Running Head: MEASLES VACCINATIONS

Measles Vaccinations and the Autism Belief: an Exploration

Name Withheld
University Withheld

MEASLES VACCINATIONS

Abstract
The purpose of this paper is to educate its readers, specifically the students of English
Composition II, about Measles, Mumps, Rubella (MMR) vaccinations and the controversy
surrounding them. They will learn about whether there is a legal case for prosecuting nonvaccinating parents, and then go in depth about what measles is and what it does, how the
misguided belief in an autism-link came to be, and how parents can be allowed to send their
unvaccinated children to school alongside children who are unable to be vaccinated using a
Personal Belief Exemption (PBE). Herd immunity will also be discussed as well as the current
measles outbreaks as a direct result of non-vaccination, and how those numbers compare to a
pre-vaccine America. It will lastly touch on how measles can continue to enter American borders,
and if and how it would be possible to eradicate measles forever. In writing this, my hope is that
the reader leaves with an understanding of the importance of proper vaccinations, and why a
parents opinion about their childs vaccinations is secondary to societal safety.
Keywords: Measles, Mumps, Rubella (MMR), Personal Beliefs Exemption (PBE)

MEASLES VACCINATIONS

Measles Vaccinations and the Autism Belief: an Exploration

What if a parent chose not to vaccinate their child for measles, based on misinformation
that the vaccine causes autism, and their child got the disease at four years old and passed it to a
one year old who was too young to vaccinate while at day care? And what if that baby dies?
Thats the scenario of a fictitious case study in an interesting paper in the Journal of Law,
Medicine and Ethics that explores the chances of a case for holding individuals responsible for
the harm caused to others by not vaccinating their children.
One can make a legitimate, state-sanctioned choice not to vaccinate, the authors write,
but that does not protect the person making that choice against the consequences of that choice
for others (Caplan, Hoke, Diamond & Karshenboyem, 2012, p. 4). Since doctors and scientists
can now pinpoint the source of a viral infection, they claim, a parent who chooses not to
vaccinate their child endangers another child, and is certainly at fault and could face criminally
negligent homicide or be sued.
Measles is a serious, infectious disease that was eradicated from American soil in 2000,
but has had a resurgence in the years since. The vaccination for measles is extremely safe, and
despite common belief, has not been shown in any peer-reviewed study to trigger autism in
children. Despite the highly contagious nature of the virus, we as a people, are capable of coming
together to eradicate measles forever.
What is measles? According to the Center for Disease Control, it is a highly contagious
and fairly deadly, infectious disease:
It begins with a fever that lasts for a couple of days, followed by a cough, runny
nose, and conjunctivitis (pink eye). A rash starts on the face and upper neck, spreads
down the back and trunk, then extends to the arms and hands, as well as the legs and feet.

MEASLES VACCINATIONS

After about 5 days, the rash fades the same order in which it appeared. Six to 20 percent
of the people who get the disease will get an ear infection, diarrhea, pneumonia, or even
encephalitis. One out of 1000 people with measles will develop inflammation of the
brain, and about one out of 1000 will die. (Center for Disease Control, 2008, para. 1, 3)
So why would anyone ever refuse the vaccine? Just like Measles outbreaks, it can be
pinpointed to a single source. In 1998, a prominent English Medical Journal called The Lancet,
published a paper by a gastroenterologist named Andrew Wakefield, which suggested a causal
link between the MMR (Measles, Mumps, Rubella) vaccine, and autism. In actuality, the
authors practices had been brought into question even before the paper was published.
Subsequent investigations revealed that the author had several conflicts of interest, had
manipulated evidence, and broken other ethical codes. The Lancet partially retracted the paper in
2004, and fully retracted it in 2010; the same year that Wakefield was stripped of his medical
license by the English Medical Register. Following the initial claim in 1998, multiple large
studies were conducted to look for a connection between Autism Spectrum Disorder (ASD) and
the MMR vaccine. Reviews of the evidence were conducted by the Center for Disease Control,
(CDC) the American Academy of Pediatrics, the Institute of Medicine of the US National
Academy of Sciences, the UK National Health Service, and the Cochrane Library. All found no
link between autism and the vaccine. And yet because of the widespread reporting of the claims
in the original paper, vaccination rates fell sharply in the western world. One 2011 journal article
even went so far as to refer to the Lancet paper as the most damaging medical hoax of the last
100 years (Flaherty, 2011, p. 1302-1304).
Additionally, the vaccine additive that the paper pointed to as the supposed culprit, a
mercury-based preservative named Thiomersal, was phased out of all routine childhood vaccines

