America is in danger of losing its “measles-free” status
September 11, 2019 9:25 AM   Subscribe

If an outbreak in New York state continues, the US will no longer be considered a nation that eliminated measles. Too many people have forgotten how serious measles is, and they’re opting out of vaccines. Because of that, we all have to worry about measles again. At the beginning of September, the Centers for Disease Control and Prevention recorded more than 1,200 measles cases in the US. That’s the largest number for any year since 1992. It’s also a huge uptick compared to 2018, when 372 cases were reported. As a result, on October 2, the US could lose its measles-elimination status. That status is conferred on countries without continuous measles transmission for at least one year, where all measles cases can be linked back to a traveler who brought the virus from another place where it’s been circulating. If an outbreak in New York state marks its one-year anniversary at the beginning of October, our elimination status will go with it.
posted by Homo neanderthalensis (71 comments total) 27 users marked this as a favorite
 
Our weekly shul announcement contains a pro-vaccine rabbinical statement signed by a few dozen Orthodox rabbis, mine included. It's not something that's an issue at my shul, but from arguments I've had in Jewish spaces online, I can't say it's limited to just the ultra-Orthodox.
posted by Ruki at 9:49 AM on September 11 [19 favorites]


My toddler is 2. At an appointment earlier in the year, the pediatrician asked if we had any travel plans, specifically singling out New York City as a place of interest. Because if we were going to be anywhere near NYC--the city that never sleeps! the shining jewel of American capitalism and excess! the land of the free, the home of the fabulously wealthy!--we were going to need to get him the second dose of measles vaccine ahead of schedule, because a bunch of mouth-breathing semi-literate retrograde dipshits with more money than sense decided that an outbreak of the plague was an acceptable price to pay for the diminished (completely non-existent, made-up-in-their-head) risk of autism for their precious babes.

Thanks, anti-vaxxers. Vaccines are the greatest advance in medicine since someone decided to wash his hands before performing surgery, and you ruined it by being militantly misinformed dingleberries.
posted by Mayor West at 9:55 AM on September 11 [74 favorites]


mouth-breathing semi-literate retrograde dipshits

I'd like to push back on this. This outbreak is in an Orthodox community, and unfortunately because of the history of medical experimentation on Jews, many in these sort of insular Orthodox Jewish communities are very skeptical of doctors and injections. Not all but a lot. So this particular outbreak is a little more complicated than "Karen from LA didn't get Timmy vaccinated because he'll catch the autisms." It's an example of the dangers of insularity and the legacy of trauma and racism coloring peoples experiences.
posted by Homo neanderthalensis at 9:59 AM on September 11 [34 favorites]


I live in Connecticut and Dingleberry Road is an honest-to-goodness real name of a road on my town.
posted by I-Write-Essays at 10:00 AM on September 11 [8 favorites]


Also, I'm not sure NYC is a place one should expect to be clean and disease-free, even in the best of times.
posted by swift at 10:08 AM on September 11 [1 favorite]


I'm not sure NYC is a place one should expect to be clean and disease-free
What's that supposed to mean?
posted by neroli at 10:26 AM on September 11 [13 favorites]


Homo neanderthalensis, I don't think that's right. The measles outbreak in NYC is very recent, only from the last year or so. If this is being driven by "the history of medical experimentation on Jews", why wasn't there resistance in these communities to vaccinations until now? Even Orthodox communities have been vaccinated historically; measles was wiped out in the entire US in 2000. What has changed in these communities that's lead to this very recent rejection of vaccines?
posted by Sangermaine at 10:27 AM on September 11 [15 favorites]


What has changed in these communities that's lead to this very recent rejection of vaccines?

More and more frequent diagnoses of autism in the communities.
posted by A god with hooves, a god with horns at 10:29 AM on September 11 [2 favorites]


Also as a Jew, in New York City, who lives near one of these measles epicenters, is trying to raise an infant in one, and cannot take my fucking child to the park without a measles risk, I actually have no problem with categorizing the Orthodox and Hasidic communities primarily responsible for these outbreaks did this with very choice words that I'm not risking the deletion of this comment by voicing.
posted by A god with hooves, a god with horns at 10:32 AM on September 11 [29 favorites]


In the ultra-orthodox communities vaccination rates have been low for a while. Compared to non-orthodox Jews where vaccination rates are very high. They're one of the religious communities that use religious exemptions, but as they're very very small and very very insular this sort of thing hasn't happened on this scale yet. But add in the worldwide resurgence of measles, yes, due to vaccine hesitancy, and add in frequent travel to Israel, and eastern Europe, areas that can have outbreaks, this was bound to happen eventually.
posted by Homo neanderthalensis at 10:33 AM on September 11 [1 favorite]


I'd like to push back on this.
Similarly, one of my colleagues in a vaccination program pointed out that even she had a certain skepticism toward vaccines, because "black people don't trust when the government tells them to put something in their bodies." Which, given the history of racist implementation of public health (or, awful abuses in the name of public health) in this country, is an understandable view.

What has changed in these communities that's lead to this very recent rejection of vaccines?

