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The CDC said Wednesday that measles in the United States had reached its highest level in 25 years. About three-quarters of these cases are in two ultra-Orthodox Jewish communities in New York. (April 24)
AP, AP
There was a time when summer was raising fear among American parents, where the danger lay in swimming pools and cinemas and where tens of thousands of children developed the weakness and paralysis of polio.
At a time when hospitals were putting up rows of iron lungs to help sick children breathe, doctors were giving them crutches and leg loops to help them walk, and hundreds of people were dying.
It was the polio outbreak.
But that was a long time ago, before what seemed like a miracle banished from polio – or "infantile paralysis" – of the country. The miracle was a vaccine and its advent in 1955 made it its developer, Jonas Salk, a national hero.
PHOTO FILE – BERGEN PINES … A polio victim in an iron lung in Bergen Pines (no year) (Photo: Photo File / NorthJersey.com)
Today, polio is a distant memory – perhaps too far away for those who say that vaccinations are dangerous and that the risk of vaccination is not worth the protection it confers.
But polio is not the only curse to have been banned by a vaccine.
Smallpox has also been eradicated – the first disease eliminated worldwide through vaccination efforts.
Measles could also have been assimilated to polio and smallpox. But this year, its spread among the pockets of under-vaccinated people across the United States has led to the the highest number of cases since the federal government declared it eliminated in 2000.
"The longer these epidemics last, the greater the chances of measles developing sustainably in the United States," warned this week by the Federal Center for Disease Control, which had recorded a record 695 cases in 22 countries. States.
Outbreaks in Rockland and Brooklyn counties, where 200 and 390 cases, respectively, were confirmed Wednesday, are among the largest and longest in the past two decades, the CDC said. The epidemics in New York and New Jersey – with 14 confirmed cases this year – are almost entirely orthodox Jews.
Eileen Connor of Waldwick, a three-year-old polio enthusiast, is very fond of her current treatments in Bergen Pines, administered by nurse Brenda Bellaviana, under the supervision of Northern District Campaign Chair Desiree Mittelstadet, Ridgewood. 14 JAN 1958 (Photo: Photo File / NorthJersey.com)
This week, California officials have also declared new homes in Los Angeles and Sacramento. Michigan recorded a record 43 cases, including more than 30 – mostly among adults – of a single Israeli traveler.
The highly contagious virus has been imported by travelers from countries where the disease is uncontrolled, such as Israel, the Philippines and Ukraine. Overall, According to the World Health Organization, the number of measles cases has increased by 300%, and she described "hesitation to vaccinate" as one of the top ten threats to health this year.
How have vaccines, which have saved millions of lives over the past 70 years and inspired hope for future protection against modern scourges like Ebola and Zika, become controversial? How was one of history's greatest achievements in public health seen as a threat by some?
The resurgence of measles is "An outrageous self-inflicted wound for our nation", Dr. Peter Hotez, pediatrician, vaccine expert and founder of the National School of Tropical Medicine at Baylor College of Medicine, tweeted this week on the occasion of the release of CDC figures.
Number of measles cases in the United States since 2010; (Photo: K. Vineys, AP)
He attributed the resurgence of infections to powerful – and often unopposed – anti-vaccination messages on social networks, to a lack of effective advocacy for immunization, and to the weakness of state legislatures that allowed parents to get infected. Easily obtain vaccine exemptions.
Opposition to vaccinations in the United States by a small but important subgroup of parents is now threatening to undermine gains in public health.
Factor of fear is gone
The roots of the anti-vax movement are varied and difficult to counter.
On the one hand, today's parents have not generally seen the painful or fatal consequences of the targeted diseases.
"When I was growing up, everyone had measles – and some people died," said Dr. Michael Gochfeld, professor emeritus at the Institute of Environmental Health Sciences and Work at Rutgers University. As for polio: "She was hiding at your door, you did not go out in the summer."
"There was fear and when vaccines became available, there was virtually no opposition," Gochfeld said.
The story continues under the photo gallery
Today, he said, infectious diseases of the past are not so much feared, and parents who do not feel safe about vaccines have less urgency to protect themselves against these contagions.
Influential study – but discredited
In addition, some parents believe that there is a link between the vaccines received by young children and the development of autism, based on a widely disseminated but completely discredited study.
British researcher Andrew Wakefield opened a Pandora's Box in 1998 with his study published in the British medical journal The Lancet, establishing a link between the onset of autism in 12 children and the measles vaccine, mumps and rubella (MMR). The study was declared fraudulent in 2010 and withdrawn by the newspaper. Wakefield's license to practice medicine was revoked.
Nevertheless, the fear persisted.
Given the timing of childhood vaccines and the age at which autism is generally diagnosed, a newly diagnosed child has recently been vaccinated, Gochfeld said, "so it's easy to make a false or misleading relationship." . "
There is no evidence that vaccines cause autism, a developmental disorder whose characteristic repetitive behaviors and loss of social interaction or communication occur when children are toddlers or preschoolers.
The vaccines also do not contain toxic chemicals, said the CDC director, the US Surgeon General and the Assistant Secretary of Health and Social Services.
National study: Preschoolers in New Jersey have the highest autism rates ever recorded in the US, but Garden State is also the best country in reporting.