MEASLES VACCINATIONS

due to the controversy, despite no legitimate evidence being found to substantiate the claims
(Bigham, 2005, p 89-101). Also, a new paper just released in the top neuroscience journal,
Neuron, (Lin et al, 2015, p. 742-754) describes how the genes known to be connected to autism
are active during fetal brain development. To put it in simple terms, it appears that there is an
extremely good chance that autism is something youre born with, not something caused by an
external source later in life.
Many states (currently 17) only require parents who disagree with vaccination to
officially record a Personal Belief Exemption (PBE) to the vaccine in order for their
unvaccinated child to attend public school and other group-environment activities alongside their
peers. But the reality is that some of those peers cannot receive the vaccine because of allergies.
Some cannot because of receiving a treatment like chemotherapy, which would prevent it from
working. Others cannot simply because they are too young to receive it. Others receive it but are
still highly susceptible to an outbreak. This can be due in part to a compromised immune system,
or that they developed an immunity to the vaccine instead, or just the fact that no vaccine is
100% effective. Thats why we are encouraged by the medical community to practice something
referred to as Herd Immunity, or community immunity. The website vaccines.gov (2013)
explains Herd Immunity as follows.
When a critical portion of a community is immunized against a contagious disease, most
members of the community are protected against that disease because there is little opportunity
for an outbreak. Even those who are not eligible for certain vaccinessuch as infants, pregnant
women, or immunocompromised individualsget some protection because the spread of
contagious disease is contained (para. 1).

MEASLES VACCINATIONS

But if all evidence supports vaccinations, and if the majority of people are in fact
vaccinating, then we should see a near eradication of measles right now, shouldnt we?
Unfortunately, no. Because measles is so highly contagious and transmittable through the air, the
Herd Immunity threshold needs to also be a 95% vaccinated rate. In many parts of the United
States this is maintained. But in certain high-population areas where income is very low or very
high, or all-natural lifestyles are heavily favored, the threshold is considerably lower.
An excellent example of this is California. Many wealthy communities there are filled
with parents who have filed PBEs for their children against the MMR vaccine. Last month a
single foreign traveler from Europe to Disneyland Resort in California caused a measles
outbreak that has currently resulted in 102 confirmed cases of measles across 14 states. In 2014,
there were 644 cases documented across 27 states; a record high number since 2000, especially
considering that in 2000 measles was declared eliminated from the United States by the Center
for Disease Control (CDC 1, 2015, para. 1). The CDCs definition of eliminated is the absence
of continuous disease transmission for 12 months or more in a specific geographic area. Measles
is no longer endemic (constantly present) in the United States (CDC 2, 2015, para. 2).
To be fair and balanced, part of the large number in 2014 comes from a single large
outbreak of 383 cases among unvaccinated Amish communities in Ohio. (They originated from a
case brought in from the Philippines.) But its also a direct result of the low Herd-Immunity
Threshold in certain areas as well. In Michigan the current threshold rate is less than 72%. In
New York, pockets of the Hasidic Jewish community are currently experiencing a mini-Measles
outbreak right now, due to religious exception to vaccination. Wherever we find a low threshold
rate of vaccination in America, so too, do we find a skyrocketing number of positively confirmed
cases of measles. This is clearly causal and not coincidental.