I mean it's consistent with what seems like a growing distrust of established authorities (see also climate deniers, growing conspiracy theories, etc), and growing industries of motherfuckers who aim to profit from a potent mixture of a little bit of fear, a little bit of distrust, and a lot of misinformation (see also Fox News, chronic lyme, Goop and other miscellaneous wack shit under the 'wellness' umbrella).
posted by entropone at 10:33 AM on September 11 [9 favorites]


Also, the numbers are higher, so there are more outbreaks. Ultra-Orthodox families are having 8+ children each.
posted by Melismata at 10:33 AM on September 11


New Yorker covered this a few weeks ago, not a lot of new information but here is a bit about the spread in NY State Orthodox enclaves:

People often talk about the anti-vaccination movement as a social-media phenomenon, but in the ultra-Orthodox community, where women are discouraged from using computers and smartphones, it has apparently spread mostly among mothers by word of mouth, through phone trees, leaflets, and gatherings: still viral, but analog. “It’s more about social networks than social media,” Gellin, of the Sabin Vaccine Institute, said. A few years ago, a slick pamphlet called “The Vaccine Safety Handbook: An Informed Parent’s Guide” became ubiquitous in Hasidic enclaves of Brooklyn. It had been produced by an organization called peach, or Parents Educating and Advocating for Children’s Health. (The identity of the parents behind it has been a well-guarded secret, although Wired recently published a story about “Chany”—her surname was withheld—a Hasidic mother in Borough Park who was its purported founder; she’d got her information from the Internet.) The pamphlet expressed alarm that, among other things, some vaccines might contain trace amounts of monkey kidneys, rabbit brains, pork products, and aborted fetuses. Definitely not kosher. Rabbis pointed out that this claim wouldn’t matter, since one does not eat a vaccine. But the M.M.R. vaccine doesn’t contain those things

https://www.newyorker.com/magazine/2019/09/02/the-message-of-measles
posted by pilot pirx at 10:38 AM on September 11 [6 favorites]


It's also worth noting that if our goal is health, and high vaccination rates, then telling people that they are stupid and wrong doesn't achieve our goals.

Understanding their desire to protect their children and their distrust of medical authorities goes a long way toward turning those who are hesitant about vaccines into allies, vaccinators.

After all, there are very few anti-vaxxers. There are a lot more people who are just mistrustful, uninformed, and at the mercy of the bad actors. They're our potential allies, not our enemies.
posted by entropone at 10:46 AM on September 11 [12 favorites]


After all, there are very few anti-vaxxers. There are a lot more people who are just mistrustful, uninformed, and at the mercy of the bad actors. They're our potential allies, not our enemies.

People always say this, but I think it's wrong. That's just the answer they are giving today (that doctors are mean to them).
posted by The_Vegetables at 11:14 AM on September 11 [7 favorites]


I'm saying that based on data from the American Academy of Pediatrics.
posted by entropone at 11:20 AM on September 11 [11 favorites]


I am exposed to an interesting array of opinions on the outbreak:

* I work in an office on the fringes of one of the big Orthodox communities here in Brooklyn, and my boss is Orthodox himself.
* A woman in my book club has a role in crisis management at the city's health department and has been showing up to the meetings looking exhausted for the past several months, and has some choice things to say about anxi-vaxxers.
* However, surprisingly, it's not my boss that got my nose most bent out of joint - it's a co-worker who's a conspiracy nut and publicly professed to being anti-vaxxer. I tried verrrrry hard to keep it together when he said that.
posted by EmpressCallipygos at 11:22 AM on September 11 [15 favorites]


Thank you, Andrew Wakefield
posted by scruss at 11:42 AM on September 11 [5 favorites]


I'd like to push back on this. This outbreak is in an Orthodox community, and unfortunately because of the history of medical experimentation on Jews, many in these sort of insular Orthodox Jewish communities are very skeptical of doctors and injections.
I am a bit hesitant to give people a pass on ignoring established medical practices because ... they don't believe in established medical practices. Isn't that what we're slagging others for?
posted by Gilgamesh's Chauffeur at 11:42 AM on September 11 [10 favorites]


i direct anyone who thinks that “follow established medical practices” — full stop — is the answer toward this horrifying post from earlier today.

vaccines are a massive public good and, as observed upthread, the greatest advance in medicine since hand washing before surgery.

however, it is not possible to simply dismiss out of hand the concerns of people who know that there is a long history of medical practitioners abusing and mutilating people.

there is an ongoing failure of trust between many communities and medical practitioners. this failure of trust can in fact be laid at the feet of medical practitioners, who are often quite blasé about the wellbeing of people in their care. this (justifiable) lack of trust can result in very bad things, like for example the existence of the antivax movement.
posted by Reclusive Novelist Thomas Pynchon at 11:47 AM on September 11 [25 favorites]


So anyway, who's getting their flu jabs soon? Because I'm heading out of state next week and I'm sure as hell going to go get that done beforehand.

The Orthodox community in New York is not one I have a more than passing familiarity with (my aunt comes from it but she hasn't identified as such in decades), so I don't know, but I imagine that there are multiple Orthodox family doctors serving their community. Reclusive Novelist makes a great point above - a lot of it's a failure of trust in medical practitioners. So why aren't the rabbis working with the doctors in their congregation to repair this trust, at least about vaccines? This is one strength of a close knit community with strong leadership, generally speaking, that if there is a breach in society-wide stuff like herd immunity, at least theoretically it's simpler to repair. Not that these rabbis don't have other things to prioritize considering the political climate, but it sure seems like the kind of thing a rabbi might focus on in the upcoming high holiday bustle.
posted by Mizu at 12:42 PM on September 11 [2 favorites]


The New Yorker article is good, I read it this week. What I liked was that the medical community that is involved in getting people vaccinated has separated the anti-vaxxers into two groups: hard-core and suspect. They don't deal with hard-core anti-vaxxers because there is no rational basis they will listen to, but the suspicious group they can educate and they are having success. I thought that was a good way to give more clarity to a really screwed up problem.

I am old, and was vaccinated for small-pox when I was born, like everyone else my age. It wasn't a big deal. I ran into this sort of thinking when I was on a committee years ago to work on the idea of "dirty bombs," and what the public health response would be. I was shocked at how people kicked against the idea of being vaccinated for small-pox.
posted by chocolatetiara at 12:44 PM on September 11 [7 favorites]


Vaccines are the greatest advance in medicine since someone decided to wash his hands before performing surgery,

Vaccination (Jenner, 1796) as a strategy (as opposed to something that just happened as disease ravaged populations) actually predates surgery pre-washing (Semmelweis, mid 1800s).

