tag:blogger.com,1999:blog-3492197469143963742.post9041381703585955041..comments2023-06-13T04:45:22.434-04:00Comments on Infection Landscapes: Measles Part 2: The Vaccine and the Control of a KillerMichael Walshhttp://www.blogger.com/profile/05038031388622939797noreply@blogger.comBlogger22125tag:blogger.com,1999:blog-3492197469143963742.post-72872010868050751722016-04-25T03:58:37.347-04:002016-04-25T03:58:37.347-04:00Yes education is very important. It is not only th...Yes education is very important. It is not only the study that connects vaccines to autism, which gives "anti-vacciners" leverage, there are more reasons why people refuse to vaccine their children. these other ideas must be addressed rationally in order that those people can feel their perspective has been taken into account and considered.Shmuelhttps://www.blogger.com/profile/16321894818345397249noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-40964087276955821832016-04-25T03:55:53.068-04:002016-04-25T03:55:53.068-04:00I found it interesting that measles has not change...I found it interesting that measles has not changed its genomic makeup throughout the changes. Are there other diseases where the virus or genomic species remains unchanged? what is unique about Measles that it does not have mutations. <br />ALthough the genetic formula for the vaccine an remain the same as it was when it was first inveted, has there been improvements on the vaccine since its first use?Shmuelhttps://www.blogger.com/profile/16321894818345397249noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-39968589740320608912016-04-21T21:12:58.542-04:002016-04-21T21:12:58.542-04:00I also agree that we need a renewed public health ...I also agree that we need a renewed public health effort to discredit the false claims against vaccines. Additionally, it would be beneficial to remind Americans (and likely those in other developed countries who have forgotten about the health burden caused by measles and consequently have seen waning vaccine rates) about the complications that measles can cause. As I mentioned via Facebook I was led to an anti-vaccination page and through the comments saw that many people believe measles is harmless. As we learned in class this is not the case but if this is the thinking of anti-vacciners it is understandable why people would feel vaccinations are unnecessary. Thus, it seems we are at a critical point where false claims must be dismantled via research and then research must be widely publicized in a way that all Americans can understand. Communication is paramount in public health initiatives. Similarly, all of the research in the world discrediting false claims is useless if it is not shared with the general public in an effective manner. Anonymoushttps://www.blogger.com/profile/17313907471755424252noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-33262555024905954162016-04-14T23:26:05.795-04:002016-04-14T23:26:05.795-04:00Recently on FB I saw a post about the link between...Recently on FB I saw a post about the link between autism and vaccinations. Quite honestly I am baffled (and horrified) that people still hold this belief despite multiple studies showing no association (as mentioned in the posting). At this point because the anti-vaccination campaigns seem to be gathering a larger uninformed mass, the media should take up the task of explaining both the importance of vaccines and discrediting the negative associations that people believe. Obviously, public health has a role to play. However, unfortunately the media (and social media) seem to more easily reach a larger mass than PH campaigns. Thus, they should increase awareness about vaccine importance while discrediting misinformation rather than just tell people they NEED to vaccinate their children. Although not every anti-vacciner can be reasoned with, many are probably just ill-informed and providing evidence to back-up any statement may help change their mind. As a side bar, The Lancet should also take a role in publishing one of the systematic reviews or meta-analyses on MMR vaccine efficacy and safety as they were the one that published the fraudulent article in the first place. Additionally, as the Lancet is a scientific magazine with a broader reader base they have the ability to reach more of the population. Either way, the anti-vaccination movement seems to be growing and social media allows these ideas to spread quickly...some sort of public health awareness initiative/ media collaboration should happen sometime in the very near future! Anonymoushttps://www.blogger.com/profile/17313907471755424252noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-72013440629877286082016-03-11T15:08:20.952-05:002016-03-11T15:08:20.952-05:00With the increase in outbreaks in recent years in ...With the increase in outbreaks in recent years in the United States, I think that public health initiatives should be made to widely discredit the false claims against measles vaccines. The argument that many people make seem