Rockland County Trial: Measles: Judges Reject Rockland Appeal on Emergency Statement
Evolution of a home: The outbreak flames in New York and New Jersey
But the growing prevalence of autism in the United States – a trend for which researchers do not have a complete explanation – poses a challenge for public health messages. It is difficult to counter the story of a single child who said that a child is autistic after receiving a vaccine, even if one has not caused the other.
Government suspicion
Another factor at stake is that many who oppose the vaccination of their children have a fundamental distrust of the government and believe that it should remain outside of their decisions regarding the immunization of their children. Education of the children.
"A deep resentment against the courts of state power across the [anti-vaccination] Julia Bowes, a historian who has studied the politics of the education of children in the United States. "The cumbersome state policies reassure citizens," she said, which applies to bus transportation, school prayer or compulsory vaccinations.
The current resistance to vaccination policies has a deep historical record, she said. In 1911, a demonstration against the mandatory smallpox vaccination law in Montclair led 350 families to ban their children from going to school and threatening to transfer them to a milder school district, she learned while doing a thesis at Rutgers. They won – the law was canceled.
A sign warns people of measles in the ultra-Orthodox Jewish community of Williamsburg on April 10, 2019 in New York. (Photo: Spencer Platt, Getty Images)
It is no coincidence that the pockets of unvaccinated children are today in communities where public education is rejected for the benefit of private schools or home schooling. New York City's measles cases have spread among the students of some ultra-Orthodox yeshivas and day care centers. Parents of children at Green Meadow Waldorf Private School filed a lawsuit against the emergency order prohibiting unvaccinated children from attending schools and public spaces in Rockland County.
Others have a skeptical worldview about science and expertise, whether in medicine, on climate change or in other areas.
Anna Kata, a health anthropologist and researcher at McMaster University in Canada, rejects biomedical and scientific data for personal experience and interpretation. She questions studies on the safety or effectiveness of vaccines and gives more weight to the actual – albeit rare – side effects of the vaccine.
Role of social media
These trends have been magnified by social media.
The epidemics in New York have been compounded because "some organizations are deliberately targeting these communities with inaccurate and misleading information about vaccines," the CDC said Wednesday. Brochures and leaflets threatening the safety of vaccines have been distributed, undermining the efforts of Orthodox rabbis and heads of institutions to dispel fears about vaccination.
Facebook and Google were both called earlier this year for providing false information during searches and spreading misinformation. Women of childbearing age in Washington State have reportedly been targeted on Facebook with anti-vax messages after the state governor said measles in a county was a public health emergency. The two companies announced that they would take steps to direct users to more credible sources, without, however, completely eliminating problematic content.
US representative Adam Schiff, a California Democrat, also blamed Amazon for accepting paid advertising from anti-vaccine groups.
Researchers have discovered that Russian trolls and robots on the Internet (one of them used the hashtag #VaccinateUS) had also "turned into weapons" public health messages to sow discord among the public American, using vaccines.
By publishing both tweets and anti-vaccine and anti-vaccine memes, they try to make believe that the safety and effectiveness of the vaccine are open to debate and create mistrust of the institutions. public health and experts.
Easier to get exemptions
This proliferation of misinformation has been accompanied, in many states, by easy access to vaccine exemptions. According to the National Conference of State Legislatures, seventeen states now allow philosophical exemptions on compulsory vaccines for public school students and allow almost all religious exemptions, some of which are fairly lax.
"When the state suddenly facilitated the task of obtaining a religious exemption by simply ticking the box, people found it more convenient," said Peter Wenger, pediatrician specializing in infectious diseases in the St Health System. Peter's New Brunswick and Chair of the Board. New Jersey Immunization Network. "It was a matter of convenience for a lot of people."
New Jersey does not ask questions – and does not require any outside verification – when parents say that their religious principles lead them to oppose the vaccination of their children.
In fact, some children can not be vaccinated for medical reasons – and all states allow medical exemptions. Babies too young to be vaccinated are also vulnerable.
These children rely on others for protection, according to a concept called collective immunity. If the whole herd is immune, the disease will not spread and vulnerable people will not be exposed. For measles, scientists say that 93-95% of the population must be immunized to protect the herd.
Under-vaccinated pouches
"We have seen high and stable vaccination rates for several years," said the CDC. But there are areas – urban and rural – where the unvaccinated population is well above average.
Once measles is declared "in an under-vaccinated community, it becomes difficult to control the spread of the disease," the agency said.
The researchers last year identified 15 metropolitan areas and 10 rural counties with higher rates of unvaccinated maternal children. They include cities of Washington, Oregon, Utah, Texas, Missouri, and Michigan, as well as counties of Idaho, Wisconsin, and Utah. .
"The current outbreak is deeply troubling," said Robert Redfield, director of the CDC. He called on health care providers "to assure patients of the effectiveness and safety of measles vaccine" so that measles can be eliminated again in the country. United States.
Alex Azar, Secretary of Health and Human Services, was the highest Trump administration official to have talked about the outbreaks.
"The suffering we see is preventable," he said. "Vaccines are a safe and highly effective public health solution for preventing this disease."
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