To Vaccinate or Not to Vaccinate

Note: A picture that was included with this story when it was originally posted has been removed.

Since the end of December, when Disneyland was connected to a measles outbreak, the disease has been on the minds of many. The issue has brought to light the debate over vaccines, as well. The question has become whether or not parents should be required to immunize their children. The outbreak has now reached over 15 states and has infected more than 100 people in the U.S., and parts of the high contraction rate can be attributed to people who go unvaccinated. The state of Illinois has reported a total of 14 cases, with 13 of the cases being linked to a day care in Palatine. The reports that  Palatine’s KinderCare has been associated with  include 11 children and two adults. However, the Cook County Department of Public Health has announced that the overall risk of measles is low, according to Outbreak News Today.

However, as measles continues to grow, it is important to understand what the disease is, the place the virus has in society today, and how the growing debate over vaccinations all started.

 What is Measles?

Rubeola, a virus more commonly known as measles, is an infectious disease that is most common in childhood. The infection can be prevented by way of vaccination. Common symptoms often include “cough, runny nose, inflamed eyes, sore throat, fever, and a red, blotchy skin rash,” according to the Mayo Clinic. The incubation period is about 10-14 days, and it is contagious four days before the rash appears until four days after it is present. The infection can be serious for small children, especially those who are unvaccinated and infants who have not received the immunization yet.

“If given at the appropriate interval and age, after two doses of measles vaccine a person is considered protected for life,” Dr. Tina Tan, an infectious disease specialist at Lurie Children’s Hospital in Chicago, told the Chicago Tribune.

The Centers for Disease Control (CDC), American Academy of Pediatrics, and American Academy of Family Physicians recommend that the first dose of the measles-mumps-rubella (MMR) vaccine is administered at 12-15 months old. It should be followed by the second dose between the ages of 4 and 6, before the child enters kindergarten.

History of the Virus and Vaccines

In 1954, John F. Enders and Dr. Thomas C. Peebles set out to create a vaccine for the measles by taking blood samples from severely ill patients during the outbreak in Boston. From there, they wanted to isolate the disease in the patients’ blood samples in order to create the vaccine. They succeeded in doing so with the blood of a 13-year-old boy named David Edmonston.

In 1963, Enders and his colleagues created a vaccine for the Edmonston-B strain of measles and licensed it to the U.S. Five years later, Maurice Hilleman and colleagues improved the vaccine, and it has become the only vaccine for the measles used in the U.S. since 1968.

In 2000, the measles was declared eliminated in the U.S., according to the CDC. This means that there was an “absence of continuous disease transmission for greater than 12 months.” This was in part due to the effective vaccination program and rates, along with enhanced measles control.

The anti-vaccine movement can be traced to 1998, when former British surgeon Andrew Wakefield published an article making a possible connection between autism and vaccines. While the article and theory was later disproven on countless accounts, vaccines still became questionable in the eyes of many people. Wakefield’s medical license has since been revoked.

Measles Today

The question regarding vaccinations recently came to light again, starting in late December 2014, when Disneyland was connected to a measles outbreak. According to the CDC, 141 people from 17 states and Washington D.C. were reported to have measles between Jan. 1- Feb. 13. Of these cases, 113, or 80 percent, have been linked to Disneyland. These numbers are still rising: 20 people contracted and reported the virus between Feb. 6-13.

Dr. Gil Chavez, deputy director of the California state health department, said that people with vaccinations need not to worry about visiting the parks. However, he suggested that anyone unvaccinated should take caution.

“But if you are unvaccinated, I would worry about it,” the doctor said on Jan. 22 in press conference. “And if you have a minor that cannot be vaccinated – under the age of 12 months, I would recommend that those children are not taken to places like Disneyland today.”

This statement was modified the next day and extended to areas such as malls and airports.

Suzi Brown, a spokeswoman from Disney, agreed with Chavez that the parks were “absolutely safe to visit” for the immunized, according to Reuters. She also said that the outbreak had not had an effect on the amount of Disneyland’s visitors.

The chief medical officer for Walt Disney Parks and resorts, Dr. Pamela Hymel, announced that vaccinations and measles tests were being offered to Disney’s cast members.

Measles in Politics

The debate on vaccines has made its way into the world of politics in the last couple of months. President Obama said in an interview with NBC News that he recommends that all parents get their children vaccinated.