to be the link with autism, but I think that maybe advertisements should be widely publicized on TV. Especially because there is so much scientific evidence proving otherwise, and the doctor that published those findings initially has had his medical license revoked. It seems that most Americans would not think of measles being a severe disease, but that is because it has been mostly eliminated in the US so they do not know how serious it can be. I think that the most effective way to get people to vaccinate children would be to educate the public on how damaging a measles infection can be. Christine Leehttps://www.blogger.com/profile/08026286087487756149noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-45945949321135971482016-02-26T16:39:12.236-05:002016-02-26T16:39:12.236-05:00This is a great review of vaccines and it is inter...This is a great review of vaccines and it is interesting to think of measles as a good candidate for eradication. It was eliminated in the U.S. but the vaccination rates are frustratingly just not high enough. During the recent Disney land outbreak I looked up some of the anti-vaccine webpages to try to understand why there is such a movement and I realized there are a lot of adverts on these pages for very expensive food supplements and alternative meds (i.e. not meds) that promise to counter the effects of autism and other disorders. So people are making money out of the distress that parents have over having a child with serious problems and the result is a measles outbreak. I believe a few states tightened the exemptions after this outbreak so only kids with valid health reasons for not being vaccinated are exempt.<br />It is interesting to see how the dose recommended was refined over time. Safety and efficacy are part of clinical trials but it is interesting to see how the efficacy and safety was monitored after introduction, over years in large populations. <br />Anonymoushttps://www.blogger.com/profile/07792996651771706535noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-45168003641366118932015-09-18T10:57:07.973-04:002015-09-18T10:57:07.973-04:00In a word, we are facing the 2015 outbreak of meas...In a word, we are facing the 2015 outbreak of measles that originated in Disneyland due to fears of Autism. Parental reservations about vaccinating their children with the Measles vaccine stems from anxiety about the preservative thimerisol, which despite evidence that it does not cause autism, was removed from the MMR vaccine since 2001 as a precaution. Thimerosal breaks down into ethylmercury, but unlike methylmercury which is found in some fish, it does not accumulate in the body as a neurotoxin. American’s reliance on herd immunity is no longer a safe bet in this global community. In a global perspective, it is unacceptable that there are still 200,000 measles deaths per year, mostly in India and many sub-Saharan African cultures, where vaccines are not widely available. WHO’s efforts to make this the Decade of Vaccines (DoV) by increasing Universal Access to all vaccines is a 2 sided coin. First, there needs to be a strong public health campaign communicating a clear message about the safety of the measles vaccine. More should be done to discredit Wakefield's unethical and fraudulent scientific misconduct, which has now become urban legend. Most people don’t know the facts on which they decide not to vaccinate. Second, universal access to the measles vaccines must be established for all children internationally, a project that the US should also be invested in; it’s a small world after all! Anonymoushttps://www.blogger.com/profile/06851929241182903843noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-39488091259219508392015-07-17T10:43:04.737-04:002015-07-17T10:43:04.737-04:00David, I'm so glad you mentioned this in your ...David, I'm so glad you mentioned this in your post. In some ways, I feel like one of the biggest problems measles presents us with these days is the obstacle to vaccination. I've read somewhere, unfortunately I can't remember where, that parts of Brooklyn--Park Slope sounds familiar--have some of the lowest vaccination rates in the country. It's paradoxical and very frustrating to know that prevention is out there but resisted due to debunked science. Just goes to show how important our positions can be in educating the public about true interpretations of jargon-heavy, complex, and exclusive science articles. There's a lot of value to make science, especially health science, more accessible.Anonymoushttps://www.blogger.com/profile/14276267209239357477noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-72050884625572646632015-06-19T11:40:15.924-04:002015-06-19T11:40:15.924-04:00I believe that that is correct: that the genome of...I believe that that is correct: that the genome of measles is quite parsimonious, so what you expect to happen with an RNA virus--mutations accumulating without a proofreading function--doesn't create a virus with new antigenic markers because the mutations lead to loss of function. <br /><br />The other reason, is that the measles virus is not segmented, so it cannot undergo genetic reassortment in the way that, say, influenza virus does.