The story of Semmelweis who first pushed for doctors to wash their hands between patients and the morgue could be instructive as one of the reasons he got pushback was because it wasn't very tactful in trying to get people to wash their hands.

I was shocked at how people kicked against the idea of being vaccinated for small-pox.

I'd be pretty hesitant too barring an actual out break (I missed being vaccinated as a child by 15 days). People can die from the vaccination and there haven't been any cases in the wild since 1978. The risk ratio is pretty firmly on not getting vaccinated for small pox at this time.
posted by Mitheral at 1:01 PM on September 11 [6 favorites]




I'm expecting a new baby next month and it sucks to have to think about this. For our previous babies we had a party in southern California to celebrate their hundredth day and meet the extended family, and we've pretty much decided it's not worth the risk taking an unvaccinated baby through socal airports this winter. I'm also generally concerned about just taking the baby out and about in public in a way I wasn't three years ago.

This is nasty because isolating new moms in their homes is really bad for their mental health...but if you live in a place where there have been measles cases it feels very selfish and also very anxiety-inducing to place one's own hypothetical mental health benefits above sheltering one's infant from measles. A lot of new mom groups meet in hospitals and hell if I'm going anywhere near a hospital with a baby if I'm not absolutely required to.
posted by potrzebie at 1:02 PM on September 11 [5 favorites]


> why aren't the rabbis working with the doctors in their congregation to repair this trust, at least about vaccines?

it seems the more pressing question is why aren’t doctors working with rabbis to restore trust, and making real material efforts to show their trustworthiness?

> Reclusive Novelist makes a great point above

i have a name, you know. it’s thomas pynchon. “reclusive novelist” merely describes my preferred level of personal publicity and the thing i do for money.
posted by Reclusive Novelist Thomas Pynchon at 1:05 PM on September 11 [8 favorites]


Use of "reclusive novelist" instead of your name helps with maintaining that preferred level of personal publicity, no? :-)
posted by clawsoon at 1:12 PM on September 11 [1 favorite]


“reclusive novelist” seems like a name that thomas pynchon could possibly use on the Internet, and i, thomas pynchon, would definitely not want to use a handle that could even hypothetically be thought of as something that thomas pynchon might use. therefore, please call me thomas pynchon.
posted by Reclusive Novelist Thomas Pynchon at 1:27 PM on September 11 [8 favorites]


anyway, this thread is not the right place to argue about my name. it’s a serious thread about a bad thing. the important intervention i want to make is to note that 1) the medical profession is in large part responsible for the widespread lack of trust in the medical profession, 2) winning back that trust is the job of medical professionals not the job of the leaders of the communities that distrust medical professional, 3) (unfortunately) establishing or reëstablishing trust is going to be a decades-long process and maybe one that the medical profession as currently configured is capable of, 4) in the absence of a dedicated, thoughtful, long-running, humble, responsible, respectful campaign by the medical profession to win back trust, and to behave in an actually trustworthy manner, nightmares like the antivax movement will continue to pop up and win influence.
posted by Reclusive Novelist Thomas Pynchon at 1:32 PM on September 11 [5 favorites]


The risk ratio is pretty firmly on not getting vaccinated for small pox at this time.

Also, it is a massive pain in the ass to take care of it for up to three weeks.
posted by Etrigan at 1:56 PM on September 11 [3 favorites]


> I'd be pretty hesitant too barring an actual out break (I missed being vaccinated as a child by 15 days). People can die from the vaccination and there haven't been any cases in the wild since 1978. The risk ratio is pretty firmly on not getting vaccinated for small pox at this time.

i recall reading back in the late cold war era that if the u.s. were to start up widespread public smallpox vaccinations again, it would have been interpreted by the soviets and chinese as a threat — an indication that the united states was planning on using smallpox as a weapon of war.
posted by Reclusive Novelist Thomas Pynchon at 1:58 PM on September 11 [2 favorites]


Vaccines are the greatest advance in medicine since someone decided to wash his hands before performing surgery

The first (rudimentary) vaccine - smallpox - is actually older than the idea of sterile surgery!

ETA: just noticed I was beaten to the punch up thread!
posted by Dysk at 2:03 PM on September 11 [4 favorites]


...in the absence of a dedicated, thoughtful, long-running, humble, responsible, respectful campaign by the medical profession to win back trust, and to behave in an actually trustworthy manner, nightmares like the antivax movement will continue to pop up and win influence.

Winning widespread trust in the medical profession is a pretty huge challenge, and as we know from ongoing issues today, it's not likely to be a switch we can just flip anytime soon.

Establishing trust in vaccines, though, that's a separate thing and of course it is also the job of community leaders. Encouraging folks to take the steps that keep vulnerable members of their community alive is...a critical part of a rabbi's job.

We can worry about other things "like antivax" as they pop up. Let's focus on antivax specifically first.
posted by mosst at 2:23 PM on September 11 [2 favorites]


neroli: What's that supposed to mean?

I hope you said this in your best Brooklyn accent while rolling up your sleeves and cracking your knuckles.
posted by dr_dank at 2:29 PM on September 11 [3 favorites]


So anyway, who's getting their flu jabs soon? Because I'm heading out of state next week and I'm sure as hell going to go get that done beforehand.

There's a sizable contingent of people who say they are pro-vaccination and of course anti-vaxxers are terrible and we should all be vaccinated. Except for the flu vaccine because that's different and doesn't count.

Search metafilter for older flu threads and you can even see it in action. Hell, there's undoubtedly pro-vaccination people reading this thread right now who are rather lackadaisical when it comes to influenza vaccination.

