MMR: Pros and Cons in the Wake of Disneyland
Following the most recent U.S. measles outbreak which began at Disneyland, the vaccine debate has been ignited once again. Whether to vaccinate along the recommended schedule, along an alternative schedule, or not at all, is a heavy decision that needs to work for each family based on their risk factors and what they’re comfortable living with. An important component of that decision is in understanding the risks of these pathogens as well as the risk of vaccinating. Complicating the matter is research on vaccine efficacy and safety which is ongoing. For the sake of this article, we will focus on the MMR vaccine and measles specifically, given its recent attention.
The measles virus is highly contagious and first presents with a progressive fever, then a rash that spreads from head to toe along with the “three c’s”: cough, coryza (runny nose), and conjunctivitis. The disease is self-limiting with complications including diarrhea (8%), ear infection (7%), pneumonia (6%), and, rarely, encephalitis (0.1%). Worldwide, measles can cause death; however, mortality is extremely rare in the U.S. and other developed countries.
Measles vaccines were first introduced in the U.S. in 1963; however, the incidence of complications and death associated with the measles had plummeted long before. The CDC currently recommends two doses of the MMR vaccine – one between 12-15 months old and another between 4-6 years old. It may be that this approach is not adequate though. What we’re finding with those who have been vaccinated is that immunity wanes over time and even people who were vaccinated on schedule can both contract and spread measles. Just like with the recent mumps outbreak among NHL players, this measles outbreak has affected both vaccinated and unvaccinated people. By comparison, those who have had wild-type measles have been shown to have stronger and longer lasting immunity. Advocates of an alternative schedule argue that waiting until a child is 2-4 years old and has had a chance for their innate immune system to take hold before vaccinating allows for stronger and longer-lasting immunity.
The current MMR vaccine has never contained the highly controversial ingredients thimerosal and aluminum. Regardless, the MMR vaccine was once erroneously linked to the development of autism thanks to the Andrew Wakefield study. Autism is a complex neurodevelopmental disorder, and it seems that its development is multifactorial. Vaccines may be partly to blame, but at this time there is no compelling evidence. Finding properly unbiased research on the safety of vaccines is difficult if not impossible. The general consensus is that they are safe. Despite this, there have been documented cases of adverse reactions and even deaths linked to vaccines, and that is tragically unfortunate. Many who choose not to vaccinate do so because they fear side effects, preservatives, chemicals, and immune load more so than the risk of illness. Because we don’t commonly see these illnesses anymore, it is hard for many to understand the risk and sequelae (abnormal conditions resulting from an illness).
Before deciding how your family wants to vaccinate, I encourage you to do your own research – read articles and opinions from a variety of perspectives. Then have a conversation with your partner or loved ones, weighing the pros and cons, before finally asking questions and discussing options with your physician. This decision is about what’s best for your family and for your community.
Dr. Brian Myers is a naturopathic primary care doctor with a focus on pediatric and family health at Live Well Clinic in La Quinta. For more information visit www.livewellclinic.org or call (760) 771-5970.
References available upon request.