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Thanks again, Jenny McCarthy and Andrew Wakefield! Thanks again for the measles!

I realize that I’ve thanked Jenny McCarthy and Andrew Wakefield before for giving the U.S. the gift of a measles resurgence. Originally, when I started this sarcastic little exercise, I assumed that it would be 5-10 years before we in the States caught up with the level of endemic measles that has been resurgent in the U.K. in the decade since Andrew Wakefield published his shoddy, fraudulent, pseudoscientific, litigation-driven article in The Lancet claiming that the MMR vaccine was responsible for “autistic enterocolitis,” leading to an anti-MMR hysteria that drove down vaccination rates and made measles endemic again in the U.K. However, I rapidly realized that I was wrong and that measles would come roaring back in the U.S. far faster than that.

Here’s yet another story about how it has done just that:

The number of measles cases in the U.S. is at its highest level since 1997, and nearly half of those involve children whose parents rejected vaccination, government health officials reported Thursday.

The number of cases is still small, just 131, but that’s just for the first seven months of the year and doctors are troubled by the trend. There were only 42 cases for all of last year.

“We’re seeing a lot more spread. That is concerning to us,” said Dr. Jane Seward, of the U.S. Centers for Disease Control and Prevention.

Pediatricians are frustrated, saying they are having to spend more time convincing parents the shot is safe.

“This year, we certainly have had parents asking more questions,” said Dr. Ari Brown, an Austin, Texas, physician who is a spokeswoman for the American Academy of Pediatrics.

The CDC’s review found that a number of cases involved home-schooled children not required to have the vaccines.


It is no longer endemic to the United States, but every year some Americans pick it up while traveling abroad and bring it home. Measles epidemics have exploded in Israel, Switzerland and some other countries. But high U.S. childhood vaccination rates have prevented major outbreaks here.

In a typical year, only one outbreak occurs in the United States, infecting perhaps 10 to 20 people. So far this year through July 30 the country has seen seven outbreaks, including one in Illinois with 30 cases, said Seward, deputy director of the CDC’s Division of Viral Diseases.

None of the 131 patients died, but 15 were hospitalized.

The article notes that vaccination rates in the U.S. are still over 90%, still high enough for herd immunity to hold sway, but that outbreak pockets, where lower vaccination rates are the rule and herd immunity has become shaky, are forming. That’s what’s allowing these outbreaks to occur. Here’s the kicker:

Of this year’s total, 122 were unvaccinated or had unknown vaccination status. Some were unvaccinated because the children were under age 1, making them too young to get their first measles shot.

In 63 of those cases _ almost all of them 19 or younger _ the patient or their parents refused vaccination, the CDC reported.

In Washington state, an outbreak was traced to a religious conference, including 16 school-aged children who were not vaccinated because of parents’ beliefs. Eleven of those kids were home schooled and not subject to vaccination rules in public schools.

The Illinois outbreak _ triggered by a teenager who had traveled to Italy _ included 25 home-schooled children, according to the CDC report.

So, rejoice, Jenny McCarthy, J.B. Handley, David Kirby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, Dr. Jay Gordon, and all the other antivaccine activists (or their willing dupes who oh-so-piously claim they are really and truly “not antivaccine”) spreading misinformation, pseudoscience, and fear about vaccines! You’re winning. You’re succeeding in casting doubt on the safety of vaccines to the point that it’s causing real problems for our public health system:

The nation once routinely saw hundreds of thousands of measles cases each year, and hundreds of deaths. But immunization campaigns were credited with dramatically reducing the numbers. The last time health officials saw this many cases was 1997, when 138 were reported. Last year, there were only 42 U.S. cases.

The American Academy of Pediatrics has made educating parents about the safety of vaccines one of its top priorities this year, in part because busy doctors have grown frustrated at the amount of time they’ve been spending answering parents’ questions about things they read on the Internet or heard from TV talk shows.

In June, the CDC interviewed 33 physicians in Austin, suburban Seattle and Hollywood, Fla., about childhood vaccinations. Several complained about patient backlogs caused by parents stirred up by information of dubious scientific merit, according to the CDC report.

Yes, each and every of you anti-vaccinationists or enablers or sympathizers with antivaccinationists (but above all, Jenny McCarthy, given that you’ve willingly–nay, enthusiastically!–become the celebrity face of the antivaccination movement, going so far as to get all your Hollywood friends to show up at Generation Rescue charities, to organize antivaccine marches on Washington, and get professional wrestling to help you raise money for the cause), this resurgence in measles is the result of your tireless labor in scaring parents with lies and pseudoscience to the point where they fear and refuse vaccination. Now your efforts are really beginning to bear fruit, and we’re catching up with the U.K., which has a decade-long head start. Measles is coming back, Who knows? If you keep it up, you could reach the golden age of pre-MMR, as described in the CDC report itself:

In the United States, measles caused 450 reported deaths and 4,000 cases of encephalitis annually before measles vaccine became available in the mid-1960s (1). Through a successful measles vaccination program, the United States eliminated endemic measles transmission (1). Sustaining elimination requires maintaining high MMR vaccine coverage rates, particularly among preschool (>90% 1-dose coverage) and school-aged children (>95% 2-dose coverage) (7). High coverage levels provide herd immunity, decreasing everyone’s risk for measles exposure and affording protection to persons who cannot be vaccinated. However, herd immunity does not provide 100% protection, especially in communities with large numbers of unvaccinated persons. For the foreseeable future, measles importations into the United States will continue to occur because measles is still common in Europe and other regions of the world. Within the United States, the current national MMR vaccine coverage rate is adequate to prevent the sustained spread of measles. However, importations of measles likely will continue to cause outbreaks in communities that have sizeable clusters of unvaccinated persons.

But, hey, if you succeed, Jenny, it’ll be far more than just isolated communities of unvaccinated persons. Then the measles can really go to town! After all:

Measles is one of the first diseases to reappear when vaccination coverage rates fall. Ongoing outbreaks are occurring in European countries where rates of vaccination coverage are lower than those in the United States, including Austria, Italy, and Switzerland (3,4). In June 2008, the United Kingdom’s Health Protection Agency declared that, because of a drop in vaccination coverage levels (to 80%–85% among children aged 2 years), measles was again endemic in the United Kingdom (3,8), 14 years after it had been eliminated. Since April 2008, two measles-related deaths have been reported in Europe, both in children ineligible to receive MMR vaccine because of congenital immunologic compromise (4,8). Such children depend on herd immunity for protection from the disease, as do children aged <12 months, who normally are too young to receive the vaccine. Otherwise healthy children with measles also are at risk for severe complications, including encephalitis and pneumonia, which can lead to permanent disability or death.

And that was just the measles. Keep it up, Jenny and other antivaccine activists, and you could probably drive vaccination rates low enough that pertussis, polio, Haemophilus influenza b, the mumps, and a whole lot of other vaccine-preventable diseases make a similar comeback. Heck, if you work hard enough, maybe they’ll all become endemic again. It’ll be just like the old days! Won’t that be grand? Isn’t that what you want? That’ll be the reward for your success.

I’m sure all the suffering, hospitalized, and dead children in the future will thank you for your tireless efforts to save them from autism now.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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