Everybody get your flu vaccines every year! Generally by Halloween is my guideline.
posted by Justinian at 2:53 PM on September 11 [13 favorites]


Yeah I got my flu vaccine the second week it was available from CVS. I'm very pro-flu vaccine, but I've been more cavalier some years. Until a couple of years ago. I got it in November, and I must have already been infected because college, and a week later (it takes 2 weeks for the flu jab to take effect) I came down with THE HELL FLU. Not a cold, a flu. My mom's immuno-compromised and can't get the flu vaccine so I'm lucky I didn't kill her. Lucky for her the strain going around that year was one she'd gotten as a kid so she beat it in 3 days and wasn't too sick. I missed a week of classes and ruined thanksgiving and felt like absolute death for weeks. Still had to write two papers which I'm sure were not my best work. PLEASE if you haven't already, get your flu vaccine now!
posted by Homo neanderthalensis at 2:59 PM on September 11 [5 favorites]


I think the problem with the flu vaccine is its so much less effective that people don't trust it as much. I got the flu 3 years in a row with the vaccine.

Now, *I* know that doesn't mean it didn't do anything (some evidence that it reduces severity, also maybe I would have gotten a second flu if I didn't have vaccine). And a 50% chance of no flu (randomly made up number) is better than a 0% chance.

But the #1 argument I hear from people who don't get the flu vaccine is some variant of "I got it once and still got the flu, so there's no point".
posted by thefoxgod at 3:15 PM on September 11 [2 favorites]


* A woman in my book club has a role in crisis management at the city's health department and has been showing up to the meetings looking exhausted for the past several months, and has some choice things to say about anxi-vaxxers.

I used to work with a woman who was old enough to have contracted polio as a child, and similarly, she was also a source of particular bon mots about anti-vaxxers.

I think the problem with the flu vaccine is its so much less effective that people don't trust it as much. I got the flu 3 years in a row with the vaccine.

If you have people in your life who express "concerns" about vaccination, or are otherwise pro-vaccination but "meh" on flu vaccination who would be willing to listen to a podcast with a jokey tone rather than an unhinged rant from you (by "you" I mean "me," and I've had to take this tack a few times), you could do worse than the Sawbones episode about vaccines. What's more, Dr. McElroy takes pains to point out that the flu vaccine is JUST LIKE all the other ones in that it's an integral part of what should be normal courses of vaccinations for non-immunocompromised individuals, full stop.
posted by mandolin conspiracy at 3:21 PM on September 11 [8 favorites]


we've pretty much decided it's not worth the risk taking an unvaccinated baby through socal airports this winter

Smart move, especially since Disneyland regularly attracts measles-carrying tourists and not everyone visiting the House of Mouse goes through John Wayne airport. The most recent incident was this past summer, and she went through LAX.

I had thought that the security theater in American airports was a damper on travel; I'm still wrapping my brain around the reality that now we have to think about disease vectors on walkabout.
posted by sobell at 3:34 PM on September 11 [4 favorites]


I'm religious about the flu shot personally. My 5yo daughter got the flu last year (verified at doctor's office) and with the combo of flu jab and early diagnosis and therefore Tamiflu, she was over it in two days and back at school good as new. It was amazing, as someone who lost her entire three-week winter break to the flu in third grade. So, so worth getting a shot to have the flu become so much easier to beat. My kids are signed up for their shots Saturday, mine is next week.

But yeah, I know tons of people including many medical professionals who don't consider themselves "anti-vax" who are in fact anti-flu-shot.
posted by potrzebie at 3:35 PM on September 11 [7 favorites]


I know someone who is antivaxx because her child " came down with autism" after the vaccine. I understand where her need for an item to blame for her child's very real issues. But there's nothing to say to someone with that mindset. You feel for their situation.

But I am strongly in favor of getting every vaccine that is appropriate for me and say so.

As for the flu vaccine, I figure that if I get enough different ones over the years, then hopefully my body will recognize a variant and make short work of it.
posted by mightshould at 4:03 PM on September 11 [2 favorites]


To the die-hard autism!!1! antivaxxers I like to suggest that exposure to screens in infancy causes autism and watch the mental gears grind. [not very plausible, but more plausible than the completely debunked vaccine hypothesis]
posted by benzenedream at 4:28 PM on September 11 [3 favorites]


Commenters pushing the bizarre argument that Jews are understandably suspicious of vaccines because of the "history of medical experimentation on Jews" (which I assume is a reference to Mengele) and a pursuant distrust of doctors, are really trivializing the legacy of the Holocaust.

From what I've read the current anti-vax sentiments seem to by a result of aggressive anti-vax propaganda being spread in Ultra-Orthodox communities over the past few years in direct contradiction to the opinion of the majority of religious authorities. This is a conspiracy theory that thrives on fear and lack of access to information, not an inevitable result of some fundamental shortcoming of the medical profession.
posted by loquacious crouton at 5:07 PM on September 11 [8 favorites]


Commenters pushing the bizarre argument that Jews are understandably suspicious of vaccines because of the "history of medical experimentation on Jews" (which I assume is a reference to Mengele) and a pursuant distrust of doctors, are really trivializing the legacy of the Holocaust.

