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posted by martyb on Thursday April 11 2019, @12:06PM   Printer-friendly
from the disease-outbreak-spotted dept.

If using the law to corral antivaxxers doesn’t work at first, try, try again. At least, that seems to be the lesson learned by New York City Mayor Bill de Blasio. On Tuesday, he declared a state of emergency and mandated residents of the Williamsburg neighborhood, where an outbreak of measles has been raging since last fall, get vaccinated for the viral disease. Those who choose not to will risk the penalty of a $1,000 fine.

https://gizmodo.com/new-york-city-orders-williamsburg-residents-to-get-vacc-1833917175


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  • (Score: 3, Informative) by martyb on Thursday April 11 2019, @03:27PM (5 children)

    by martyb (76) Subscriber Badge on Thursday April 11 2019, @03:27PM (#828009) Journal

    https://en.wikipedia.org/wiki/Measles [wikipedia.org]:

    Measles affects about 20 million people a year, primarily in the developing areas of Africa and Asia. While often regarded as a childhood illness, it can affect people of any age. It is one of the leading vaccine-preventable disease causes of death. In 1980, 2.6 million people died of it, and in 1990, 545,000 died; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000. Rates of disease and deaths, however, increased in 2017 due to a decrease in immunization. The risk of death among those infected is about 0.2%, but may be up to 10% in people with malnutrition. Most of those who die from the infection are less than five years old.

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  • (Score: 0, Informative) by Anonymous Coward on Thursday April 11 2019, @03:33PM (4 children)

    by Anonymous Coward on Thursday April 11 2019, @03:33PM (#828018)

    You can't compare measles complications in developing countries to the US. Instead look at the US/UK in the 1960s. Rate of complications had already dropped at least two orders of magnitude in those countries by then.

    • (Score: 3, Disagree) by martyb on Thursday April 11 2019, @03:44PM (3 children)

      by martyb (76) Subscriber Badge on Thursday April 11 2019, @03:44PM (#828034) Journal

      You can't compare measles complications in developing countries to the US. Instead look at the US/UK in the 1960s. Rate of complications had already dropped at least two orders of magnitude in those countries by then.

      Why can't they be compared? It is because of vaccinations in those countries that the number of deaths was dramatically reduced. What you are advocating could KILL people. Especially those who are immunocompromised or on anti-rejection drugs because of organ transplants. Those people depend on "herd immunity" to reduce the number of active cases and so protect them from coming into contact with this extremely contagious disease.

      This is analogous to driving without a fastened seatbelt on the off-chance one would be in an accident where being flung from the vehicle would save one's life, ignoring the far more common cases where it would prevent/reduce injury or death.

      --
      Wit is intellect, dancing.
      • (Score: 1, Interesting) by Anonymous Coward on Thursday April 11 2019, @04:18PM (2 children)

        by Anonymous Coward on Thursday April 11 2019, @04:18PM (#828077)

        Why can't they be compared? It is because of vaccinations in those countries that the number of deaths was dramatically reduced.

        No, the deaths were drastically reduced before vaccinations.

        Death from measles in Britain is now unusual. In 1961 the rate was as low as 2 per 10,000 notifications-a figure which was repeated in Miller's experience in 1963. Further- more, in one-half of the deaths there was an accompanying chronic disease or disability which in the majority was described as a serious handicap. It is reasonable, therefore, to conclude that in the past 30 years mortality from measles has been reduced to virtually the lowest figure possible.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1815980/ [nih.gov]

        Figure 1 presents annual morbidity and mortality for the expanding reporting areas from 1912 to 1959. Note the stability of the morbidity rate and the steady downward trend in the mortality rate. Also, there is the somewhat ominous suggestion of a cessation of this downward trend since 1955 similar to the leveling off of the infant death rates during the past six years. The morbidity figures testify to the stability of the biological balance of measles during the period. The decline in mortality demonstrates the degree to which we have adapted to this balance and have learned to live with this parasite.

        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1522578/ [nih.gov]

        What you are advocating could KILL people.

        Not sure where I advocated anything. What I would advocate is either:

        1) Go all out and eradicate measles and be done with it
        2) Only vaccinate select people like healthcare workers, etc.

        Right now, we are vaccinating just below the eradication threshold which is known to cause giant epidemics:

        The second scenario represents the impact of a vaccination programme that reaches high levels of coverage (85% of all new-borns) which are, nevertheless, not high enough to lead to eradication of the agent. However, for the first 15 years after the introduction of vaccination, it appears as if eradication has been achieved, there are no infections. Then, suddenly, a new epidemic appears as if from nowhere. This is an illustration of a phenomenon known as the ‘honeymoon period’. This is the period of very low incidence that immediately follows the introduction of a non-eradicating mass vaccination policy. This happens because susceptible individuals accumulate much more slowly in a vaccinated community. Such patterns were predicted using mathematical models in the 1980s6 and have since been observed in communities in Asia, Africa and South America7. Honeymoon periods are only predicted to occur when the newly introduced vaccination programme has coverage close to the eradication threshold.

        http://www.ncbi.nlm.nih.gov/pubmed/12176860 [nih.gov]

        Meanwhile the immunity of hundreds of millions of adults is waning:

