TMC PULSE

t m c » p u l s e | j u n e 2 0 1 7 21 ENDEMIC MEASLES DECLARED ELIMINATED IN THE U.S. Andrew Wakefield publishes his paper in The Lancet CLAIMING A CONNECTION BETWEEN THE MMR VACCINE AND AUTISM. The paper was later retracted and Wakefield was banned from practic- ing medicine in the U.K. LOW VACCINATION RATES lead to a resurgence of measles cases. Merck licenses a measles, mumps, rubella (MMR) COMBINATION VACCINE. Rubella is also known as German measles, though it's not as infectious or, generally, as serious as the measles. In the decade after the MMR vaccine is licensed, MEASLES CASES DROP DRAMATICALLY. When questioned by The Washington Post regarding the recent outbreak, Wakefield said he was simply providing information about vaccines and autism. "The Somalis had decided themselves they were partic- ularly concerned. I was responding to that," he said. "I don't feel responsible at all." So, what does an outbreak in Minnesota have to do with Texas? Although Wakefield travels the country promoting his anti-vaccine agenda, he lives in Austin. He speaks at anti-vaccine rallies on the steps of the state capitol building, and he holds screenings of his film, Vaxxed: From Cover-Up to Catastrophe, throughout the state. Meanwhile, non-medi- cal vaccine exemptions have increased since 2003, when the state enacted some of the loosest vaccine exemption laws in the country. At least one private school in Austin has an exemption rate of more than 40 percent. "In 2003, we had less than 5,000. In 2016 we had 45,000 to 50,000 exemptions," said Richard Lyn-Cook, M.D., medical director of Harris Health School-Based Clinics and assistant professor at Baylor College of Medicine. "It just takes one person to come in contact with a traveler who was not vac- cinated and can spread it to a child less than one, the most vulnerable population." A common refrain among vaccine critics is that the measles is not dangerous. Robert "Dr. Bob" Sears, M.D., a California pediatrician and high-profile proponent of "alter- native" vaccine schedules, wrote in a Facebook post: "Ask any grandma or grandpa (well, older ones anyway), and they'll say, 'Measles? So what? We all had it. It's like chicken pox.'" Lyn-Cook has a different take. "About 50,000 were hospitalized per year before the vaccine," he said. "It was unbelievably dangerous to our pop- ulation, and if we were hospitalizing 50,000 kids a year for a different disease it would be a national disaster." Internationally, 2017 has been a bad year for measles. In Europe, the largest outbreaks have occurred in Romania and Italy. According to the European Centre for Disease Prevention and Control, most immunization rates in affected areas have fallen below the 95 percent threshold, due to skepticism about the vaccine and adults being ill-informed about how suscep- tible they are to the disease. Some locations have extenuating circumstances. In Guinea, where a full-scale epidemic is raging, vaccinations dropped during the 2014-2015 Ebola epidemic, according to Doctors Without Borders. Vaccination activities were suspended due to the risk of infection. (continued) 1971 1981 1989 1998 2000 Credit: Egg photo: World Health Organization, John Enders portrait: Harvard University, Measles must go van: CDC, Measles virus particle: CDC/Cynthia S. Goldsmith; William Bellini, Ph.D., College of Physicians of Philadelphia, timeline and photos About 50,000 were hospitalized per year before the vaccine. It was unbelievably danger- ous to our population, and if we were hospitaliz- ing 50,000 kids a year for a dierent disease it would be a national disaster. — RICHARD LYN-COOK, M.D. Medical director of Harris Health School-Based Clinics and assistant professor at Baylor College of Medicine

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