Here in the U.S. we have been so successful in eradicating childhood disease through widespread vaccination programs we are setting ourselves up for the return of epidemics of measles, diphtheria, polio and other scourges of pre-vaccine times. We have forgotten what it was like when hundreds of infants and children died or sustained lifelong disability from these diseases annually.
That first paragraph does seem a little inflammatory upon reading but having heard from my parents what it was like to go through a childhood that included these diseases, I wouldn’t wish for it again. My mother told me she had the mumps and measles at the same time. She was lucky to have recovered instead of becoming disabled or dying. In which case (and this sounds self-serving, I know) I wouldn’t be writing this now.
At the time the only way to try to keep these diseases from spreading was to quarantine the homes of the sick, hanging a sign on the door telling everyone to stay away. Unfortunately, by the time the illness was diagnosed the person had been contagious for quite a while. Of such things epidemics are made.
The recent measles outbreak in the Dallas area made me think again of how good we all have it. According to CDC statistics there were an estimated 530,217 cases of measles annually in the U.S. before an effective vaccine became available. The next highest morbidity rate was for whooping cough (aka pertussis) at 200,752 cases annually. This shows just how incredibly contagious measles were and are. Only chicken pox (varicella infection) overshadowed it.
The thing is, people don’t usually die from measles itself. It is more insidious. Measles opens the floodgates wide for secondary infections, most commonly pneumonia (often fatal to the youngest and oldest) but other infections as well. This immune suppressive effect can last for weeks or months after the initial infection. And, like most illnesses, measles and other diseases like it hit infants, the elderly, and the immune-compromised the hardest.
These are the people you protect when you get yourself and your child vaccinated. These vaccinations aren’t just to protect your child. They protect your infant, your nieces and nephews, your cousin undergoing chemotherapy. It keeps safe the HIV positive patient and the neighbor in her 90s. These are the ones who must depend on herd immunity to keep away what, to them, is a plague.
Maybe some numbers will shed some light on what we are now missing out on.
The numbers of cases listed below were reported in the Morbidity and Mortality Weekly Report (MMWR) and the number of deaths is from the National Center for Health Statistics Mortality Report for the years shown. These are for the U.S. only.
|Disease||Year||Number of Cases (Morbidity)||Deaths (Mortality)|
|1963 (vaccine introduced)||385,156||364|
|Mumps||1968 (1 year after vaccine introduced)||152,209||25|
*even with vaccine introduced in 1921
**vaccine introduced 1926
At its peak in 1952, there were 57,879 cases of paralytic polio. 3,145 died from it. There simply weren’t enough iron lungs (the precursor to the respirator) to go around. Some in iron lungs recovered enough to leave them behind. Others did not. Many who seemed to have recovered had disabling complications later in life.
The other diseases also had unwelcome consequences. Mumps was a major cause of childhood deafness. Pertussis in infants 6 months and younger causes the highest rate of hospitalization, pneumonia, seizures, encephalopathy, and death of all age groups. Rubella, with over 56,000 cases reported in 1969, caused 29 deaths and 62 cases of Congenital Rubella Syndrome (CRS).
CRS refers to the birth defects caused in utero when the mother is exposed to or contracts Rubella. CRS includes heart defects, cataracts, mental retardation, and deafness. In 1964 to 1965, before a vaccine became available, an epidemic of rubella resulted in 2,100 neonatal deaths and 11,250 miscarriages. Of the rest there were 11,000 born deaf, 3,500 born blind, and 1800 were mentally retarded.
I knew a man in college whose grandmother was exposed to rubella when pregnant with his uncle. I saw his uncle at the age of 50 suffering frequent seizures and difficulty in walking normally. He was mentally retarded, had trouble speaking clearly, and still lived with his mother, my friend’s grandmother. My friend’s father thought his brother was dangerous and refused to allow his children near him.
I have children. I know how very protective parents are, susceptible to worrying about anything that is even rumored to harm our children. But rather than be worried that vaccinations may result in some unseen harm to our child, we should be worried about the harm that will come to all children and many adults as well if too many of us refuse to properly immunize our children.
A brief version of this article appeared as a Volunteer Voices Column Dallas Morning News in September 2013.