<br /><br />It's possible that the blame belongs with celebrity attention, but it seams as though we're also losing our collective memory. I've never met anyone with the measles, or any of the potentially awful sequelae (like irreversible encephalopathy). I think it may be the case that, where vaccines are concerned, and especially effective vaccines, it might be our challenge to remember that we are actively preventing disease, especially when that disease's marks on society aren't seen.Anonymoushttps://www.blogger.com/profile/00446188801114332575noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-53685195346530585562014-11-20T18:50:41.621-05:002014-11-20T18:50:41.621-05:00It's a shame that so many believe what they he...It's a shame that so many believe what they hear on television such as he link of Autism and the MMR vaccine. I myself know people who have children and don't want them vaccinated because hearing about the bogus report. There has to be more awareness and education with medications and vaccinations because up to this day many people still do not know why they have to finish antibiotics that they have started.Anonymoushttps://www.blogger.com/profile/14122314050191522427noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-11065087023213318782014-07-18T18:09:02.625-04:002014-07-18T18:09:02.625-04:00I agree. A lot of these theories and anti-vaccinat...I agree. A lot of these theories and anti-vaccination belief arise from misinformation. People of such communities and groups are not ultimately uninformed. Trust and effective communication are crucial to relay the importance of immunization.Racquel Breretonnoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-18996253546365284662014-07-11T08:03:41.659-04:002014-07-11T08:03:41.659-04:00Difaa, I completely agree that many people are now...Difaa, I completely agree that many people are now depending on herd immunity for measles versus becoming protected and vaccinated themselves however this leads now to a greater percentage of people that are unvaccinated thus lowering the herd immunity rate, increasing the potential for spread of disease higher than we have experience in some years. I believe some children were excused from having the vaccine before entering school due to religious/culture beliefs and backgrounds but now many parents are not having their children vaccinated for fear that the vaccine is potentially harmful due to not enough knowledge, since the disease hasn’t been around for a few decades now, as well as media rumors endorsed by also uninformed celebrities. In other countries that are still developing, knowledge of measles and the vaccine are probably low as well as reaching populations in various types of outskirts and regions can be difficult.Nicole Mastrogiovanninoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-77010578568557667932014-07-09T11:07:49.159-04:002014-07-09T11:07:49.159-04:00One of the reason many individuals do not get vacc...One of the reason many individuals do not get vaccinated is because they depend on herd immunity. People are depending heavily on herd immunity when it is currently declining due to the lack of vaccinations occurring. <br /><br />What are the current herd immunity percentage?<br /><br />I am curious to understand why some kids can enter school when they are not vaccinated. If herd immunity is declining, shouldn’t there be a stronger enforcement of children vaccinating? Difaanoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-41679474767991282762014-07-04T19:13:19.141-04:002014-07-04T19:13:19.141-04:00I also looked into this issue of religious exempti...I also looked into this issue of religious exemptions for immunizations. It seems that all 50 states require some form of vaccination before a child begins at a public school. However, 48 states have allowed religious exemptions and 18 states have allowed exemptions by "personal belief," by which they mean religious denominations not recognized by the State, such as Pastafarianism, or the Church of the Flying Spaghetti Monster <br />(http://www.vaccinesafety.edu/cc-exem.htm). <br /><br />This allows the population the option to forego vaccinating their child (in NY, only 0.45% had claimed such a religious exemption in 2011). However, in a recent ruling in NY, a federal judge upheld the City's barring of unvaccinated children from school even though 2 of the children had exemptions, writing in his opinion that he doubted the constitutionality of religious objections to vaccination <br />(http://www.nytimes.com/2014/06/23/nyregion/judge-upholds-policy-barring-unvaccinated-students-during-illnesses.html).