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I would like to take this opportunity to echo my co-blogger Steve’s sentiment and thank Jenny McCarthy.

What? You say. Has Gorski completely lost his mind? (Or maybe you used another word besides “mind,” a perhaps not so savory word.) Not really. I just agree with Steve that accomplishment should be recognized, and there’s no doubt that in her year as the new celebrity spokesperson for the antivaccination movement, Jenny McCarthy has pulled off a major coup.

She’s helped reignite a movement that was until her entrance (and especially the entrance of her far more famous boyfriend Jim Carrey, who’s said some things just as breathtakingly dumb as Jenny has) more or less moribund, to the point where it’s now become so effective that measles is coming back far faster than I had thought possible. Between her tireless prosletyzing on Oprah Winfrey’s show that vaccines caused her son’s autism and that “biomedical” quackery can “cure it”; her organizing of a march on Washington, D.C. this summer to push an explicitly antivaccine agenda disguised under the deceptive and disingenuous (but brilliantly Orwellian) slogan “Green Our Vaccines“; her holding celebrity fundraisers (complete with Britney Spears, Hugh Hefner, and Charlie Sheen, yet!); and her fronting WWE events to raise money for Generation Rescue, she’s done it all in a little more than a year. And she’s not resting on her “laurels” (such as they are), either. This September, she will be publishing the followup to her previous book on “healing autism” (with quackery), Mother Warriors: A Nation of Parents Healing Autism Against All Odds. No doubt she will again appear with Oprah to fawning acclaim to make the unfounded assertion that vaccines injured her son to make him autistic and that her favored forms of quackery have successfully “healed him.”

In light of these “accomplishments,” it’s only right that we all give Jenny (and Jim) the “thanks” they deserves for their role in bringing the measles back to the U.S.



As further evidence that this is the case, last week, the CDC released an update to its Morbidity and Mortality Weekly Report (MMWR) that demonstrates very clearly that the antivaccination movement is having an effect. Let’s put it this way. A mere eight years ago, measles was considered, in effect, eradicated from the U.S., thanks to a vigorous vaccination program and a very high vaccine uptake. All that remained were a handful, usually less than 100, cases of measles from outside the U.S. That’s all changing now:

The number of measles cases in the U.S. is at its highest level since 1997, and nearly half of those involve children whose parents rejected vaccination, government health officials reported Thursday. The number of cases is still small, just 131, but that’s just for the first seven months of the year and doctors are troubled by the trend. There were only 42 cases for all of last year. “We’re seeing a lot more spread. That is concerning to us,” said Dr. Jane Seward, of the U.S. Centers for Disease Control and Prevention. Pediatricians are frustrated, saying they are having to spend more time convincing parents the shot is safe. “This year, we certainly have had parents asking more questions,” said Dr. Ari Brown, an Austin, Texas, physician who is a spokeswoman for the American Academy of Pediatrics. The CDC’s review found that a number of cases involved home-schooled children not required to have the vaccines. […] It is no longer endemic to the United States, but every year some Americans pick it up while traveling abroad and bring it home. Measles epidemics have exploded in Israel, Switzerland and some other countries. But high U.S. childhood vaccination rates have prevented major outbreaks here. In a typical year, only one outbreak occurs in the United States, infecting perhaps 10 to 20 people. So far this year through July 30 the country has seen seven outbreaks, including one in Illinois with 30 cases, said Seward, deputy director of the CDC’s Division of Viral Diseases. None of the 131 patients died, but 15 were hospitalized.

It’s not all bad news. The article and the MMWR report note that vaccination rates in the U.S. are still over 90%, still high enough for herd immunity to hold sway, but that outbreak pockets, where lower vaccination rates are the rule and herd immunity has become shaky, are forming. That’s what’s allowing these outbreaks to occur. Here’s the kicker:

Of this year’s total, 122 were unvaccinated or had unknown vaccination status. Some were unvaccinated because the children were under age 1, making them too young to get their first measles shot. In 63 of those cases _ almost all of them 19 or younger _ the patient or their parents refused vaccination, the CDC reported. In Washington state, an outbreak was traced to a religious conference, including 16 school-aged children who were not vaccinated because of parents’ beliefs. Eleven of those kids were home schooled and not subject to vaccination rules in public schools. The Illinois outbreak _ triggered by a teenager who had traveled to Italy _ included 25 home-schooled children, according to the CDC report.

So, rejoice, Jenny McCarthy, J.B. Handley, David Kirby, Kim Stagliano, Dan Olmsted, Barbara Loe Fisher, and all the other antivaccine activists (or their enablers, such as pediatrician to the stars’ children, including Jenny McCarthy’s son Evan, Dr. Jay Gordon, who oh-so-piously claim they are really and truly “not antivaccine” but then repeat antivaccination pseudoscience word-for-word) spreading misinformation, pseudoscience, and fear about vaccines! You’re winning. You’re succeeding in casting doubt on the safety of vaccines to the point that it’s causing real problems for our public health system:

The nation once routinely saw hundreds of thousands of measles cases each year, and hundreds of deaths. But immunization campaigns were credited with dramatically reducing the numbers. The last time health officials saw this many cases was 1997, when 138 were reported. Last year, there were only 42 U.S. cases. The American Academy of Pediatrics has made educating parents about the safety of vaccines one of its top priorities this year, in part because busy doctors have grown frustrated at the amount of time they’ve been spending answering parents’ questions about things they read on the Internet or heard from TV talk shows. In June, the CDC interviewed 33 physicians in Austin, suburban Seattle and Hollywood, Fla., about childhood vaccinations. Several complained about patient backlogs caused by parents stirred up by information of dubious scientific merit, according to the CDC report.

