While measles outbreaks are spreading in the United States, why does the "anti-vax" movement persist?

(HealthDay) – Outbreaks across the United States, including one in the state of Washington where 50 cases have been identified so far, have once again shone the spotlight on parents who refuse to vaccinate their children .

These outbreaks are a clear sign of the break-in of "collective immunity", the overall protection found when a large majority of the population became immune to a disease, said Dr. Paul Offit. He is director of the Vaccine Education Center at the Children's Hospital of Philadelphia.

"Measles is the most contagious vaccine preventable disease, so it's always the first to come back when you see a decline in herd immunity," Offit said.

The World Health Organization has learned and recently stated that the anti-vaxxer movement poses a major threat to public health.

Given this, why does the anti-vaccine sentiment continue to flourish in parts of America?

It is often thought that it is because people have forgotten how serious diseases such as measles, chickenpox and whooping cough can be serious.

"This happens because people are not afraid of diseases," Offit said. "I think vaccines are in some ways victims of their own success."

But other factors come into play, including reluctance to administer a series of vaccines to a young child so early in life, fears now denied of a connection to autism, the feeling that diseases are naturally part of childhood and a deep illness. Sitting mistrust towards the medical community.

Measles outbreaks were "inevitable," said Dr. Dawn Nolt, an badociate professor of pediatric infectious diseases at the OHSU Doernbecher Children's Hospital in Portland, Oregon. She lives near the Washington border, where the biggest measles outbreak is currently taking place.

"Pockets of communities where vaccination rates are low are poised to be zero for an epidemic," said Nolt. "All you need is someone in this community, we knew it was going to happen."

This is especially true of measles, which is incredibly virulent.

Offit explained that "it is not necessary to be in direct contact with a person with measles.You just have to be in his airspace within two hours of arriving."

According to Nolt, despite its power of propagation, three questions usually arise for parents who are reluctant to vaccinate their children against measles: is the vaccine safe? Is the vaccine necessary? Why would not I have the freedom to choose my child's vaccines?

"I think what's important is to really understand that families have some concerns and that we need to understand them," said Nolt. "We can not regroup them all and think that this conversation meets all their concerns."

Parents' concerns about vaccination are often prompted by the recommended vaccination schedule, said Offit.

"What has happened is that we are asking parents of young children in this country to be vaccinated to prevent 14 different diseases," Offit said. "This can represent up to 26 vaccinations during these first years of life, up to five injections at a time, to prevent diseases that most people do not see, using body fluids. that most people do not understand. "

It is therefore important that doctors explain to parents that these vaccines are "literally a drop of water in the ocean" compared to the myriad of immune systems that cause daily encounters with children, said Offit .

"Very soon after birth, you have billions of bacteria on the surface of your body, to which you bring an immune response," said Offit. "The foods you eat are not sterile.The dust you inhale is not sterile.The water you drink is not sterile.You are constantly exposed to bacteria that you bring an immune response. "

Physicians must also deal with a 1998 misconception of vaccinations and autism, said Dr. Talia Swartz, Assistant Professor of Infectious Diseases at the Icahn School of Medicine, Mount Sinai, New York.

The study was later found to be fraudulent and withdrawn, but "a major press has continued to report its concerns, even though these concerns have been refuted on the basis of large-scale population studies," Swartz said. .

It is important to stress that the safety of these vaccines is widely tested, said Lori Freeman, executive director of the National Association of County and City Health Officers.

According to experts, epidemics constitute a strong argument regarding the need to use vaccines.

However, some parents still welcome epidemics with a shrug of the shoulders.

Nolt said that "some people think that vaccines are not necessary because the disease is more" natural "than the vaccine."

And arguments based on altruism: vaccinate your child to protect the rest of the community, especially children who can not to be vaccinated, just go for it, she added.

"I think this makes sense for people who have a close family or immunocompromised friends.For someone who has not had that experience, I think it's harder to sell "said Nolt.

Offit is also pessimistic that outbreaks alone will convince reluctant parents to vaccinate their children.

"I think children will have to die [for attitudes to change]"As far as measles is concerned, you will probably have to treat 1,000 to 2,000 cases a year to start seeing measles again, but that can happen." Before the arrival of a measles vaccine United States in 1963, every year, about 500 children died of measles. "

The "freedom of choice" argument may be the most difficult for doctors to counter, Nolt said. The mistrust of organized medicine, federal regulators and pharmaceutical companies is not something a pediatrician can easily counteract with a conversation.

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