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Epidemics across the United States have forced officials to declare emergencies. Why are we starting to see the rise of these epidemics? This goes back to the anti-vax movement.
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Measles outbreaks in the United States this year – the 387 cases currently reported in 15 states are already the second most significant figure in two decades – have highlighted the importance of controlling the disease through immunization.

However, the urgency of addressing the problem is far from uniform, with the States concerned more likely to take legislative action once they have experienced a crisis. This left others in a reactive position as a disease once considered eradicated for a comeback.

"I think unfortunately the essence of the momentum is only in states that have had problems," said Health Commissioner Mark Levine of Vermont, who has tabled a report. bill banning the religious exemption of vaccines, after the abandonment of the philosophical dispensation. in 2016. "There is no problem in defining the problem. But not everyone agrees with that as long as the problem is not solved by themselves. "

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Take the case of Washington, one of the 17 states that allows personal exemptions from vaccinations or philosophical exemptions, in addition to the medical examination authorized by all states and the religious dispensation in force in all states except the United States. California, Mississippi and West Virginia.

A severe measles outbreak linked to an eastern European traveler broke out in Clark County, at the southern tip of the state north of Portland, in the 39th district of the city. Oregon, early January, prompting Governor Jay Inslee to declare the state of emergency.

Of the 74 cases reported in Washington, 73 were identified as coming from Clark County, where the vaccination rate for kindergarten children dropped from 91.4% in 2005 to 76.5%, which is well below the one required for herd immunity last year. Sixty of those who contracted the disease were unvaccinated; most other vaccination status could not be verified.

Vaccinations in the county have almost quintupled for miners and have grown exponentially for adults in the weeks following the epidemic but, by that time, the highly contagious and potentially fatal disease had had catastrophic consequences about health.

Sarah Myriam of New Jersey holds her two-year-old daughter Aliyah, joining activists opposed to vaccinations before a Senate Committee hearing on health, education, work and pensions on vaccine safety. Is held on March 5, 2019. (Photo: J. Scott Applewhite, AP)

The epidemic has also cost the state health services and local health services more than $ 1.6 million, which could have vaccinated 40,000 people with a vaccine that costs $ 20 per injection and requires two doses. for an efficiency of 97%.

"Prevention works and saves community resources," said Michele Roberts, director of the Office of Immunization and Child Profile in Washington.

More: Extensive study adds to evidence that measles vaccine does not cause autism

Two Clark County lawmakers have introduced legislation to remove personal belief exemptions for school-age children, one that applies to all vaccines and the same. other, vaccination against measles, mumps and rubella.

The first was rejected, but the last one, Bill 1638, has been clarified and is currently in the Senate.

In a speech to a congressional committee on March 5, US Secretary of Health John Weisman said, "Public health systems at all levels are struggling because of chronic underfunding, poor health, and poor health. increase in the size of the population and the emergence of new threats. We are constantly responding to crises rather than trying to prevent them. "

"If you allow populations to go below the level required for collective immunity and if you allow them to receive sufficiently low vaccine levels, then, as the rest of the world still has a lot of active measles, all case can come and take over. in a population. "

Mark Levine, Vermont Health Commissioner

"A moral law"

That was the case of California too.

In 2015, after experiencing a Disneyland-related measles outbreak that had sickened nearly 160 people, California removed personal and religious exemptions. The state's legislature is now considering strengthening the rules on medical exemptions after tripling the number of children entering kindergarten since the 2015 law came into effect.

According to the Association of State and Territory Health Officials, Arizona, Iowa, Maine, Minnesota, New Jersey, New York, and Oregon are countries that are considering getting rid of the disease. personal exemption. Four of these seven countries – Arizona, New Jersey, New York and Oregon – have had measles cases this year.

In addition, several states are debating bills to expand or protect exemptions, illustrating the complexity of the issue and the strong emotions felt by both sides.

Hundreds of Washingtonians came to protest HB 1638 outside the capital in February, and public health practitioners like Levine fear that their voices will be drowned in a cacophony of uninformed vaccine opponents – or badly intentional – using social media and even robots. to spread their message.

Breach in protection: Anti-vaxxers open the door to measles, mumps and other old diseases that go back to extinction.

The long-held myth that vaccines are linked to autism continues to spread, as is the notion of dangerousness even when studies prove it, and agencies like the Centers for Disease Control and Prevention guarantee their safety.

Experts say that side effects occur, but they are rare and usually mild, such as a rash or fever.

Nevertheless, organizations such as the National Vaccine Information Center may give the impression that parents are risking the lives of their children by getting them vaccinated.

President Barbara Loe Fisher said that the NVIC, which she co-founded in 1982 as the Unsatisfied Parents Together, only promotes informed consent and does not make recommendations regarding immunization.

