Measles on the rise in the US

Here is a blog post that expands on my mini tweet storm about measles becoming endemic again in the US due to a drop in children’s vaccination rates. I put the graphics and links all in one place so you don’t have to keep clicking through to other websites to see them.

This story comes from Arstechnica where they quote the researchers who point at that a drop of 5% in the MMR vaccination rate drop will triple the number of cases and be very costly in terms of public healthcare costs. The personal costs are pretty high, too. Quoting:

Measles, in particular, requires vigilant vaccination. The highly infectious virus can linger in the air for hours after a cough or sneeze. Those sickened develop high fevers, rashes, inflamed eyes, and cold-like stuffy nose and cough. But people can spread the infection days before those symptoms appear. About 30 percent develop complications, such as pneumonia, brain swelling, and blindness.

So there’s that.

Since I am originally from California I was curious about how prevalent unvaccinated kids are these days in my home state. A while ago I did an analysis of data from the California Department of Public Health on the percentage of kindergarten children who had been granted “Personal Belief Exemptions” in 2015. Here is a map of California with counties colored according to percentage of unvaccinated kids.

Note that it looks like most of the northern half of the state suffers from this risk. The county names are not listed in the graphic but the 20 with the lowest vaccination rates are shown on my Rpubs page at http://rpubs.com/markdg/AntivaxxerHotspots. Nevada county leads with 21.4% unvaccinated, followed by Mariposa county at around 15%. Amazing in this day and age, like a third world country in this respect.

Something odd I noticed when I was writing this post is that the data that I used in this analysis has been moved or removed from the CDPH website. So the link to the source on my Rpubs page is now broken. The CDPH website does have some summary data that shows vaccination rates overall are climbing back up. Here, for example they say that overall vaccination rates went from 93% in school year 2015-2016 to 96% in 2016-2017. So that’s good news, although still a little low. I haven’t spent the time to search for the raw data; perhaps it is there somewhere.

The developing country of Thailand, where I live, hasn’t lost its mind. The vaccination rate for measles has risen rapidly since 1984 and was reported at 99% in 2015. Here is a chart from World Bank based on the data they have collected.

Vaccination Rates of Children Age 12 – 23 Months in Thailand

From http://data.worldbank.org/indicator/SH.IMM.MEAS?locations=TH on 27 July 2017.

Maybe it is because so many people in Thailand can still remember the horrible days before nearly everyone received vaccinations.

Got my flu vaccination

The small clinics in the nearby town have this year’s flu vaccination available now. So I got mine. The version offered here is called Influvac 2010 (southern hemisphere). The composition of three vaccines: A/California/7/2009 (H1N1)-like strain, A/Perth/16/2009 (H3N2)-like strain, and B/Brisbane/60/2008-like strain. So I guess I should be protected now for this year, assuming the forecast was correct for which strains will make the rounds.

Since it is the season there seems to be a number of stories around from the anti-vaccination crowd. I have to admit that I don’t quite understand their objections. I have seen several assertions from these groups.

Some say that vaccines are of little benefit and are pushed mainly as a source of profits for big pharma. Sure, how beneficial a vaccine is must vary from disease to disease. Certainly for some of the older devastating diseases like smallpox vaccines have made all the difference. The profit motive – no doubt, because that is what big pharma is all about. Still, I’m not sure that this makes a valid point for avoiding vaccination.

I have read the stories in which some parents are claiming that their child’s autism was brought on by vaccination. I don’t know what to make of that. Obviously if the vaccines are causing that problem the number of cases is an extremely small percentage of the children who are vaccinated. So I’m not sure that there is a real issue there. Except of course the devastating impact for some individuals, the majority of people are benefited by the population being immune to those serious diseases.

There is another group which is making claims about some kind of government conspiracy, that vaccines are some kind of intentional infection that will be used to control the masses, or something like that. I couldn’t stick with those stories long enough to read them through.

And lastly was a story I read today on the BlogHer blog by a woman who says she is a nurse (no link because the blog owners don’t allow trackbacks and require you to log in to add comments – they’re doing it wrong if they want quality comments and links to their blog). That author’s main beef seems to be that she hates being told she has to do something, in that she is railing against the possibility of mandatory flu vaccinations for health care workers. She then proceeds to throw out a number of nonsense arguments to support her case. So, being the call-em-out kind of person I am, I want to pick apart her case.

First she spends a couple of paragraphs trying to use an analogy to make her case because, as she says, she “gets to mention them half as much as [she] would like to .” Strike one. Analogies are sometimes useful but more often they are not because the reader ends up spending more time trying to resolve the parts of the analogy that don’t align with the situation in question. Waste of space. Delete those two parts of the story and just get to the situation at hand, not how the flu and a hurricane are alike.

Then she gives some statistics on the chances of getting the flu. I don’t know if they are correct but regardless she draws the wrong conclusion. She says that the CDC reports that the chances of getting the flu if you don’t get vaccinated are 5 to 20 percent and she implies that those rates are too small to make the vaccination worthwhile. Wrong conclusion. Those are some pretty significant numbers. Although no details were given on how that percentage range was determined, it seems likely that overall number is simply total infection rate divided by total population. So lots of demographic sectors are lumped together, including sectors who have on average a higher infection rate as well as those with a lower rate. Those with no exposure to others would have a zero infection rate. Those exposed to many sick people would have a higher rate, like health care workers for example.

Then we have her statistical analysis, starting with this:

We all know the flu vaccine is not 100% effective at protecting anyone from the flu. But did you know this?
In any given year an estimated 10 to 20 percent of vaccinated people will still get the flu. So, even if every person in the country was vaccinated, each year between 10 and 20 percent of people would still get the flu. That’s not much different than 5 to 20 percent of non-vaccinated people.

It is saying that the people who are vaccinated get the flu at a higher rate than those who are not vaccinated. So how could that make sense? It would make sense in light of the demographic issues I mentioned in the previous paragraph. It is highly likely that the people who get vaccinated are high risk groups, and that without vaccinations their infection rate would be much higher. The conclusion that the infection rate for vaccinated and non-vaccinated people is practically the same so vaccinations aren’t needed is based on incomplete information.

Finally we get to hear that “the precautions a health care worker is taking to prevent other hospital-born illnesses are the same precautions that help prevent the spread of colds, viruses, and the flu.” I think we have all heard already about the very high rate of infectious disease spread in hospitals so an argument based on the precautions health care workers take is a strong argument for mandatory vaccinations for them.