Measles: The Grim Reality
(Part I of this series: Parents: Does the CDC Think We are Stupid?)
Before measles immunization was available, nearly everyone in the U.S. got measles. An average of 450 measles-associated deaths were reported each year between 1953 and 1963.
Was measles a major health problem between 1953 and 1963? Were parents begging for a vaccine? Terrified that their child would die or be permanently damaged by a dangerous disease? Well, no. Some here could give their answer to that question, but better still, ask your parents, and grand-parents what they thought about measles. Find out who in your family was “at risk” of serious complications or death.
The big question, when you see a death rate, is how many deaths occur in relation to the total number of cases? The reported cases, with something like measles, are always going to be much lower than the total cases, and reported cases will generally be more severe, more likely to be hospitalized, and more likely to have a bad outcome. I had measles when I was eight, but my parents didn’t report my case of measles, I never saw a doctor and no one in my family (including two younger siblings) caught it from me. Here, from the CDC Pink Book, is the complete story:
Before 1963, approximately 500,000 cases and 500 deaths were reported annually, with epidemic cycles every 2–3 years. However, the actual number of cases was estimated at 3–4 million annually. More than 50% of persons had measles by age 6, and more than 90% had measles by age 15. The highest incidence was among 5–9-year-olds, who generally accounted for more than 50% of reported cases.
So, what was the death rate? I’m going to take the 3 million cases and the 450 annual deaths: One death for every 6,500 cases approximately. This is why parents tried to expose their children to measles, rather than being terrified that they might catch measles. Everyone knew that measles is more dangerous in adults, so you wanted to be sure that your kid had them during childhood.
Back to the CDC’s information for parents page called “What Would Happen If We Stopped Vaccinating”:
In the U.S., up to 20 percent of persons with measles are hospitalized. Seventeen percent of measles cases have had one or more complications, such as ear infections, pneumonia, or diarrhea. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage.
This paragraph isn’t very clear, because there are no dates included. Obviously, these stats don’t apply to the period between 1953 and 1963, when measles ran rampant and millions of children had it every year. If they did, they would be able to show pictures of wards filled with measles victims. Hmm, 20% of 3 million would be: 600,000 children per year being hospitalized as a result of measles. Yep, we would have heard about that.
What could have made measles turn so dangerous between the 50’s and the end of the 20th century?
Well, there are multiple factors, which I’ll take one by one:
First, again from the Pink Book–
In addition, measles susceptibility of infants younger than 1 year of age may have increased. During the 1989–1991 measles resurgence, incidence rates for infants were more than twice as high as those in any other age group. The mothers of many infants who developed measles were young, and their measles immunity was most often due to vaccination rather than infection with wild virus. As a result, a smaller amount of antibody was transferred across the placenta to the fetus, compared with antibody transfer from mothers who had higher antibody titers resulting from wild-virus infection. The lower quantity of antibody resulted in immunity that waned more rapidly, making infants susceptible at a younger age than in the past.
Translation: Mother Nature knows more about protecting infants from measles than we do.
Step 1 in turning measles from a normal childhood illness into a deadly disease is to eliminate or diminish the immunity that infants used to receive from their moms.
Step 2 is to reduce herd immunity among adults. If you had measles as a child, you are very likely to have lifelong immunity. People born before 1957 in the U.S., probably have had measles (95% roughly) and are, therefore, permanently immune. No measles vaccine can provide this degree of immunity on the population level.
The vaccination-induced measles virus antibodies decline in the absence of natural booster infections. It is important to follow how long the protection achieved by the present vaccine programme will last after elimination of indigenous measles.¹
In contrast, the other 14 children with initial titers of less than 5 had secondary immune responses (only IgG measles antibody) with GMTs of 28 and 9 three weeks and ten months after vaccination. Since the antibody responses in these children who had previously been stimulated by measles antigen were modest and transient, it is suggested that booster immunization may not be effective in preventing future secondary vaccine failures.²
But the CDC says:
This replication causes the body to develop an immunity that, in 95% of children, lasts for a lifetime.
A second dose of the vaccine is recommended to protect those 5% who did not develop immunity in the first dose and to give “booster” effect to those who did develop an immune response.³
Since measles is more deadly in adults, measles nowadays is a much more dangerous disease. Millions of adults are not immune to measles because they were vaccinated in childhood and their vaccine immunity has waned.
Step 3 is to use bad statistics to make a bad situation look even worse than it actually is. The problem is underreporting:
Measles surveillance is complex: the patient must seek health care, the diagnosis must be recognized by the physician, and the case must be reported to health departments. The portion of total (incident) measles cases that is reported to health departments is termed “completeness of reporting.” Few studies describe this measure of the quality of surveillance in the United States; these studies use different methods, but they are all limited because the actual number of measles cases needed to derive completeness of reporting could not be determined.
Estimates of completeness of reporting from the 1980s and 1990s vary widely, from 3% to 58%. One study suggests that 85% of patients with measles sought health care, the proportion of compatible illnesses for which measles was considered varied from 13% to 75%, and the proportion of suspected cases that were reported varied from 22% to 67%. Few cases were laboratory-confirmed, but all were reported. Surveillance in the United States is responsive, and its sensitivity likely increases when measles is circulating. Continued efforts to reinforce the clinical recognition and reporting of measles cases are warranted. 4
The CDC’s Parents’ Pages continue:
As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles.
This is an amazing statistic: one in every 333 people who are ill with measles in the U.S. will die. The end result of many years of vaccination has been to transform a mild childhood disease that killed one person out of 6,500 into a disease that is almost as deadly as it is in the developing world, where people struggle with hunger and sanitation problems. But, before we buy this stat (uncited, as usual), we should look again at the problem of under-reporting of measles cases. If only 50% of the cases in the outbreak in question (which one it is we will never know) were reported, then the death rate drops from 3 in 1,000 to 3 in 2,000. If 25% of the cases were reported then the actual death rate would have been 3 in 4,000. Still bad, though.
The big question, and one to which I’ll be returning again and again in this series, is why is the CDC lying to parents? Obviously, it isn’t due to ignorance, since they have accurate information available in The Pink Book, published on the same web-site by the same organization. Does the CDC believe the only way to keep vaccination rates high is to frighten parents with fake numbers of deaths and injuries?
To be continued–the next article will look at Pertussis–the craziest stats of all!