Hi. I'm Jewish. Never tell me I'm trivializing the legacy of the Holocaust again pls. It is 100% true that the current madness has been propped up by anti-vax propaganda, but, just spit-balling here- the argument I'm making is that the only reason that propaganda has gotten as far as it has IS in fact the history of trauma around medical stuff in the Jewish community. It's the same reason the Somali-American community was ripe for anti-vaxxers and why some members of the black community in America can be very skeptical of doctors to their own detriment. There is a LONG HISTORY of the medical community in this and other countries treating various marginalized people as fodder for experimentation (Mengele, Tuskegee) and unfortunately that means in the more insular of those communities it is very easy to fall into these anti-science anti-vaccine traps. Forgive me if I don't blame the marginalized group themselves for that mistrust.
posted by Homo neanderthalensis at 5:21 PM on September 11 [13 favorites]


Buzzfeed has a nice article which digs into who is actually running PEACH, one of the groups distributing antivax propaganda to the Jewish community (previous WIRED article referenced in the New Yorker link above).
posted by benzenedream at 5:43 PM on September 11 [2 favorites]


What keeps me up at night: if we don't figure out how to put out the measles fire, it will only be the first disease that comes roaring back into a tinder-dry field. The modern death rate for diptheria is 5-10% overall, up to 20% among children under 5; historically, it was 50%.
posted by Mary Ellen Carter at 5:44 PM on September 11 [10 favorites]


I'm Jewish too. I don't understand what that has to do with pushing incorrect arguments.
posted by loquacious crouton at 5:48 PM on September 11 [7 favorites]


I’m not sure where in your comment you show that my argument is incorrect- other than accusing me of trivializing the holocaust and going “nuh-uh”. The medical community has lost the trust of a lot of groups as evidenced by any fpp on the blue about say- women and AFAB people’s health. Maybe next time one of those articles is posted you can read the comments from AFAB person after AFAB person talking about their negative and sometimes downright criminal experiences with doctors. There IS a fundamental shortcoming in the medical community- it’s not taking marginalized peoples concerns or lives seriously, and when you combine that fact with unscrupulous quacks like anti-vaxxers you have the potential for a firestorm.
posted by Homo neanderthalensis at 6:06 PM on September 11 [1 favorite]


[Couple comments removed. Facts are fine; telling people what they actually think or that they're wrong to be upset about something pretty much never helps anything.]
posted by cortex (staff) at 6:45 PM on September 11 [2 favorites]


Winning widespread trust in the medical profession is a pretty huge challenge, and as we know from ongoing issues today, it's not likely to be a switch we can just flip anytime soon.

Establishing trust in vaccines, though, that's a separate thing


WTF? No, it's not. There is no "trust vaccines, not doctors" option. That way lieth bathroom-meth-lab "homeopathic" vaccines applied topically to babies' foreheads, or turned into "healing incense."

The medical industry has routinely ignored the needs of women, and guess who's usually responsible for getting the kids vaccinated? The medical industry literally teaches that black people over-report pain; it's not surprising that some black parents are nervous about subjecting their kids to a procedure that "only hurts a little."

Almost nobody is anti-vax because they think autism is worse than measles. (I know there are some, and they're horrible. But most are counting on avoiding both.) Definitely nobody thinks autism is worse than death, blindness, or other permanent impairment by measles. But they don't trust doctors to assess the risk of those two options--they heard that vaccines might cause autism, and they know doctors lie to them, so why would they believe their Friendly Neighborhood Insurance-Company Paid Doctor to tell them the truth about vaccines? They also know that all of their questions are met with, "It'll be fine; get vaccinated." Followed by, "The risks of side-effects are so tiny that they don't matter."

That's what their cousin's friend's hairdresser was told, before her kid had a horrible reaction and was hospitalized for it. That's what her doctor said, before giving her the sleep pills that made her menstrual cramps go from painful to debilitating. That's what her husband's doctor said, before he got the blood pressure medication that gave him horrific mood swings.

No, she's not buying "The side effects won't matter; just trust me." Which doesn't leave her much in the way of resources to make an informed choice about her child's health, much less the community's.

Want people to trust vaccines? Convince doctors and nurses to stop lying to patients, and to believe them when they mention their symptoms. Oh, and get rid of the ones who insist on religious standards for women's health care, because this whole, "we can't do anything that might impair your babymaking abilities" approach means that many women - again, the ones usually tasked with vaccination management - believe that doctors practice agenda-driven medicine, not patient-focused medicine.

"All babies need vaccinations, regardless of their current circumstances" can sound an awful lot like, "all women need an intact uterus, regardless of their current circumstances."
posted by ErisLordFreedom at 6:47 PM on September 11 [9 favorites]


'Convince doctors and nurses to stop lying to patients, and to believe them when they mention their symptoms.'
What reason would doctors, much less nurses have to lie to patients?
posted by PollyWaffle at 7:27 PM on September 11 [1 favorite]


Power. Control. "This is how we've always done things and it's easier for me to do it this way despite the studies showing that we should do it a new way so I'm going to do it the old way" Bias. Racism. Misogyny. Take your pick.
posted by Homo neanderthalensis at 7:42 PM on September 11 [6 favorites]


Dishonest doctors: Why physicians lie
* two-thirds of doctors agree they should share serious medical errors with their patients, one-third did not completely agree.
* Nearly two-fifths of the respondents said they did not disclose their financial relationships with drug and device companies.
* And more than 55% of physicians said they often or sometimes described a patient's prognosis in a more positive manner than the facts might support.
* fear of litigation
* physician is often forced to see four or more patients per hour. Questions go unanswered or half answered

And that's aside from the horrific arrangements like the Tuskegee syphilis experiment and the casual theft of Henrietta Lacks biopsy material, which involved lying to people (or just "not telling them" things they should know) "for the good of better medicine for everyone."

Then there's doctors like Larry Nassar, who lied to his patients and their parents so he could continue assaulting little girls.

Because of the creeps and abusers and scam artists, we desperately need ethical, well-intentioned doctors to be honest. Instead, we get a whole lot of doctors who think "patients don't understand" or "they don't need to know" or "I might face a lawsuit if I admit I wasn't entirely confident about that decision."

It took Larry Nassar over 20 years to lose his medical license after the complaints started. Not only do doctors lie to their patients and parents, the medical industry allows them to continue lying for decades - if the patients are female or children or both.
posted by ErisLordFreedom at 8:41 PM on September 11 [11 favorites]


Asshole doctors and vaccines have both been around since the 1950s. Why did the antivax movement arise in the last twenty years instead of the 1960s?
posted by benzenedream at 9:28 PM on September 11 [3 favorites]


Because in the 1960s, people often stayed with one employer, who provided insurance, for their whole lives. They might not trust "the medical industry," but they trusted their family doctor.

