Doctor's Orders

Welcome back to Contemplative Being! 

This week I wanted to address something that has been in the news every day for the past month or so, yes, you guess it, the measles.  If you are wondering how this relates to ethics you’ll see just keep reading. If you are anything like me you may be wondering why the U.S. is dealing with a measles outbreak especially considering the fact that in 2000 the CDC officially declared that the measles was eliminated in this country. Keep in mind that this does not mean that the virus was whipped off the planet; it has been and continues to be present all over the world infecting millions of people. The reason the U.S. was able to banish the virus was thanks to a vaccine first introduced in 1963. A few years later in 1968 the vaccine was improved to make it the highly effective vaccine we have today. In 1967 and 1969 vaccines were developed for mumps and rubella respectively and in 1971 all three vaccines were combined into one known as MMR.

CDC - Thin-section transmission electron micrograph (TEM)
image of a single measles virus particle

The measles is highly contagious. There is a 90% chance that an unvaccinated individual will contract the disease if they come in contact with the virus which is spread through the air and can remain alive for up to two hour. Having lived in this country my entire life in a time when vaccination for the virus was normal I must say that I do not really know much about the disease and for some reason the name “measles” does not really sound scary but I have learned that it should be. According to the World Health Organization measles is one of the leading causes of death particularly of children around the world. From 2000-2013 thanks to the vaccine there was a 75% drop in measles deaths worldwide. According to the CDC in the U.S. there were fewer than 200 reported cases of the disease since it was declared effectively eliminated in the country in 2000 through 2013 and fewer than 100 cases in nine of those years. Last year that number spiked to nearly 700 cases and we are on track to go even higher this year, in the first month of 2015 over 100 cases have already been reported.  By now you probably have a few questions. First how could the U.S have declared the disease eliminated in 2000 if people have still been getting infected? And what happened to make the number of cases skyrocket last year and likely again this year? The answer to the first question is that since the virus has remained highly active in the rest of the world infected travelers bring it with them but thanks to the high level of vaccination here it did not spread. The answer to the second question is a bit more involved but it boils down to fewer people in this country being vaccinated which leads to another question which is why are fewer people being vaccinated?

Photo of Andrew Wakefield

Back in 1998 a British doctor by the name of Andrew Wakefield submitted a paper to The Lancet a medical journal that reported a link between the MMR vaccine and autism. As you might expect the media took this information and ran with it. What the media failed to report on was that in 2004 the article partially retracted and fully retraced in 2010 because the research was found to have been fraudulent and the doctor was barred from practicing medicine as a result. So why would Andrew Wakefield do this? You guessed it, money. Prior to publishing his report he filed for a patent for a single measles (non-combined) vaccine that his report claimed would be safer. Not only that, he was actually being paid big bucks by trial lawyers that wanted to sue vaccine manufacturers for “vaccine injury”, Wakefield seemingly forgot to disclose these facts in his study. Immediately following the publication of the article in 1998 numerous research groups have attempted to replicate the findings of Wakefield with no success. The CDC along with the UK National Health Service and several other organizations have stated conclusively that there is no link between the MMR vaccine and autism.

The damage was done; frightened parents did not want to put their kids at risk of developing autism so they have opted out of the vaccine which is typically administered to children when they turn one with a booster before starting school. No there are large numbers of unvaccinated children and young adults all over the country so when one of those people comes in proximity to an infected person that may have contracted the virus while traveling elsewhere the virus spreads and continues to do so like a wildfire. Although the research has been discredited there is still a large anti-vaccine movement that continues to believe in this link. According to the World Health Organization in 2013, 16 people die every hour from the measles and from 2000-2013 the vaccine has prevented an estimated 15.6 million deaths and yet the rate of vaccination in the U.S. has dropped in that timeframe.  

It’s hard to believe that one man could do so much damage just to make a buck. This serves as an example of what can happen when ethical considerations are ignored. Andrew Wakefield failed every ethical test and only time will tell how many will die needlessly as a result of his actions.

Thanks for reading, see you next week.

References and Links

Measles. (2014, November 3). Centers for Disease Control and Prevention. Retrieved February 7, 2015, from http://www.cdc.gov/measles/about/index.html

Measles Cases and Outbreaks. (2015, February 2). Centers for Disease Control and Prevention. Retrieved February 7, 2015, from http://www.cdc.gov/measles/cases-outbreaks.html

Measles. (n.d.). World Health Organization. Retrieved February 7, 2015, from http://www.who.int/mediacentre/factsheets/fs286/en/

Gorski, D. (2009). Antivaccine hero Andrew Wakefield: Scientific fraud?. Science-Based Medicine. Retrieved February 7, 2015, from http://www.sciencebasedmedicine.org/antivaccine-hero-andrew-wakefield-scientific-fraud/

Beaubien, J. (2015). Measles Vaccination Rates: Tanzania Does Better Than U.S. NPR. Retrieved February 7, 2015, from http://www.npr.org/blogs/goatsandsoda/2015/02/06/384068229/measles-vaccination-rates-tanzania-does-better-than-u-s