There is always someone looking back to the good old days when everyone got measles and “no one died or had a problem.”
It is a denial of the efficacy of vaccinations and a lack of understanding of broad statistics.
So when your uncle or aunt makes such a comment let me give you a few points to discuss.
Measles is a highly contagious viral disease that can lead to severe complications, including pneumonia, encephalitis, and death. The risk of complications is particularly high in young children, immunocompromised individuals, and those with underlying health conditions.
During the 2018-2019 measles outbreak in New York City, it was observed that activities such as "measles parties" facilitated the spread of the virus, leading to increased transmission and higher infection rates among susceptible populations. Meaning - the infants, grandparents, people undergoing chemotherapy or have other immunocompromises.
Most anti-vaccination types don’t understand that measles can cause long-term health issues. For instance, subacute sclerosing panencephalitis (SSPE) is a rare but fatal complication that can occur years after the initial measles infection, predominantly affecting children who contracted measles at a young age. This underscores the importance of preventing measles infection through vaccination rather than intentional exposure.
Additionally, measles outbreaks place a significant burden on public health resources. Containing outbreaks requires extensive contact tracing, isolation measures, and post-exposure prophylaxis, which are resource-intensive and costly. For example, the response to a measles outbreak in Salt Lake County, Utah, involved tracing thousands of contacts and providing prophylaxis to nearly 400 people, costing approximately $300,000. Already Texas has spent at least that much money following up on this epidemic.
Finally, the practice of holding measles parties undermines public health efforts to maintain high vaccination coverage, which is crucial for herd immunity. High vaccination rates are essential to prevent outbreaks and protect those who cannot be vaccinated, such as infants and individuals with certain medical conditions. We need a 95% vaccination rate.
Before the implementation of vaccination programs, measles mortality rates were significantly high. Historical data indicates that during the early 20th century, mortality rates during measles epidemics could be as high as 40% in certain isolated populations, such as the Polynesian island of Rotuma and Boer War concentration camps. In more general settings, the case fatality ratio (CFR) for measles varied widely but was often substantial. For example, in an isolated German village in 1861, the overall CFR was 6.4%, with a higher rate of 10% among children under five years of age.
In developing countries, the CFR for measles could exceed 5% before widespread vaccination efforts. In 1980, before the global use of measles vaccines, an estimated 2.6 million measles deaths occurred annually worldwide. These high mortality rates underscore the critical impact of vaccination programs in reducing measles-related deaths.
Facts won’t change the mind of the anti-vaccination minded individual. But for those on the fringe, it helps to provide information so they don’t fear vaccination or think that it is simply a “mild” disease.
References:
Measles Epidemics of Variable Lethality in the Early 20th Century. Shanks GD, Hu Z, Waller M, et al. American Journal of Epidemiology. 2014;179(4):413-22. doi:10.1093/aje/kwt282.
Measles in the European Past: Outbreak of Severe Measles in an Isolated German Village, 1861. Aaby P, Thoma H, Dietz K. The Journal of Infection. 2022;84(5):668-674. doi:10.1016/j.jinf.2022.02.010.
Measles. Rota PA, Moss WJ, Takeda M, et al. Nature Reviews. Disease Primers. 2016;2:16049. doi:10.1038/nrdp.2016.49.
Progress in Global Measles Control, 2000-2010. MMWR. Morbidity and Mortality Weekly Report. 2012;61(4):73-8.
Transmission Dynamics of and Insights From the 2018-2019 Measles Outbreak in New York City: A Modeling Study. Yang W. Science Advances. 2020;6(22):eaaz4037. doi:10.1126/sciadv.aaz4037.
High Risk of Subacute Sclerosing Panencephalitis Following Measles Outbreaks in Georgia. Khetsuriani N, Sanadze K, Abuladze M, Tatishvili N. Clinical Microbiology and Infection : The Official Publication of the European Society of Clinical Microbiology and Infectious Diseases. 2020;26(6):737-742. doi:10.1016/j.cmi.2019.10.035.
Protecting the Public's Health: Critical Functions of the Section 317 Immunization Program-a Report of the National Vaccine Advisory Committee. Public Health Reports (Washington, D.C. : 1974). 2013 Mar-Apr;128(2):78-95. doi:10.1177/003335491312800203.
Consequences of Undervaccination — Measles Outbreak, New York City, 2018–2019. Zucker JR, Rosen JB, Iwamoto M, et al. The New England Journal of Medicine. 2020;382(11):1009-1017. doi:10.1056/NEJMoa1912514.