People who change doctors every two years when their jobs change don't develop that trust. The "vax causes autism" bogus report came out when coverage started to drop - many people had limited coverage wherein services and meds were sometimes included and sometimes, apparently randomly, not covered, and many more people had no medical coverage at all and only saw doctors in the emergency room. And vaccinations didn't immediately plummet... but now it's been 20 years, and the people who were kids then are parents now, and are being told they need to trust this guy they met two months ago, who can't remember how to pronounce their name.

"He's a doctor." What do they know of doctors? They may not have ever had a regular doctor. They may not have friends who've had a doctor for more than two years. They have no reason to trust doctors in abstract, and no time to develop trust for whichever one is currently "their doctor."

They don't doubt that good doctors exist, that some are wise, kind, considerate, and supportive. But they don't know which doctors those are, and they are positive there are plenty who are greedy, lazy, abusive, or just going through the motions to draw a paycheck.
posted by ErisLordFreedom at 9:52 PM on September 11 [6 favorites]


As we became successful in eradicating most if not all childhood illnesses, less and less people remembered their toll. In the 1960's measles and mumps was still a common thing, and you or your parents might know multiple people in leg braces or iron lungs from Polio. Your favorite cousin might have been born seriously disabled due to her mother catching rubella while pregnant, and smallpox was yet to be eradicated worldwide.

Now most people will never know anyone with more than a passing familiarity with these illnesses, except those of us who have polio survivors in the family, or older parents. And it's important to note, even in the 1960's there were people who were anti-vax, but the ever-present toll of these diseases pushed them far far into the fringe, and the government was never willing to coddle them or entertain their ideas. But now, with more and more people never having seen the toll, the price we all paid for living with these diseases, they have bad experience after bad experience in the medical community and without the horrors of these diseases readily apparent, it's very easy to think- Well maybe they weren't so bad.

Dr so-and-so botched my mother's hysterectomy, what does he know about vaccines. Dr. such-and-such wouldn't give my dad painkillers after his surgery because he's black, why should I trust her about vaccines. Dr. whats-his-face wouldn't tie my tubes because my future husband would object, he must be in the pocket of big pharma! And so it goes. Injustice after injustice is delivered to people by men and women in white coats, and vaccines are pushed by those men and women so why should I trust them?

It's not the doctors couldn't do bad things in the past, it's not even that most doctors are bad. It's that the entire system is sick and biased and the most vulnerable suffer because of it, and without the lived experience of how bad these diseases are... It's very easy to get swept up in the anti-vaxxers web of lies.
posted by Homo neanderthalensis at 9:58 PM on September 11 [8 favorites]


You need a new country where doctors are not on the take, like everyone seems to be.
posted by PollyWaffle at 11:16 PM on September 11 [1 favorite]


"All babies need vaccinations, regardless of their current circumstances" can sound an awful lot like, "all women need an intact uterus, regardless of their current circumstances."
This is something you might hear from angry idiots on the internet, particularly in places like this one, but vaccines are only as safe as they are because we know how to identify kids for whom they would be unsafe. Pediatricians are much more aware of the diversity in kids ability to be safely vaccinated than either these quack communities or the kinds of people who fantasize about fashioning syringe guns to go around shooting children. Screening for contraindications is an absolutely essential part of the vaccination process for both children and adults. Many babies absolutley should not recieve vaccinations and they are forced by their various circumstances to rely on their communities to protect them through herd immunity.

One of the big reasons why medically unnessesary vaccine delays are so harmful isn't just that kids don't get the befefits of vaccines as soon as they are big enough to get them, but also that the practice disrupts the carefully designed system for using earlier vaccines to predict reactions to later ones.
posted by Blasdelb at 2:04 AM on September 12 [9 favorites]


As an aside on the flu jab, for anyone in the UK: as someone who is a bit twitchy around needles, and has in the past keeled over when a blood sample was taken, I had my NHS flu jab this morning and was pleasantly surprised by the tininess of the needle. Barely hurt at all, over in a jiffy, and no residual pain. :)
posted by Morfil Ffyrnig at 2:31 AM on September 12 [2 favorites]


Why did the antivax movement arise in the last twenty years instead of the 1960s?

I'm totally not joking, I think the internet and fragmentation of mass media has played a huge role in this.
posted by smoke at 5:00 AM on September 12 [11 favorites]


I am so mad about this. So mad.

. . . in part because I started to fall prey to vaccine skepticism myself, in my daughter's infancy, and so I see how it works and have realized what the probable-motivations are for those who seed vaccine skepticism in new parents. You see, in part because of significant medical anxiety and trauma around my body/gender, we had a home birth. At the time, it very much felt like the right choice for us, and I liked our midwives as people (some of the only gender affirming health practitioners I've ever encountered), and we had good outcomes, though it's not a decision I ever want to have to make again, in part because of what happened after. They were really, really good at promoting breastfeeding, and I was successful at it--so successful that my kiddo never took a bottle and I had a massive oversupply, meaning I was physically tied to her and in physical pain when I was not with her. Which led to me quitting my job in the first few weeks after her birth. Because of social isolation, I started going to breastfeeding circles at my midwives and found myself plunged into the heavy attachment parenting crowd, none of whom worked, all of whom who were exclusively breastfeeding. Many had a bunch of kids very closely spaced, were tandem nursing, and this was promoted as ideal, nurturing, and natural--to have one child or children who were born more than two years apart was tacitly seen as cruel to your child. Almost all of these parents were co-sleeping ("the family bed"), babywearing, extended nursing, never feeding processed or convenience foods (and so spending a lot of time cooking), taking their children everywhere which to a certain extent isolates you away from adult society. Pseudoscience was also casually laced into the culture. Amber necklaces. Paranoia about fluoride. That sort of thing.