Asked about the government's duty to protect its citizens through a public health policy, Mr. Fisher said, "Are you saying that a public health law that requires a some minority of people to risk their lives, to sacrifice their lives, is a moral law when we do not give them the choice to participate in this sacrifice or not? It is not a moral law of public health. "

More: Growing up unvaccinated: my mother's anti-vax put me at risk for the health of the entire community

In numbers

The precise number of vaccine-related deaths in the United States is difficult to identify, but the CDC reports that life-threatening allergic reactions of a substance in a vaccine occur approximately once a million doses.

Since the National Vaccine Injury Compensation Program was established in 1986, 1,295 claims have been filed for death, making it a no-fault option in court. About 54% of these requests were for DPT (diphtheria, tetanus, pertussis), which was replaced in the 1990s by the safer DTaP.

This leaves 599 death requests for other vaccines. Since 55% of claims for bodily injury or death have been dismissed, it may be reasonable to conclude that approximately 270 death requests were determined to be vaccine-related. This is nine per year since 1986, which is still a tragedy, but significantly lower than the annual number of deaths due to peanut allergy (estimated at 75-125) or bee stings, wasps or of hornets (89 in 2017).

"Sometimes they present things in a very reasonable way, but at other times they make statements that are patently false."

Nate Smith, director of the Arkansas Department of Health, at the National Vaccine Information Center

According to Mr. Fisher, more than $ 4 billion was paid by the compensation program, but according to CDC figures, 3.4 billion doses of covered vaccine were distributed in the United States from 2006 to 2017 and 4 250 compensated claims were examined. This amounts to 1.25 claims paid for each million doses.

Nevertheless, Fisher says the anti-vax movement will continue to grow and see it as part of the fight for civil liberties.

"Today, everyone knows someone who was healthy, who was vaccinated and who has never been," she said. "That's the reason this issue will not go away, no matter what kind of law and what type of censorship is applied. . & # 39; & # 39;

Nate Smith, director of the Arkansas Department of Health, is one of the many critics of the CINV, calling it an "anti-vaccination group" and saying that what makes organizations so dangerous is that they may seem provide legitimate information.

"Sometimes they present things very reasonably, but at other times they make statements that are patently false," Smith said. "So it's very difficult for someone who does not have training in immunization science or public health to discern."

State of emergency: Measles outbreak: How Rockland County became absolute zero – then hit the "third rails" with an emergency declaration

Like other health officials, Smith recognizes that vaccines are neither safe nor 100% effective. They present minor risks, he said, which are minimized by administering vaccines in environments where a reaction can be managed quickly, such as in a medical facility.

In addition, the inoculation certainly beats the alternative.

Before the introduction of the measles vaccine program in 1963, 3 to 4 million Americans contracted the disease each year and about 400 to 500 million died from it. The MMR vaccine reduced the disease rate by 99% and was declared eliminated in 2000.

The impact of vaccines

But measles is still a scourge in the world, killing 110,000 people in 2017 – mostly children under 5 – said the World Health Organization.

The disease is transmitted through the droplets of the nose, mouth or throat of an infected person, and the virus can persist in the air or surfaces for up to two hours, and spread to 90% of non-infected people. immunized and exposed to a person with the disease. measles.

According to the WHO, vaccines have drastically reduced the estimated number of deaths to 21.1 million between 2000 and 2017, indicating an increase in the rate of inoculation of children from 72% to 85%.

This is why doctors are so adamant about the importance of the MMR vaccine, despite the possible side effects.

Sudden surge: Measles cases have reached the second highest level since elimination in 2000

"Drugs, foods, all the substances that the body comes into contact with can cause allergic reactions," Smith said. "Of course, if we tried to avoid any possibility of an allergic reaction, we would stop taking any medicine, eat any food and we would not go outside because we could come into contact with an insect."

As logical as his argument may seem, Smith recognizes the political climate in each state – the immunization policy is not determined by the federal government – plays an important role in the promulgated immunization laws.

In the absence of measles cases reported this year in Arkansas, he said the momentum had not yet taken the step to remove philosophical and religious exemptions from the state.

Smith, Levine and their colleagues are concerned, however, that it is not only infected travelers entering the country who pose a danger, but also the growing communities of unvaccinated people, who have helped break the wall of protection against vaccination. provided.

What would happen if states chose to make vaccines voluntary rather than mandatory?

"I think the answer to this question has already been revealed with this measles outbreak," Levine said. "If you allow populations to go below the level required for collective immunity and if you allow them to receive sufficiently low vaccine levels, then, as the rest of the world still has a lot of active measles, all case can come and take over. in a population. & # 39; & # 39;

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