Efficacy and Measles

In the wake of the New York Times article about vaccination and the ongoing measles outbreak, no one seems to be discussing the efficacy problem. I’m not referring to the herd immunity issue–which is a serious problem (boldface mine):

You see, I belong in that percentage of people who rely on what’s known as herd immunity to keep them safe. My immune system is impaired to the point where I’m very vulnerable to infectious diseases. First from Crohn’s Disease and arthritis. Second, by the fact that I take Humira to control and counteract both the CD and arthritis. Humira is what’s known as a TNF inhibitor. en.wikipedia.org By binding to tumour necrosis factors in the body, it reduces and restrains inflammation responses. Since both CD and arthritis are caused by inflammation, it does a very good job of keeping both in check. Problem is, TNF is a natural part of the immune system, and by knocking down the TNF response, Humira is knocking down part of the immune system. This makes me vulnerable to infections of all sorts. Before I could start taking Humira, I had to be tested for tuberculosis, to make sure I wasn’t unknowingly carrying it. Taking Humira is so risky that the FDA issued a black box warning that has to be carried on the product labeling. This is to alert doctors of the extra need to carefully monitor patients taking Humira. Risky or not, to me it is utterly worth it. After years of struggling to keep my CD under control, Humira has brought me sweet relief. Plus, I don’t have to take another medication to control my arthritis; Humira takes care of both. Bonus! Nonetheless, I cannot ignore how vulnerable Humira makes me. I can’t take certain vaccines, such as the MMR. Nor can I take the zoster vaccine that prevents shingles, despite the fact I had chicken pox when I was a child. These are live attenuated vaccines, which makes them too dangerous for someone with a damaged immune system to take. In other words, someone like me.

Which is why I could cheerfully strangle Andrew Wakefield and Jenny McCarthy. Why I wish so-called anti-vaxxers could be wiped off the face of the earth. These people could quite possibly be responsible for my death, and neither know nor care. That’s not even hyperbole. It’s the absolute truth….

Look, I have zero fucks to give about your special snowflake(s). If you want to leave them open to being killed or maimed by one of the most contagious diseases known, that’s your business. And theirs when they grow old enough to tell you how stupid you’re being. But your idiocy is putting my life at risk, and I take grave exception to that. Being dead or permanently disfigured is not something I want to be involved in.

Unfortunately, it gets worse: even for healthy people, no vaccine is completely effective. The efficacy rates I’ve found range from 95 percent to 99 percent.

If enough vaccinated people are exposed to the measles viruses, some will become sick. Unlike Ebola, someone infected with measles can be contagious without symptoms (or symptoms that resemble a cold) for up to a week.

So think about large gatherings (like the sportsball event being held in Arizona, a state in which there are measles cases), offices, transportation (planes, trains, and buses). While I don’t think the worste case, doomsday scenario of everyone who attended the Super Bowl being exposed is likely (or even possible), it raises a second point–contact tracing. Trying to keep tabs on a large group of people who might have been exposed is very difficult, especially if they’ve dispersed. At some point, our public health system could be overwhelmed by the logistics of tracking these infections. Right now, this isn’t a problem (though it is an expense for limited budgets), and hopefully it won’t be.

In my experience, though, hope isn’t a great public health strategy.

Measles can be scary: I really wish those scientists would do something useful and find a way to prevent the measles. Like maybe a simple shot or something….

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5 Responses to Efficacy and Measles

  1. NewEnglandBob says:

    Sorry that you are put at risk. I am also incensed over those ignorant, malicious people.

  2. A “simple shot” of Irish cream liqueur, banana liqueur, and blue curacao liqueur may be most useful when encountering anti-vaxxer lunacy.

  3. anecdata: both my brother and I received the full measles vaccine protocol standard at the time (late ’60s), and both of us got measles (fortunately, with no lasting ill effects). It’s not clear whether we got a bad/mishandled batch (perhaps more likely since the two of us, vaccinated at the same time, had the same experience) or whether we shared some genetic or environmental factor that reduced efficacy in our case. I’m also not sure how, in a place and time where most children were vaccinated, we were exposed to the virus. But it does happen, and the larger the percentage of the population that is vaccinated, the less likely such vaccine failures are to have any ill effects (for instance, had I not gotten measles as a child, I wouldn’t have known, as an adult woman, that I was vulnerable, and could have caught it while pregnant, which presents particular dangers to the fetus).

  4. Dbp says:

    I personally consider parents who refuse to vaccinate for stupid reasons to be abusing their children. Full on abuse. I don’t see this as any different from people who pray over their sick children instead of giving them insulin. These people cannot be reviled enough. People should start calling child protection agencies when someone they know is medically neglecting their child.

  5. Jessica says:

    I couldn’t agree more. I take immunosuppressants and all I can think is how selfish to not vaccinate. I also feel really bad for all the to young to vaccinate babies who will get measles. It is child endangerment. Why do we allow stupidity to endanger others lives.

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