All of the families there used the same pediatrician, who was recommended by our midwives because his practice promoted breastfeeding and was not judgmental about bedsharing. Because my child was born at home, the only injection she received at birth was a vitamin K shot. We went in when my daughter was two months old for her first vaccine visit.

I was nervous, because my husband has food allergies and I had (many) febrile seizures as a baby. And when you have an infant, and are socially isolated, surrounded by people who talk about doing things in a Right and Natural way, you're vulnerable. It's very easy for your anxieties to be amplified. I wanted to vaccinate my daughter. I believed in vaccination. But I was scared. The pediatrician asked why, seemed to listen to my responses. Wrote the name of the Sears vaccine book on a napkin. "I never tell people what to do," he said. "I want you to do your research and make your own decisions."

I went home, read it, talked to the other parents in my social group and realized that just about everyone was doing a modified Sears schedule. It seemed like a reasonable middle ground. I thought my fears were somewhat rationally founded--the doctor didn't dismiss me, after all. We started going once a month to give my daughter two vaccines at a time.

. . . it sucked. Bad. She got sick--not from the vaccines, but from being in a doctor's office, like colds and stomach bugs--every single time we went in. Then, at 21 months, she had a febrile seizure from a high fever from hand, foot and mouth. We took her to the ER, where we were treated with suspicion when we told the doctor she was on the Sears schedule. Shortly after, there was a measles outbreak in our county. I realized that she was in far more danger from measles and the high fevers that might result than the vaccinations themselves. We had her vaccinated immediately, and switched to a standard schedule. When I brought her in for her MMR, the doctor said something weird about "watching her to make sure she doesn't stop speaking." I realized that he actually still believed vaccines caused autism--or at least wanted me to believe that. And I had never believed that. Around the same time, I began to notice weird language in their newsletters about how "unfair" the department of health had been about vaccine requirements.

A few months later, I was talking to a friend about all this, and she laughed. She'd been raised by Jehovah's Witnesses and was surrounded by people who were skeptical about vaccines. And she said that the pediatrician we went to was a Jehovah's Witness and was antivaxxx, as many in her community as a child were. I felt really angry! I'd had no idea that he had some kind of religious motivation for all of this.

Slowly, pieces began to fall into place. I started to see how so much about the culture I'd fallen into was covertly religiously motivated. That the Searses are Evangelical Christians who think it's best if childbearing people stay home. That many of the "gentle" mommy bloggers my friends shared were Mormon. I began to see how the advice I'd taken--told, in gentle and non-threatening ways, that I would be the best parent to my child if I'd followed it--has the side effect of making female-identified parents stay home, often with many children. I saw the way that non-childbearing parents are sometimes cut off from nurturing, the gendered dynamic of it (which had always felt unnatural to me, as a gender non-conforming person), because they're supposed to be home earning money. While the moms nurse through co-sleeping induced exhaustion and cook and clean and plan activities for their children, never using daycare or formula. I began to see how I almost lost myself, my gender identity, my career in all of this. I began to finally pull myself out of it, and watched many friends I'd met through our midwives (who are amazing people, really, and I'm very glad I met them) do the same. We weaned. Finished vaccinating our kids. Put them into daycare. Returned to our jobs. Over time, only a minority of the parents continued to lean into this sort of obligatory mothering, but a few did--mostly those who had given in to the edict that they had to have "two under two" or even "three under three."

Maybe I sound like a conspiracy theorist, but I started to realize that this is what it was all about: obligatory mothering, guilt, telling people with breasts and uteruses that there is only one way to be a good parent. And all with religious or political motivations behind it. Get smart, educated women out of the workforce. Make them choose to stay home. But until this latest outbreak, I sometimes struggled to see how the vaccine component fit into that.

And then New York state got rid of religious exemptions for schooling--all private and public schools. And suddenly, the minority of friends who had still leaned into attachment parenting principles were not only choosing alternative educational models. They were pulling their children out of school completely. Quitting jobs to homeschool. And all saying approximately the same thing in their social media profiles and in emails and at book club. They rarely say outright that vaccines cause autism, though there's a steady undercurrent of suspicion. They talk, instead, about vaccines being "harsh." About catch-up schedules being "inhumane and untested." They talk about the government wanting to control children's bodies and women's choices, or they posit that the focus on Orthodox Jewish communities must be religiously motivated. "Anti-semitic," they cry, even though none of them are Jewish and none of them care about the rise of actual antisemitism (as a Jew, personally, I'm glad the government is acting to protect Jewish children from serious illness!) They make comparisons between mandatory school vaccines and pro-life stances. "Our bodies, our choice!" they cry. It's very clear that they're all trading information and getting it from the same sources--the same pediatrician we went to, for one, who has told them all that it's literally impossible to vaccinate children on according to the catch up schedule because he implies that you can only give your children one shot at a time and so "we would need to get nineteen injection visits in six weeks." It's all factually untrue, but they don't care, or don't see it.

And now they're all scrambling to learn how to teach their children, who will never go to school, or to camp, or to enrichment programs, who will, at best, be in homeschooling coops surrounded by other unvaccinated children with no government oversight. What's going to happen when one of those kids gets sick? They all say that measles isn't deadly, and so it doesn't matter. They laugh at what they perceive to be exaggerated health risks. "The Waldorf school has lost 40% of its enrollment!" they cry. "The government is cruel to not care about that, but we HAD to home school. We had no choice!" Someone in my social circle--an adult who was raised in a similarly crunchy, hippie family and who wasn't vaccinated--was hospitalized with bacterial meningitis a few months ago. Measles might not kill you, but meningitis very well could. I was so relieved my daughter was vaccinated, and even more relieved that she won't be in school with un and undervaccinated children. Meanwhile, one of my now-homeschooling friends talked about giving her children preventative colloidal silver and garlic oil and "watching her kids for symptoms." Of fucking meningitis. It's terrifying.

