Measles

This was never a vaccine I thought about giving DS as in my mind he is safer having had the disease, like I did.

Recent discussion has highlighted to me just how much is not known about the vaccine, the disease and the risks with both. What is interesting ,is that it is fairly easy to find information on the risks for the disease and a bit harder, but still possible, to find the information on just *who* is at risk for developing complications from the disease. From the medical literature available, the vaccine would appear to be almost completely risk free for the vast majority of the population. There is no information available, so no discussion is happening. Only musings and frustration by those who want the information (parents, and seemingly often mothers)

So, what I have learnt.

Poverty seems to be the leading factor in developing complications. This does not mean that just because you have access to clean water and fresh food you are safe. You could still be malnourished. And you could still be treated with fever reducing drugs and antibiotics, which it would seem do not do the patient any favours. And there are children who have immune systems that are weak, making them more at risk. In my understanding the three things that put you at risk for complications are:

  • the age at which you contract measles (under 2 and over 9 being the risky groups, with 5-9 years of age being the optimal age group)
  • the individual state of health and access to a variety of fresh, mineral rich foods. (not malnourished – lacking in essential minerals, fats, proteins, vitamins)
  • having a condition that results in a compromised immune system.

If you contract measles under the age of 2, breastfeeding decreases the risk of death. In Africa. So I do not know if this would be attributed to reducing the odds of being malnourished, or something else.

OK, so that is what I have learnt about the disease.

Now for the vaccine.

The measles vaccine has undergone some changes since it was first lisceneced for use in the USA in 1963. This was the  Edmonston B measles vaccine. This vaccine was very reactive, resulting in a high fever and a rash (sounds like measles). Vaccines that would use a virus that was even more attenuated (weakened) were developed around the world.

In 1965 a study was designed to test the further attentuated vaccine against the Edmonston B and a placebo (no mention of what this placebo was). The further attenuated virus still produced sufficient antibodies, but without such side effects (that had required immunoglobulin administration simultaneously with the vaccine). This vaccine was in use until 1975, in the US.

One of the further attenuated Edmonston vaccines, is the Shwartz strain, in use in the USA from 1965 – 1976. It is still widely used throughout the world.

Today the only measles vaccine liscened for use in the USA is the Moraten strain, lisenced in 1968.

I do not yet understand why other strains in use in other countries are not lisenced for use in the USA, but I am sure it would be interesting to find out.

Some other points for consideration when it comes to measles and the vaccine.

  • The vaccine does not produce life long immunity in the absense of the wild virus circulating in the population. Requiring boosters for adults (a population that is more at risk for complications)
  • Mothers who are relying on vaccine induced immunity do not have suffiient antibodies to pass through the placenta, leaving young infants more at risk, another population more at risk for serious complications.
  • The risks for the vaccine are unknown.
  • Recent reading in epidemiology brought to light an interesting idea. That the way a population receives immunity from a natural disease is essentially different from the way a population receives immunity from vaccination programmes – as in the pattern of exposure. And that populations that are exposed to a disease are better protected than a population exposed to a vaccine. Resulting in models that attempt to copy how a population would be exposed in nature and apply these principles in vaccination programmes.

To my thinking, the vaccination programme is a bit of groping in the dark and messing with peoples lives without knowing exactly what is happening. I for one would rather take my risk with the disease (as in have the disease) than with the vaccine. Too many unknowns for me.

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