<br /><br />A new challenge for public health officials in trying to gain the trust of the community is the rising prices of vaccinations. As Dr. Walsh pointed out in the article, a cold chain is required for the MMR vaccine and it can apparently get quite expensive. Just this week, I saw an article in the NYT where some poor doctor had to remortgage her house to afford the spiking costs of vaccines and secure fridges for these vaccines. The MMR shot apparently costs her patients over $50, and there are two shots. Many patients may not be able to afford the $100 and with insurance companies reimbursing doctors insufficiently for these expensive shots, many private primary care physicians may soon stop offering vaccines. This could spell disaster for many communities, especially poor communities which see an influx of immigrants and/or travelers. Poor communities that either don't have enough information about the benefits of vaccines, don't have enough money to afford the vaccines, or don't have enough doctors offering vaccinations will be at a higher risk for an epidemic if (or should I say when, with the speed of travel being what it is) a malignant organism is introduced. Public health officials must focus on all these issues if measles is to be eradicated. Here's the article:<br />http://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html.<br />Mohammad Raohttps://www.blogger.com/profile/07745537034237857591noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-19099363437837428642014-07-02T16:56:12.347-04:002014-07-02T16:56:12.347-04:00While I wish the section on the safety of the meas...While I wish the section on the safety of the measles vaccine was not necessary, it has indeed become a growing issue in the United States. Through the efforts of certain bad actors on the national stage, we have seen the reemergence of measles in 17 outbreaks in the first 6 months (until June 27th) alone. There have been 539 cases in the first half of 2014, keeping us on pace for a record number of cases in the 21st century so far, the highest number of cases per year since measles elimination was achieved here in 2000 (http://www.cdc.gov/measles/cases-outbreaks.html). One of the reasons for the resurgence this year is because the Philippines is experiencing a large outbreak, and a number of cases where imported into the US from that area. This is another factor, in addition to the one presented in the article, that undermines attempts at eradication of the disease: increasingly fast travel and laxer public health regulations of travel can influence the spread of disease. <br /><br />Also, I’d like to bring up the hard numbers on vaccination rates. As was mentioned in this article, measles is so infectious that a 95% vaccination rate of a population is required to affect elimination of measles. The CDC in 2013 found that 20 states reported less than 95% coverage of the 2 doses of MMR vaccine among kindergarten children in the 2012-2013 school year (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm; Table 1). It is hardly a surprise that 8 of these 20 states have had cases of measles so far this year. Mohammad Raohttps://www.blogger.com/profile/07745537034237857591noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-55651678409289527992014-07-02T13:37:29.727-04:002014-07-02T13:37:29.727-04:00I do agree with your view of being in the brink of...I do agree with your view of being in the brink of a widespread epidemic, many individuals are opting out of vaccinating there children as a result of speculation that it leads to autism. The fact that these assumptions are gaining much support is pretty worrisome, especially with such a highly infectious disease. Individuals are using the flawed study as well as celebrities who have decided to not vaccinate their children as reasons to also opt out. Public health and CDC campaign should focus on these individuals as well as provide more education on the vaccinations.Disleirynoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-90936289507318576232014-06-18T14:49:26.305-04:002014-06-18T14:49:26.305-04:00In recent times, Measles has gained more coverage ...In recent times, Measles has gained more coverage due to its now reemergence with now 477 confirmed cases from Jan 1 to June 13th as reported by the CDC <br />http://www.cdc.gov/measles/cases-outbreaks.html. Alarming is that this is the highest amount of cases since measles elimination was documented in 2000 with one of the largest clusters in Ohio (138 confirmed cases), California (60) and NY (26) http://www.washingtonpost.com/news/to-your-health/wp/2014/05/29/u-s-measles-outbreak-sets-record-for-post-elimination-era/. Majority of these cases were from travelers and those who weren't vaccinated highlighting an important aspect of public health efforts in trying to combat measles and how fear and lack of awareness following the Wakefield study has now created an atmosphere of doubt and long-term consequences. Herd immunity is now more jeopardized in this sense and that efforts need to be revived to further make sure measles doesn't become more widespread.