        To examine the persistence of vaccine-induced antibody, participants of a vaccine study in 1971, with documentation of antibody 1–7 years after vaccination, were followed up in 1997–1999 to determine the presence and titer of measles antibody. Of the 56 participants (77% were 2-dose recipients), all had antibodies detected by the plaque reduction neutralization (PRN) antibody assay an average of 26–33 years after the first or second dose of measles vaccine; 92% had a PRN titer considered protective (>1:120).

        https://www.ncbi.nlm.nih.gov/pubmed/15106101 [nih.gov]

        Somewhat concerning are the results of the most recently vaccinated group 3. Those in the group have lived their lives in an environment that can be considered completely free of natural boosters. As soon as 5 years after the second dose of MMR vaccination, 4% of the individuals were seronegative and 14% low positive for measles.

        https://www.ncbi.nlm.nih.gov/pubmed/22966129 [nih.gov]

        Can you imagine what is going to happen when tens or hundreds of millions adults all get measles at the same time? Because that is what is going to happen if we keep doing what is advocated by the CDC. We should have never altered the epidemiology of measles to begin with if you ask me, but now that we have...

        • (Score: 3, Informative) by martyb on Thursday April 11 2019, @09:16PM (1 child)

          by martyb (76) Subscriber Badge on Thursday April 11 2019, @09:16PM (#828269) Journal

          Okay, maybe I am misunderstanding what you are advocating. Are you suggesting that, because of complications, people should not be vaccinated? Or that we should go all out and vaccinate everyone we can until we can eradicate the disease?

          I sensed you were advocating for no vaccination. If you were advocating otherwise, I would appreciate a statement of what you are advocating.

          According to the WHO (World Health Organization) in 2014 [archive.org] (emphasis added):

          Key facts

          • Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.
          • In 2013, there were 145 700 measles deaths globally – about 400 deaths every day or 16 deaths every hour.
          • Measles vaccination resulted in a 75% drop in measles deaths between 2000 and 2013 worldwide.
          • In 2013, about 84% of the world's children received one dose of measles vaccine by their first birthday through routine health services – up from 73% in 2000.
          • During 2000-2013, measles vaccination prevented an estimated 15.6 million deaths making measles vaccine one of the best buys in public health.

          Measles is a highly contagious, serious disease caused by a virus. In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year.

          The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. Approximately 145 700 people died from measles in 2013 – mostly children under the age of 5.

          [...] Accelerated immunization activities have had a major impact on reducing measles deaths. During 2000-2013, measles vaccination prevented an estimated 15.6 million deaths. Global measles deaths have decreased by 75% from an estimated 544 200 in 2000 to 145 700 in 2013.

          [...] By 2013, the global push to improve vaccine coverage resulted in a 75% reduction in deaths. During 2000-2013, with support from the Measles & Rubella Initiative (M&R; Initiative), measles vaccination prevented an estimated 15.6 million. During 2013, about 205 million children were vaccinated against measles during mass vaccination campaigns in 34 countries. All WHO Regions have now established goals to eliminate this preventable killer disease by 2020.

          Their stated goal (emphasis added):

          By the end of 2020

          • To achieve measles and rubella elimination in at least 5 WHO regions.

          The strategy focuses on the implementation of 5 core components:

          • achieve and maintain high vaccination coverage with 2 doses of measles- and rubella-containing vaccines;
          • monitor the disease using effective surveillance, and evaluate programmatic efforts to ensure progress and the positive impact of vaccination activities;
          • develop and maintain outbreak preparedness, rapid response to outbreaks and the effective treatment of cases;
          • communicate and engage to build public confidence and demand for immunization;
          • perform the research and development needed to support cost-effective action and improve vaccination and diagnostic tools.

          Unfortunately, recent reduced vaccination rates has precluded attaining that goal:

          Based on current trends and performance, global immunization experts concluded that the 2015 measles milestones and elimination goals will not be achieved on time. Resuming progress will require countries and immunization partners to raise the visibility of measles elimination, address barriers to measles vaccination, and make substantial and sustained additional investments to strengthen health systems and achieve equitable access to immunization services.

          As I understand it, the World Health Organization is advocating for MORE vaccination participation with a goal of eradicating this disease. That makes sense to me.

          --
          Wit is intellect, dancing.
          • (Score: -1, Troll) by Anonymous Coward on Thursday April 11 2019, @09:27PM

            by Anonymous Coward on Thursday April 11 2019, @09:27PM (#828284)

            First, there isn't a single reference on that page so I have no idea where those numbers are coming from. There isn't even an author to hold responsible, so I don't consider it a reliable source.

            goal of eradicating this disease.

            Read carefully, they talk about "eliminating" instead of "eradicating":

            Although 3 of 6 World Health Organization regions have established measles elimination targets, measles elimination goals are not well defined. In general, disease elimination has been defined as the reduction of incidence in a population to zero. However, measles is so contagious that zero incidence is difficult to achieve and sustain because the risk of imported measles remains while measles is endemic in any country. Also,imported cases will occasionally result in short chains of indigenous transmission unless a country achieves 100% immunity. Therefore, the United States currently uses the absence of endemic measles (i.e., no indigenous chains of transmission persisting for ⩾1 year) as the programmatic goal for measles elimination.

            https://www.ncbi.nlm.nih.gov/pubmed/15106085 [nih.gov]

            This is a huge difference, because eradication means there is no longer any excuse for the vaccine. Elimination means buying the vaccine for every new generation forever.