinois Senator Dick Durbin told a Chicago TV station that another suspected measles case had been identified in Madison County on Friday, the Illinois Public Health Department said they no longer consider it a potential case.

We decided to take a look at the numbers. In fact, vaccination rates are quite high for schoolchildren in both Missouri and Illinois—nearly every county in both states reported vaccination rates above 90 percent for most of the shots required by law.

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Common reasons for non-vaccination include allergies, medical concerns, and religious objections. Children under the age of 1 are too young for the vaccine, and can be at risk during an outbreak. The map above includes children who have begun vaccinations, but are on a delayed immunization schedule.

How common are the measles?

Not very, but outbreaks have become more frequent.

644 cases of measles were reported in 2014, the most since the disease was declared eliminated from the US in 2000. More than a hundred cases were reported in January of 2015, most of them linked to an outbreak at Disneyland.   

The abdomen of a patient with a measles rash. Prior to widespread immunization, measles was common in childhood, with more than 90% of infants and children infected by age 12. Recently, fewer than 1,000 measles cases have been reported annually since 1993.
Credit Centers for Disease Control and Prevention

Over the past decade, outbreaks tend to be related to unvaccinated people contracting measles abroad, and spreading among communities of people who are not immunized.

95 percent of school children in the city of St. Louis are up-to-date with their immunizations, according to data obtained from the state of Missouri.

“It’s very disappointing that some parents choose not to vaccinate their children based on rumor and fear tactics, but it’s a very small percentage of people,” said St. Louis Health Department director Pam Walker.

Before vaccines were available, measles was quite common. The CDC estimates that between 3 and 4 million Americans contracted measles each year in the decade before the vaccine was developed, with up to 500 deaths a year.

By comparison, influenza killed 1,532 people in 2010, according to the CDC. (Pneumonia, which is often a complication of the flu, killed about 52,000).     

What do measles feel like?

Dr. Ken Haller remembers getting the measles in 1962, at the age of 7.

“I remember being absolutely miserable for two weeks. My muscles were achey, I could barely swallow, the lights were too bright,” Haller said. “It’s just a really horrible disease.”

Today, Haller is a pediatrician at Cardinal Glennon Children’s Medical Center. He says he often talks to parents to allay their concerns about the safety of vaccines, which often stem from a 1998 study linking the measles vaccine to autism, which was later debunked. He published a review of available research in 2012, which can be found here.   

“We really want people go get vaccinated, and get kids vaccinated, because you’re not just protecting yourself, you’re protecting other vulnerable people,” Haller said.  

Symptoms of measles include a high fever, cough, a runny nose and watery eyes. After a few days, patients may develop a rash of flat red spots and small raised bumps. About one in 1,000 patients will develop inflammation of the brain, which can lead to a loss of hearing or permanent brain damage. The disease is fatal in about 1 in 1000 cases.

Mild reactions to the vaccine, such as a fever or rash, are relatively common. In extremely rare cases, children may develop a severe allergic reaction or other complications. Further information can be found on the CDC’s website.

Who isn’t vaccinated?

Missouri and Illinois allow two exemptions for non-vaccination when children attend school: medical and religious.  

Children with immune diseases, blood disorders, or cancer are often unable to get the vaccine for medical reasons. Members of some religious sects, such as the Amish or Christian Scientists, sometimes oppose vaccination. (An outbreak among Christian Science students at Principia College in 1985 led to three deaths and a quarantine).

St. Charles-based chiropractor, Mackenzie Mcnamara, says her patients represent a range of opinions over the issue. Some choose to vaccinate, some choose not to, and others decide to vaccinate on a delayed schedule. Mcnamara separates herself from the ‘anti-vaccine movement,’ but says parents should be able to choose whether or not they vaccinate their child.

Measles are highly contagious, and the death rate if a person contracts the disease is 1 in 1000. But due to the abundant use of vaccines, deaths due to measles have been virtually eliminated in the U.S. Mcnamara says some parents worry about the possibility of side effects from the vaccine.  

“Clearly there is a risk, and [parents] should be able to choose if they assume that risk with their child,” Mcnamara said. She adds that friends and clients have felt a sense of backlash against their opposition to vaccines since the outbreak in California.

“I think there’s a definite middle ground, I wish people would see that too,” Mcnamara said.

Follow St. Louis Public Radio’s Durrie Bouscaren on Twitter, @durrieB.