<br />Anonymoushttps://www.blogger.com/profile/13004424672438793997noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-25639981163877450482013-09-13T12:51:36.201-04:002013-09-13T12:51:36.201-04:00I agree with the notion that distrust or doubt in ...I agree with the notion that distrust or doubt in medicine, or sometimes worse – the confusion by “scientific knowledge” as published in Wakefield’s study, leads to refusal of vaccination and anti-vaccine movements in the general public. The safety, effectiveness and adverse effects of a vaccine are certainly important factors the public is most concerned about. In addition, these information will not be confirmed until years of study, just like MMR vaccine. It is the public health and medical professionals’ obligation to clarify the misunderstanding and to disseminate the correct information to the public. More importantly, a strict and on-going surveillance system should be maintained to help eliminate the disease – not just continuing on the current vaccination protocol, but also focusing on the program that targets on the generation who has missed the best opportunity for vaccination due to false information, as importations of measles from other countries that have low adherence to the vaccination have posed the greatest risk for outbreaks in U.S. Anonymoushttps://www.blogger.com/profile/17602518758241358960noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-35119138524431290302012-09-20T20:21:21.614-04:002012-09-20T20:21:21.614-04:00@ Andriane Melanthiou you raise a very valid point...@ Andriane Melanthiou you raise a very valid point that public health professionals should investigate how religions can sometime impede individuals from participating in vaccination programs, and how these actions possibly put the general public at risk. I found online that unicef in 2004 started an international intervention program specifically focusing on building trust in immunization by partnering with different religious leaders and groups throughout the world (However, I am not sure if it is still being conducted). The main objectives of this intervention were: forging alliances, building trust, learning from each other, and providing resources. All in hopes that these partnerships would lead to an increase in vaccinations in areas of the world that need them the most. <br />Here is the link if you are interested:www.unicef.org/ceecis/building_trust_immunization.pdf <br />Bianca H.https://www.blogger.com/profile/09685324878511088126noreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-62657150632950038112011-10-07T13:52:52.855-04:002011-10-07T13:52:52.855-04:00Immunizations have been a great way of protecting ...Immunizations have been a great way of protecting the public from a variety of diseases and associated outbreaks. I know that besides the anti-vaccine movements we have seen in the past, a lot of religious groups do not believe in vaccinations or even regularly visiting a physician. This is a bit scary to say the least because such beliefs really place the general public at high risk. This is something for public health professionals to look into because we should be able to get important health messages across to everyone. Future outbreaks will therefore be reduced if not prevented altogether.Andriane Melanthiounoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-38132945339128433002011-09-29T17:02:26.295-04:002011-09-29T17:02:26.295-04:00I agree with this idea of needing financial suppor...I agree with this idea of needing financial support for attention, but I also believe that a lot of anti-vaccine movements have to do with a general distrust for government or medicine in general. As we saw this week with the ebola outbreak case study, there was a strong distrust for the health care workers in Gabon investigating the outbreak; I realize that an outbreak is different then a vaccine, but the idea is the same. The media and celebrity influences will get the word out there, but I belief that a distrust in authority is also a main driving factor. Like the Swine Flu outbreak of 2009, it seems as though people are just waiting for a reason to support these anti-vaccine movementsChristopher Donnellynoreply@blogger.comtag:blogger.com,1999:blog-3492197469143963742.post-14355810741875962922011-09-09T11:53:04.105-04:002011-09-09T11:53:04.105-04:00When you discuss the damaging Wakefield study, you...When you discuss the damaging Wakefield study, you place the blame on the media for propagation of the story. I think that at least part of the blame belongs with the celebrity attention that the study received. Anti-vaccine movements, like other movements, need to have fame and/or money to be able to present their side to others and convince others of their side. <br />You also mention toward the end there is a low mutation rate, despite the fact that it is an RNA virus. Is it possible, with its small genome that only codes for 8 proteins, that each protein is so specific to measles infection that a mutation will negatively affect the virus's ability to infect?Dov Rosenbaumnoreply@blogger.com