Intended for healthcare professionals

Rapid response to:


US county bars unvaccinated children from public spaces amid measles emergency

BMJ 2019; 364 doi: (Published 28 March 2019) Cite this as: BMJ 2019;364:l1481

Linked opinion

Measles in America—what’s playing out in New York State is nightmarish

Rapid Response:

Re: US county bars unvaccinated children from public spaces amid measles emergency

Response to Dr Anand

Dr Anand writes: “I am all for Measles vaccination where the person has NOT had laboratory confirmed measles NOR clinically diagnosed measles with KOPLIK SPOTS. . . Where the patient or guardian gives a history suggestive of rubella or rubeola or of mumps, a vaccine is not given without prior test for naturally acquired antibodies.”

1. Given that until recently naturally occurring cases of measles, mumps, and rubella had all but disappeared in the US, this would involve only a few hundred cases;
2. However, if someone has immunity from the natural disease, then an attenuated (severely weakened) vaccine would have NO effect, thus giving the MMR would be absolutely NO problem.
3. Despite any necessity, to ensure those who had natural immunity from one of the three were protected against the other two, the pharmaceutical companies would have to produce separate vaccines for these few, losing millions of dollars in the process. Never going to happen !
4. So, all his requirement would do is add costs and delays to kids getting vaccinated, especially given that even if they had had one of the three, they still need to be protected against the others.

Dr Anand writes: “The immunising doctor arranges to follow up and record all adverse reactions which he then notifies to the appropriate authority responsible for maintaining a register, analysing adverse reactions, collating the data from all the population so immunised.

From the CDC Vaccine Safety Website: “Healthcare providers are required by law to report: “Any adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine. Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period that occurs within the specified time period after vaccination.

Healthcare providers are encouraged to report:
Any adverse event that occurs after the administration of a vaccine licensed in the United States, whether or not it is clear that a vaccine caused the adverse event
Vaccine administration errors.”

Dr Anand raises requirements that have already been met ! ! !

Dr Anand writes: “Parent or guardian gives full, free, INFORMED consent. No pushing, prodding, bullying.”

He seems to have missed what I wrote in a previous comment, so I repeat it here: “We usually live in dense urban environments. People have rights; but also responsibilities. Do we consign the above children [those who have medical conditions so they can’t be vaccinated, are too young, or for some reason their immune systems did not respond to a vaccine] to staying at home, not going to school, not going to parks, not going shopping with their parents? Not allowing visitors to their homes? Whether we have a vulnerable child or not, I think of the phrase: “There but for the Grace of God go I.” Individuals live in communities !”

Despite what antivaccinationists believe, vaccines are quite safe, though not 100%; but the chances of a serious adverse event are minuscule. On the other hand, as more and more parents refuse to vaccinate their children, they put not only their children at risk; but others as well. So, society has a right by law to protect them and the law does exactly that.

Dr Anand writes: “I did wonder why you found it necessary to bring in the epithet “anti-vaxxer” if you were not implying that I AM AN ANTI-VAXXER. . . if you search the Rapid Responses in the BMJ and also the indexes of the Lancet and the BMJ, Dr Harrison, you will find how enthusiastic I have been for proper vaccination for various diseases going back a professional life-time.”

As I wrote in my previous RR to Dr Anand: “Typical antivaxxer’s unending questions.”
As I’ve clearly explained above, his requirement to determine if a child had a natural infection from one of the MMR is mistaken, his requirement of doctors to report adverse events shows he hasn’t done his homework, and, since we live in communities, rights have to be balanced with responsibilities, and the law clearly protects those vulnerable who can’t be vaccinated or the vaccine didn’t take. It is typical of antivaccinationists to claim they are pro-vaccine, just so many caveats that are either mistaken or illogical that the end result would be a severe reduction in vaccinations. Thus, Dr Anand is an antivaccinationist ! ! !


CDC Information for Healthcare Providers. What to Report. Available at:

CDC VAERS Table of Reportable Events Following Vaccination. Available at:

Reiss D (2015 Oct 5). Parental and Children’s Rights - Vaccination Mandates. Skeptical Raptor. Available at:

Reiss D (2015 Oct 6). Vaccines and Religious Exemptions - Recent Legal Decision. Skeptical Raptor. Available at:

Reiss D (2019 Mar 30). New York county's move on vaccinations was bold, necessary and perfectly legal. CNN. Available at:

Competing interests: No competing interests

08 May 2019
Joel A Harrison
Long-Retired Epidemiologist
I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks