February 11, 2019
Vaccine preventable diseases are making the headlines again. It is time to reconsider your vaccine stance if you or your child have not had the measles or hepatitis A vaccines. In 2018, we had a significant uptick in cases of measles in New York City and there are currently significant outbreaks of both diseases on the west coast of the US. Currently, there are measles cases in California, Colorado, Connecticut, Georgia, Illinois, New Jersey, Oregon, Texas and Washington. The vast majority of documented cases are in non-vaccinated individuals with the index case coming from abroad where the traveler visited an area with high rates of the disease.
Measles has become a major problem in Clark County Washington state this year in a community with a high anti-vaccination rate. They have over 50 cases as of this writing. This virus is highly contagious by exposure to the air following a cough or a sneeze from an infected patient. Remarkably, the virus is alive for 2 hours in the air following a cough or sneeze. Infectivity is extremely high for an unvaccinated individual.
Measles presents with high fever, rash, cough, myalgias, sore throat and red eyes. Children often look very sick. The rash begins 14 days after exposure and is characterized by red bumps that start on the head and move down the body. The illness can be mild or severe. Minor complications like pneumonia, otitis media or sinusitis are quite common following measles infection. Some children go on to get encephalitis, a brain inflammatory disorder that can be deadly. This occurs in 1 in 1000 cases of measles. The death rate from the measles virus is 1-2 per 1000 infected individuals with the less than 5 year olds getting the brunt of the hit.
Another rare but serious complication of measles is a disorder called sub-acute sclerosing pan-encephalitis. This is a brain disorder that occurs years after you have recovered from the virus. The immune system over reacts to the virus and slowly causes sclerosis of the brain tissue leading to death. This occurs in 1 per 10,000 infected individuals.
I have yet to see this disease live and in person as it was all but eradicated from the US in the 1990's. My partner, Dr. Koontz, has seen it many times during his years of training in Texas in the 1960's. I listen to his stories and he confirms that this is a scary player for doctors and patents alike.
Hepatitis A has recently surfaced in Charlotte and has the potential to do some significant damage to one's liver if the inflammation following infection is robust. There have been 69 cases in North Carolina in the last calendar year with 72% of these patients spending time in the hospital and one death. It is transmitted via contaminated food stuffs or person to person from an infected individual.
These diseases are preventable and the sum total of the available data is that we should vaccinate against them. I have spoken at length with many Integrative and Functional Medicine colleagues who are thoughtful, well read on this topic and much more intelligent than I am. The consensus is that patients should vaccinate. The biggest fear for most parents is a vaccine induced case of autism. This is entirely understandable if we had evidence to prove this hypothesis. Unfortunately, we do not. In fact the emerging evidence is leaning more towards epigenetic effects on the fetus in the womb well before the first vaccine is given. I even have personally witnessed case reports where large families had early adoption of vaccination only to stop with later children for various reasons. Unfortunately, the later unvaccinated children ending up with full blown autism.
As a pediatrician, I have no dog in this fight other than the health and welfare of your child and yourself. Our entire practice has no conflict of interest on this topic as no one works for or receives money from a Pharma/vaccine company. This is a critical point as we want our opinion to be as unbiased as possible.