“I understand that there are families that in some cases are concerned about the effect of vaccinations,” the president said. “We’ve looked at this again and again. There is every reason to get vaccinated, but there aren’t reasons to not.”

However, some Republican presidential hopefuls did not fully agree, according to the Chicago Tribune. New Jersey governor Chris Christie proclaimed that immunizations should be left up to parents with “some measure of choice.” This statement was then modified by Christie, who later said that children should receive vaccinations.

Another Republican, Rand Paul, a Kentucky senator, stated that vaccines “ought to be voluntary.” Thirty percent of Americans share Paul’s viewpoint and believe that vaccines should be subject to parent’s discretion, according to a report from Pew Research Center released in late January. However, 68 percent say that vaccines should be required.

Doctors’ and Parents’ Opinions

As the debate over vaccinations continues, many doctors have formed a policy under which they refuse to see unvaccinated patients.

Dr. Margaret Van Blerk, a pediatrician,  works in Orange County, Calif.. This region has reported 35 confirmed cases of measles during the current outbreak on Feb. 18. The area also has one of the largest groups of unvaccinated children in California. Van Blerk’s practice is on the brink of letting go of patients who refuse immunizations, according to CBS News.

“We probably will just not be able to see them here anymore,” she said. “I don’t want people bringing their children in here and being fearful they’re going to get exposed to kids who are not vaccinated.”

This concern is widely held by both parents and doctors as the anti-vaccination movement grows.

Jason Muelver, a 43-year old father with two daughters ages 2 and 3, told the Chicago Tribune that he believes that vaccinations are “pretty much a responsibility” and is upset over parents who chose not to vaccinate their children.

Many medical professionals agree with his statement and highly recommend that parents vaccinate their children for their sake and for the sake of others.

“We are uncomfortable with kids in our practice who are not vaccinated,” Dr. Kenneth Fox, a pediatrician with NorthShore University HealthSystem told the Chicago Tribune. “It’s irresponsible to put other kids in danger. This isn’t like Starbucks… you can’t come in and have it your way.”

This belief system does not ring true for everyone, though. Dr. Robert Minkus, a pediatrician in the Skokie area, has seen a rise in questions about vaccines in the last couple months. He is willing to part from the usual immunization schedule and promotes the idea of patients claiming “ownership” of their health, according to the Chicago Tribune.

“When you respect their right to disagree,” he said, “they are more likely to get [vaccinated] because they trust you.”

Libertyville and Measles

Overall, in the sense of vaccinations, Libertyville is covered if a measles outbreak were to hit. According to a Chicago Tribune chart, 99.6 percent of the population at LHS has the measles vaccines. 99 percent of children in the District 70 elementary schools are vaccinated, and 99.5 percent of middle schoolers in Highland and Oak Grove are vaccinated, as well.

Dr. Susan Sheinkop, a pediatrician at Lake Shore Pediatrics in Libertyville, said that these rates were “fantastic” and “awesome.” Ms. Traut, the school nurse at Libertyville High School agreed, calling the statistics “great.”

Dr. Sheinkop attributes the growing number of parents that do not vaccinate their children to a lack of information about the disease and vaccines. Vaccinations have greatly eliminated the presence of diseases like polio and measles, so parents rarely see the disastrous effects that the diseases can have. The pediatrician recalled her earlier days as a doctor in an emergency room, where she saw huge numbers of children affected by the Hib, Haemophilus influenza, type b bacteria. This bacteria causes diseases such as meningitis and pneumonia, as well as many others, according to Dr. Sheinkop’s blog post on Chicago Parent.  Since the vaccine came out, there has been a 99% decrease of the bacteria.

“It’s like a miracle,” she said, referring to the effectiveness of vaccinations.

While the state of Illinois require six different types of vaccinations, including the MMR vaccine for measles, families are allowed to object to vaccinations because of medical reasons or on the basis of their specific religious beliefs.

“We have some here that are unvaccinated; we have some students who are religiously exempted,” Ms. Traut commented on the LHS student body.

Both professionals stressed the importance of vaccines and felt very strongly that parents vaccinate their children.

“Vaccines are a fundamental part of health care for children,” Sheinkop said. “Vaccines have really made children healthier. The benefits so far outweigh the risks.”