Apr 1, 2019
Measles is making a comeback despite being declared eliminated in the U.S. in 2000 by the Centers for Disease Control (CDC). There were 206 reported cases in January and February alone this year, according to the CDC.
Measles can be very serious and even deadly. Before the measles vaccine was introduced in 1963, an estimated four million people in the U.S. were infected each year, with 48,000 hospitalizations and 500 deaths. Measles can even cause encephalitis, a brain disease, that doesn’t show up until years later.
Infectious diseases like measles can be completely eradicated. Smallpox, for example, has been effectively eradicated across the world. The main reason for the return of measles is the increase in the number of parents not having their children vaccinated.
This has led many to see the problem as simply the result of selfish choices by individual parents. The continued existence of infectious diseases, which science has provided the means to eliminate, however, is a social problem, not simply one of individual choices, and requires social solutions.
In part, the decline in the rate of childhood immunization reflects distrust in the population toward both the medical industry and government. The U.S. spends more on healthcare than other industrialized countries, yet has worse health outcomes, and this contributes to this mistrust.
Some of the black population carry a mistrust of the scientific establishment because of a past history of abuses, like the Tuskegee syphilis experiments, in which black men who had syphilis were denied access to penicillin, though it was already known to treat the disease.
The problem is made worse by false information that has been put out about the safety of vaccines. In the late 1990s, The Lancet, a respected medical journal, published a paper linking the Measles, Mumps, Rubella (MMR) vaccine to autism in a group of 12 children.
Other scientists have since debunked the study. It turns out Andrew Wakefield, the doctor who wrote the paper, falsified data and has since lost his medical license. Other scientists have since found no such link in larger studies. Nevertheless, opponents of vaccination continue to popularize the false findings of this study in addition to other false ideas about vaccines. Some, for example, have pointed out that measles deaths decreased dramatically before the vaccine was introduced due to improved sanitation such as improved sewage and water systems. This suggests that improved sanitation would be sufficient to eliminate the disease.
Certainly, sanitation played a role in decreasing rates of infectious diseases. Access to quality sewage systems was a demand that took serious social fights by public health advocates to force the wealthy class to provide to workers and the poor.
The argument that sanitation is enough hides the real truth. While deaths from measles did decline before the vaccine, the number of people contracting measles did not. So why did measles become less deadly before the vaccine’s discovery? The reason is that measles patients most often died from other communicable diseases, like pneumonia, for example. Measles caused their immune systems to be compromised, making them less able to fight off other diseases. Medical advances for fighting those other diseases, like antibiotics, were the reason fewer died. Antibiotics are only effective, though, against bacterial diseases, not on diseases caused by viruses, like measles.
While measles has become less deadly, it remains a danger to some, such as children whose immune systems aren’t yet developed or elderly people and others with compromised immune systems.
Vaccines are important to eliminating infectious diseases because they help to provide what’s called “herd immunity.” Herd immunity means that should one person contract the measles, any possible outbreak can be contained if they are surrounded by people who have been vaccinated. No vaccine is 100% effective. This means that people who do not get a vaccine and then contract the disease put some others who got the vaccine at risk. The higher the vaccination rate, the greater the immunity for everyone.
This, though, requires people to view vaccines as a social obligation, which is made more difficult by mistrust of science and governments. Some of this mistrust is pushed by the religious right. It’s also made worse by the lack of access to scientific education caused by cuts to the public schools.
Immunization could be universally required by the government. Currently, all 50 states in the U.S. legally require children to be immunized, but 17 states allow parents to request exceptions. For such requirements to work, however, requires public trust.
They also require everyone to have access to immunizations. This is not always the case. In this society, some parents don’t have access to medical care and can’t afford to take their kids to a doctor. Some could qualify for Medicaid, but don’t know it. For some, lack of time due to long hours of work or lack of transportation add to the problem, especially when immunizations require multiple visits to the doctor.
Immunizations could be made widely available for free. They could be given in day care centers and pre-schools. Such campaigns were more common in the past than they are today.
The cost of medical care in the U.S. has caused some people to question whether pharmaceutical companies stand to profit from the production of vaccines. While this concern is understandable, in the case of vaccines, which are effective in preventing disease, the concern is misplaced. The pharmaceutical industry and the medical industry would stand to make greater profits from disease outbreaks, which often require hospitalizations and additional medical treatments.
Vaccines have contributed to higher life expectancies around the world. The inequalities and divisions inherent in capitalism interfere with the collective effort required to completely eradicate infectious diseases. As long as it exists, outbreaks like the current one of measles are likely to continue.