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Any time you crowd children — or adolescents, or young adults — together, there’s an opportunity for some of the more contagious childhood diseases to take advantage of those who are susceptible. That was true in the First World War, where barrack life and troop ship transports contributed to the virulent spread of the 1918 influenza, which unlike most strains of flu, was more deadly to the healthy young than to the elderly.
Many colleges require a specific list of immunizations before students move into dormitories, including meningococcal vaccine to prevent bacterial meningitis. But measles-mumps-rubella vaccine is always at the top of the list. That’s because measles is so contagious that if the herd immunity — when a high percentage of a population is protected by immunization — drops even a few percentage points, the measles virus can take full advantage.
“The first things you see, the cracks in your public health system,” Dr. Ratner said, will be infections like this, “measles, infectious through the respiratory route and good at moving from susceptible people to susceptible people.”
When my own daughter went off to college, someone looked carefully at her immunization records, always accepted without question at her school, and discovered that her very first MMR had been given a couple of months before her first birthday, and therefore didn’t count; she had to go get one more dose before she took up residency in her dorm room.
I had asked for that early MMR, because we were going to take her traveling in a country where there was still, at that time, a danger of measles exposure (no, not Brooklyn). You can give the MMR as early as 6 months if a child is at increased risk of measles exposure, and it provides some protection, but you have to repeat the shot after the child turns 1. I had forgotten to do that, and no one had ever noticed. As the pediatrician mother of the child with the incomplete vaccine record, I was a little embarrbaded, but mostly impressed.
Dr. Stimson went on to note that those World War I soldiers who had grown up in more isolated, usually rural circumstances, were less likely to be immune to the childhood diseases, and “when thousands of these rural young men are first mbaded together in army camps, contagious diseases are apt to be very common,” he said. This had also been noted in the American Civil War, when measles was a particularly devastating disease, and the recruits coming off the farm were especially vulnerable.
The young men of 1918 were going into terrible danger (Dr. Stimson himself was wounded in action in Flanders, serving with the British troops) but they were also in danger because they were exposed to one another’s viruses and bacteria.
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