In response to an earlier post “Should Vaccines Be Mandatory?” several readers expressed concern. They wondered whether people who didn’t vaccinate might endanger others with compromised immune systems who couldn’t vaccinate, such as the elderly or infants.
People with poor immune function are more likely to be exposed to the flu and/or pneumonia, than measles from an unvaccinated person. Many thousands of Americans get the flu annually, while less than 200 people each year develop measles. The flu can lead to pneumonia also, making these two infections the 9th highest cause of death in the U.S. (http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf, p.1). The measures that compromised individuals take to protect themselves from these more common, deadly threats (e.g., avoiding crowds), would protect them from measles as well. These precautions are necessary, because the effectiveness of annual flu shots can be as low as 10% (http://www.cdc.gov/flu/professionals/vaccination/effectiveness-studies.htm).
Contrary to popular opinion, the measles vaccine doesn’t always work either. One half of the Canadian cases of measles come from vaccinated individuals; in the U.S., about one-third of people in a measles outbreak have received one or two doses of the vaccine (http://www.edwardjennersociety.org/wp-content/uploads/The-re-emergence-of-measles1.pdf, p. 103). Only about 25% of those vaccinated maintain measles immunity for 10 years or more; 75% of the vaccinated population loses their protection before that, although they often get a milder form of measles if infected (http://www.edwardjennersociety.org/wp-content/uploads/The-re-emergence-of-measles1.pdf). As one might expect,the immune system doesn’t respond as strongly to a vaccine as it does when it mounts a full scale response to an actual infection. Only people who have had measles as a child can expect a lifetime of protection.
I had measles before we had the vaccine. Back then, some people purposefully exposed children to make sure they had immunity to measles, mumps, and occasionally other childhood diseases. Parents wanted to be sure that their girl children especially had immunity, as getting measles while pregnant could be detrimental to the unborn child. The good news is that many of our seniors probably still have immunity to childhood diseases, even if they haven’t been able to vaccinate.
In conclusion, universal vaccination for measles is unlikely to significantly protect compromised individuals, not only because the vaccine has limitations, but because other infections (e.g., flu, pneumonia) are the real threat. If an immune-compromised individual alters their lifestyle to avoid those more common, deadly infections, they are likely to avoid the measles too.
Inexpensive Vitamin A is currently being studied as a treatment and preventative for infections, including measles (http://www.sciencedaily.com/releases/2010/12/101207191447.htm). If my immune system became compromised, Vitamin A supplementation is something I’d likely explore.
