Orange County Measles and a Song

Orange County, California — great weather, affluent communities, thriving businesses, the original Disneyland Resort, and a measles outbreak.

By now you’ve probably heard of the Disneyland measles outbreak. As of yesterday, at least 87 cases of measles have been confirmed across seven states and Mexico. And unlike ebola, measles is highly contagious and can be transmitted beginning four days before symptoms appear. But the most troubling aspect of this outbreak is that it’s not really an accident.

Now, I don’t mean that anyone intentionally infected people with measles. Nevertheless, the collective actions–or more specifically, inactions–of parents choosing to not vaccinate their children have created a population susceptible to measles. We knew it would happen. Not exactly when or exactly where, but that the lower the vaccination rates, the higher the probability of an outbreak. So, now it’s happened. And nobody is really surprised, except perhaps, some of the very folks that contributed to the problem.

Measles are Preventable

Prior to the widespread availability of the measles vaccine in 1963, there were 3 to 4 million (yes, million) cases of measles in the U.S. annually. Each year, this lead to 400 to 500 fatalities, 48,000 hospitalizations, and 1000 cases of chronic disability from measles encephalitis. As you can see in the following graph from the CDC, widespread use of the vaccine essentially eradicated the disease.

Measles--United States, 1950-2001

The measles vaccine has been so effective that in the United States, most people alive today have never seen measles. Few remember the levels of suffering, injury, and death of the pre-vaccine era.

The measles vaccine works. But only if it is used.

Dangerous Pseudoscience

pseudoscience (noun): a collection of beliefs or practices mistakenly regarded as being based on scientific method.

Quite simply put, the Orange County measles outbreak is the predictable (and predicted) result of reliance on a dangerous pseudoscience. This has given rise to the recent anti-vaccination movement in the United States and elsewhere. Consider this prophetic warning from a measles FAQ published by the CDC in 2008 (emphasis mine):

The virus is highly contagious and can spread rapidly in areas where vaccination is not widespread. It is estimated that in 2006 there were 242,000 measles deaths worldwide—that equals about 663 deaths every day or 27 deaths every hour. If vaccinations were stopped, measles cases would return to pre-vaccine levels and hundreds of people would die from measles-related illnesses.

But the anti-vaccination movement is not based on evidence. It is based on pseudoscience.

In 1998, Andrew Wakefield (later exposed as a crank and a charlatan) published a paper in a respected scientific journal, claiming a link between vaccines and autism. The paper has since been thoroughly discredited by the scientific community. In 2010, The Lancet retracted and renounced the Wakefield paper. The British Medical Journal, BMJ, called Wakefield’s study an “elaborate fraud” based on misrepresented or altered medical histories.

But, it was too late.  The seeds of a new, dangerous pseudoscience had been sown. For a more complete, but easy to digest history, I highly recommend taking a look at The Facts in the Case of Dr. Andrew Wakefield, a concise history presented in comic book form.

A number of celebrities with huge media visibility–notably Oprah-backed Jenny McCarthy, her then husband Jim Carey (and deserving of “honorable” mention, Bill Maher)–began a concerted anti-vaccination campaign. McCarthy cited her “mommy instinct” as evidence that vaccines were bad. Bill Maher had is wacky instinct that clean living and eating right somehow prevents viral infections. Every time science knocked down an anti-vaccine argument, they simply moved the goal posts and kept beating the drum.

And now, in 2015, we have the Orange County measles outbreak.

A Perfect Storm

As it turns out, Orange County presents a perfect storm of conditions for a measles outbreak. It is the third most populous county in California. It is home to many attractions (e.g., Disneyland, Knott’s Berry Farm, numerous professional sports teams, etc.) and businesses, including the headquarters for many Fortune 500 companies. All of this ensures a steady flow of people–from all over the country, and in fact, all over the world–into and out of Orange County on a daily basis.

And Orange County has one other important ingredient: some of the lowest vaccination rates in the country. For example, at Journey School in Aliso Viejo, 62 percent of kindergarteners are not up to date with their vaccinations. This puts the kindergarten population well below the 95% immunization rate needed to produce the “heard immunity” to avoid widespread outbreaks.

Out With a Song

The bottom line is this:

  • Measles are preventable. The measles vaccine works and is safe. Much, much safer than not using it.
  • The modern Andrew Wakefield-inspired, Jenny McCarthy-promoted, anti-vaccine movement is misguided and dangerous. Deadly dangerous. It is based on pseudoscience. It has a body count.

I find it quite frustrating that the evidence–mountains of evidence on both vaccine efficacy and safety–is freely available, and has been for years. Yet, the anti-vaccination movement, although ever-so-slowly losing momentum, is still incredibly effective at suppressing vaccination rates. Which, in turn, is leading to the resurgence of previously eradicated diseases. The Orange County measles outbreak being the latest example.

But sometimes, a picture is worth a thousand words. And a music video is worth a thousand pictures. So, I’ll leave you with the prophetic, 2009 video, The Jenny McCarthy Song, by Brian Thompson of The Amateur Scientist.