Re: Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback
Stephen O'Dea [1] raises some interesting points. In my letter yesterday [2] I was pointing to the paradox that whereas there was immunity from measles for life in the days when virtually everyone caught it, the vaccine only offers imperfect and waning immunity [3]. Another problem is that vaccinated mothers may no longer hand on measles anti-bodies to their infants [4,5], which makes them a vulnerable group. Apart from anything else it is very hard to see how herd immunity from vaccines could ever be remotely obtainable, even if 95% [6] of children or 100% were vaccinated.
We are told that this is the worst outbreak yet [6], which is perhaps out of line with the WHO projection of 110,000 deaths globally in 2017 [7]. I also recall the former Italian Health Minister, Beatrice Lorenzin, who was appointed at the White House to head the Global Health Security Agenda in 2014 [8] declaring that 270 children died in a recent outbreak of measles in London while regretting misinformation on the web [9]. Who is to say who is not telling the truth anymore?
[1] Stephen M O'Dea, 'Re: Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback', 25 February 2019, https://www.bmj.com/content/364/bmj.l739/rr
[3] Kontio M, Jokinen S, Paunio M, Peltola H, Davidkin I, 'Waning antibody levels and avidity: implications for MMR vaccine-induced protection', Infect Dis. 2012 Nov 15;206(10):1542-8. doi: 10.1093/infdis/jis568. Epub 2012 Sep 10.
[4] Sandra Waaijenborg, Susan J. M. Hahné, Liesbeth Mollema, Gaby P. Smits, Guy A. M. Berbers, Fiona R. M. van der Klis, Hester E. de Melker, and Jacco Wallinga, 'Waning of Maternal Antibodies Against Measles, Mumps, Rubella, and Varicella in Communities With Contrasting Vaccination Coverage', J Infect Dis. 2013 Jul 1; 208(1): 10–16.
[5] Zhao et al, 'Low titers of measles antibody in mothers whose infants suffered from measles before eligible age for measles vaccination' Virol J. 2010; 7: 87., Published online 2010 May 6. doi: 10.1186/1743-422X-7-87
[6] Owen Dyer, 'Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback',
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l739 (Published 14 February 2019)
Rapid Response:
Re: Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback
Stephen O'Dea [1] raises some interesting points. In my letter yesterday [2] I was pointing to the paradox that whereas there was immunity from measles for life in the days when virtually everyone caught it, the vaccine only offers imperfect and waning immunity [3]. Another problem is that vaccinated mothers may no longer hand on measles anti-bodies to their infants [4,5], which makes them a vulnerable group. Apart from anything else it is very hard to see how herd immunity from vaccines could ever be remotely obtainable, even if 95% [6] of children or 100% were vaccinated.
We are told that this is the worst outbreak yet [6], which is perhaps out of line with the WHO projection of 110,000 deaths globally in 2017 [7]. I also recall the former Italian Health Minister, Beatrice Lorenzin, who was appointed at the White House to head the Global Health Security Agenda in 2014 [8] declaring that 270 children died in a recent outbreak of measles in London while regretting misinformation on the web [9]. Who is to say who is not telling the truth anymore?
[1] Stephen M O'Dea, 'Re: Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback', 25 February 2019, https://www.bmj.com/content/364/bmj.l739/rr
[2] John Stone, 'Re: US measles, vaccine mandates and totalitarian pharmocracy', 25 February 2019, https://www.bmj.com/content/363/bmj.k5246/rr-2
[3] Kontio M, Jokinen S, Paunio M, Peltola H, Davidkin I, 'Waning antibody levels and avidity: implications for MMR vaccine-induced protection', Infect Dis. 2012 Nov 15;206(10):1542-8. doi: 10.1093/infdis/jis568. Epub 2012 Sep 10.
[4] Sandra Waaijenborg, Susan J. M. Hahné, Liesbeth Mollema, Gaby P. Smits, Guy A. M. Berbers, Fiona R. M. van der Klis, Hester E. de Melker, and Jacco Wallinga, 'Waning of Maternal Antibodies Against Measles, Mumps, Rubella, and Varicella in Communities With Contrasting Vaccination Coverage', J Infect Dis. 2013 Jul 1; 208(1): 10–16.
[5] Zhao et al, 'Low titers of measles antibody in mothers whose infants suffered from measles before eligible age for measles vaccination' Virol J. 2010; 7: 87., Published online 2010 May 6. doi: 10.1186/1743-422X-7-87
[6] Owen Dyer, 'Philippines measles outbreak is deadliest yet as vaccine scepticism spurs disease comeback',
BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l739 (Published 14 February 2019)
[7] World Health Organization, 'Measles', 29 November 2019, https://www.who.int/news-room/fact-sheets/detail/measles
[8] John Stone, 'Re: MEPs devise strategy to tackle vaccine hesitancy among public -Echoes of WMD', 26 March 2018, https://www.bmj.com/content/360/bmj.k1378/rr
[9] John Stone, 'Re: Compulsory vaccination and growing measles threat - Prof Melegaro's response', 21 October 2017, https://www.bmj.com/content/358/bmj.j3429/rr-7
Competing interests: No competing interests