Yes, Jenny, this resurgence in measles is at least in part the result of your tireless labor in scaring parents with lies and pseudoscience to the point where they fear and refuse vaccination. Now, thanks to you and your allies, your efforts are really beginning to bear fruit, and we’re catching up with the U.K., which has a decade-long head start. Measles is coming back, Who knows? If you keep it up, you could reach the golden age of pre-MMR, as described in the CDC report:

In the United States, measles caused 450 reported deaths and 4,000 cases of encephalitis annually before measles vaccine became available in the mid-1960s (1). Through a successful measles vaccination program, the United States eliminated endemic measles transmission (1). Sustaining elimination requires maintaining high MMR vaccine coverage rates, particularly among preschool (>90% 1-dose coverage) and school-aged children (>95% 2-dose coverage) (7). High coverage levels provide herd immunity, decreasing everyone’s risk for measles exposure and affording protection to persons who cannot be vaccinated. However, herd immunity does not provide 100% protection, especially in communities with large numbers of unvaccinated persons. For the foreseeable future, measles importations into the United States will continue to occur because measles is still common in Europe and other regions of the world. Within the United States, the current national MMR vaccine coverage rate is adequate to prevent the sustained spread of measles. However, importations of measles likely will continue to cause outbreaks in communities that have sizeable clusters of unvaccinated persons.

But, hey, if Jenny succeeds, it’ll be far more than just isolated communities of unvaccinated persons being victimized by measles outbreaks. If Jenny succeeds, the measles can really go to town in a manner not seen since the pre-vaccine era of early 1960s! After all:

Measles is one of the first diseases to reappear when vaccination coverage rates fall. Ongoing outbreaks are occurring in European countries where rates of vaccination coverage are lower than those in the United States, including Austria, Italy, and Switzerland (3,4). In June 2008, the United Kingdom’s Health Protection Agency declared that, because of a drop in vaccination coverage levels (to 80%–85% among children aged 2 years), measles was again endemic in the United Kingdom (3,8), 14 years after it had been eliminated. Since April 2008, two measles-related deaths have been reported in Europe, both in children ineligible to receive MMR vaccine because of congenital immunologic compromise (4,8). Such children depend on herd immunity for protection from the disease, as do children aged <12 months, who normally are too young to receive the vaccine. Otherwise healthy children with measles also are at risk for severe complications, including encephalitis and pneumonia, which can lead to permanent disability or death.

Let’s not forget that that was just the measles. Keep it up, Jenny and other antivaccine activists, and you can probably drive vaccination rates low enough that polio, Haemophilus influenza b, the mumps, pertussis and a whole lot of other vaccine-preventable diseases currently under good control make a similar comeback. Heck, if you work hard enough, maybe they’ll all become endemic again. It’ll be just like the old days! That’ll be the reward for your success, just as the manner in which Andrew Wakefield’s incompetent, litigation-driven, and unethical “research” led measles, which had been similarly declared as conquered in the U.K. 14 years ago to become endemic again less than ten years after Wakefield first published his results. (Indeed, we should thank Andrew Wakefiedl as well for his role in paving the way for Jenny McCarthy and friends here in the U.S.!) That’s the world to which Jenny McCarthy and her merry band of antivaccine activists are leading us in name of a false dichotomy that parents face a choice between either vaccine-preventable infectious diseases or autism. It’s a false dichotomy because the best scientific evidence says that mercury in the thimerosal that used to be in vaccines does not cause autism, nor do vaccines themselves. Indeed, Jenny’s claims that her son Evan has “recovered” from his “vaccine injury”-induced autism have recently been revealed to be highly doubtful, and more recently even her fellow travelers can’t seem to keep their stories straight.

I’m sure all the suffering, hospitalized, and dead children in the future will Jenny for her tireless efforts to “save them from autism” now at the cost of suffering and dying from vaccine-preventable diseases in the future. Steve Novella put it well when he said:

The idiocy of antivaccinationists partly rests upon the modern luxury of never having had to live through the horrible epidemics of the past. I wonder how much the current generation will have to suffer through before they get it. And I will say it again – if Jenny McCarthy is going to put her own “mommy instinct” before the consensus of scientific opinion, and exploit her dubious celebrity to champion anti-science, then she is going to have to take responsibility for her actions. The way I figure it, so far there are at least 68 measles cases on her tally sheet, and the number is growing.

I fear how large that number will grow before there is a backlash against the antivaccine activists who had a large role in causing this incipient public health disaster.

ADDENDUM:

By the way, my blog bud PalMD also thanks Jenny for the opportunity to fill in a gap in his medical education by providing him with the future opportunity to see cases of diseases that had previously been driven to being very rare, thanks to vaccines.