MEASLES VACCINATIONS

How important has this vaccine been to the public as a whole? Before the start of the
National Measles Vaccination Program in 1963, it is estimated that there were approximately 3 to
4 million people getting measles each year in the United States. Out of those, between 400 and
500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (swelling of the brain)
every year from measles. Compare that to 2013, when there were just 159 confirmed cases and
no deaths. (CDC 3, 2015, para. 11)
Measles is still common in many countries. As a result, it will continue to be brought into
the United States. It is still possible for it to become endemic in the United States again. As a
result we need to continue to be vigilant.
There is, hope to eradicate measles forever. All member states in the six World Health
Organization regions have committed to eliminating measles by the year 2020. If we eliminate it
from each country and each region of the world, there will be nowhere left from where it can
spread. (CDC 3, 2015, para. 15)

MEASLES VACCINATIONS

Conclusion
In conclusion, measles is a serious, infectious disease. Modern vaccinations removed it
from American soil, but due to an incorrect study and misguided precautions, it has had a
resurgence. There are much fewer cases now than there were pre-vaccination, but we have also
previously had fewer cases than present day as well. Ultimately, only vigilance and stringent
dedication to vaccination will ever truly rid us of this disease.

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9
References

American Association of Pediatrics., (2014). Immunization.

http://www2.aap.org/immunization/families/mmr.html para. 3
Bigham, M., & Copes, R. (2005). Thiomersal in vaccines: balancing the risk of adverse effects
with the risk of vaccine-preventable disease. Drug Safety, 28(2), 89-101.
doi:10.2165/00002018-200528020-00001
Caplan, A., Hoke, D., Diamond, N., and Karshenboyem, V.(2012). Free to Choose but Liable for
the Consequences: Should Non- Vaccinators Be Penalized for the Harm They Do?
Journal of Law, Medicine, and Ethics p. 606
CDC 1: Center for Disease Control, (2015). Measles Cases and Outbreaks
http://www.cdc.gov/measles/cases-outbreaks.html para 1
CDC 2: Center for Disease Control, (2015). Frequently Asked Questions about Measles in the
U.S. http://www.cdc.gov/measles/about/faqs.html para 2, 11, 1
Flaherty, D., (2011). The vaccine-autism connection: a public health crisis caused by unethical
medical practices and fraudulent science. Annals of Pharmacotherapy, 45(10), 1302-1304
doi:10.1345/aph.1Q318
Lin, G., Corominas, R., Lemmens, I., Yang, X., Tavernier, J., Hill, D., Vidal, M., Sebat, J.,
Iakoucheva, L. (2015). Spatiotemporal 16p11.2 Protein Network Implicates Cortical Late
Mid-Fetal Brain Development and KCTD13-Cul3-RhoA Pathway in Psychiatric
Diseases. Neuron, 85(4), 742-754 doi:http://dx.doi.org/10.1016/j.neuron.2015.01.010
Vaccines.gov, (2013). Community Immunity (Herd Immunity)
http://www.vaccines.gov/basics/protection/ para. 1

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10
Self-Reflection Essay

While revising this essay, it was important for me to remove the argumentative portions
of my writing and reword some of the critical portions that had an argumentative tone to them. I
ended up deleting a large paragraph, but integrating more information about what measles is, and
what the Lancet paper did, in order to make up for the missing portion. It was also important for
me to more clearly define a thesis statement. After my introduction in paragraphs one and two, I
used the third paragraph on page one as my thesis statement. While its not as strong as I would
like it to be, it covers the meat and potatoes rather succinctly. I also did not submit a reflection
with my initial draft of this essay, so by writing this I am making an effort to improve my overall
product.
In my revisions I wanted to leave the overall format and feeling of the essay, while
removing the taking a side portions. I felt the data used was quite solid and does a great job
informing the reader about the virus, the vaccine, the controversy behind the vaccine, and why
its so important to vaccinate. Also, I was able in this essay, to use a wider variety of references
than in my argumentative essay, which was a small relief for me. Im not entirely sure how to
accurately describe my own writing style in these essays. I would say that I know I have a large
margin of room for improvement, but I do however also think that for my first informative and
argumentative essays in 21 years I did an overall excellent job.
As an addendum and sidebar, I wanted to briefly thank you as well, Prof. Xxxx. This was
my second English class in that time. ENG122 was online, but the essays were much, much
shorter and simpler. It even allowed us to use either APA OR MLA formatting. I was quite
nervous after seeing the ENG123 syllabus about being able to complete the tasks to standard, but
your discussions in class prepared us and eased my mind enough to get through this. Thank you!