I'm so glad that I made it out to the other side. Sending my child to school, returning to my career, weaning--those have all been godsends for me. I feel like myself again. I feel whole. It scares me that I might have lost myself because of bad advice from religious extremists. It scares me even more to see people lean into that advice, though I understand what's at work there. They all think this will make them good parents. They've been tricked.
posted by PhoBWanKenobi at 9:00 AM on September 12 [46 favorites]


Measles most certainly does kill people. There is a 0.2% risk of death from the primary progression of the disease. And after that, about 1 in 600 babies who get measles and 1 in 10000 adults who get measles will get post-measles encephalitis, for which there is no known cure. It’s just fatal. You have measles and then you get better and then one day up to ten years later your nerves stop working and you die. It’s what killed Roald Dahl’s daughter.

Measles is fucking terrifying.
posted by bq at 11:45 AM on September 12 [4 favorites]


Measles most certainly does kill people.

Yes. Of course it does. And yet here's an email a friend sent me: "In this recent outbreak of measles, not one child has died or been irrevocably injured. According to one recent study, alchohol lead to 2.8 million deaths in 2016. The statistics for deaths from guns and cars are likewise staggering. The suicide rate is rising, steeply. No meaningful laws shall be made about these things. The things we worship in America. The entrenched powers. . . . I don’t have religious objections. I have reason-based objections. I don’t view the current measles outbreak as a health emergency. My understanding is that measles is not the threat, even if/once contracted, it once was. Even if I decided vaccinating my children for it was the best choice for the greater good and my children, I would like the option NOT to use the MMR vaccine, which Japan has recently stopped using, but one devoted only to measles. "

Here's another comment from a local message board:

"I survived measles. So did every single legislator who voted to mandate unsafety-tested injections on all of our kids. How ludicrous. Measles is infectious, contagious like the cold but is very very rarely serious. "

It's terrifying because people in positions of authority to these people have co-opted scientific language to con them into following their agenda for other reasons. And people very often can't tell the difference, and so are convinced that, like, measles is totally nbd.
posted by PhoBWanKenobi at 12:04 PM on September 12 [2 favorites]


COLLOIDAL SILVER? Jesus christ, those poor kids. I hope they don't turn blue. I still can't believe it's legal to sell this nonsense.
posted by bowtiesarecool at 2:03 PM on September 12 [4 favorites]


I still can't believe it's legal to sell this nonsense.

Colloidal silver has some antibacterial effects in topical use, so it's legal to sell for that. It's not harmful to ingest in small amounts (toxicity builds up over time, but that's true of many things that are legal to sell to eat), so it's legal to sell as a "supplement" with no specific medical benefit claims.

...and then there's sites like this one, that imply the topical benefits connect with ingestion benefits, very carefully not mentioning that things like "Some women take colloidal silver during pregnancy to aid the baby’s growth and health" are not based on any kind of medical science.

With propaganda like that popping up when people look for medical info about "what's best for my child," is it any wonder they're dubious about vaccines?
posted by ErisLordFreedom at 5:59 PM on September 12 [1 favorite]




Besides the direct deaths and encephalitis measles also suppresses the immune system for years. There are significant risks from secondary infections up to three years later because measles virus impaired the “memory immunity,” which means the body was less able to fend off infections that it should have had antibodies for.
"I survived measles. So did every single legislator who voted to mandate unsafety-tested injections on all of our kids. How ludicrous. Measles is infectious, contagious like the cold but is very very rarely serious. "
FFS, the kids who died from measles aren't legislating anything nor posting inane antivax bullshit on the internet. Lack of awareness of survivor-ship bias is my top rage inducing logical fallacy.
posted by Mitheral at 8:46 PM on September 12 [9 favorites]


The UK's Jewish Chronicle published this last week. I don't know whether the Vox article is out of date or if we're comparing apples with oranges:
Measles outbreak affecting Strictly Orthodox areas is over, New York health official says
posted by Joe in Australia at 12:19 AM on September 13


From the Vox article:

More than 75 percent of this year’s 1,200-plus cases can be traced to New York, where patients with measles are still popping up in Rockland and Wyoming counties. Even though a related outbreak in New York City is officially over and the number of cases reported in the state has dwindled in the last several weeks, “a few of them are actually recent cases,” the spokesperson said. And right now, state health officials are still struggling to control the outbreak.

Emphasis mine. So it does look like they're addressing two different things, sort of: JC's statement isn't looking at the whole state.
posted by Dysk at 6:35 AM on September 13 [1 favorite]


The big outbreak originated in the ultra-Orthodox Jewish in Brooklyn but the crazy people out here on Long Island who are protesting or those storming the state Regents board aren't from that community. I've read that after the measles outbreak, the rabbis got together, issued a you-will-get-vaccinated, and that was the end of that.


A lot of people were skating by the vaccination requirements, claiming religious/philosophical objections, until the state legislature, because of the Brooklyn outbreak, very firmly put a virtually immediate halt to the exemption. And tightened limits on medical exemptions too, requiring the doctors to spell out exactly the patients' condition. Because of the various excuses, doctors say, New York State had fallen below the percentage of vaccinations required to maintain herd immunity.

The anti-vaxxers out here are middle-class people in their 30s and 40s who will not hesitate to lie about their reasons for avoiding vaccines, including claiming that kids have to get 72 shots before they start school. When the legislature eliminated the religious exemption this summer, people went bonkers. It's not over yet because while kids were allowed to start school missing a few vaccines, time is running out for them.

A few weeks ago, I was witness to a townhall-type meeting where a state legislator was accused of all kinds of sins for having voted for the ban. When a woman in the crowd stood up to identify as having autism that she said had nothing to do with the vaccines, other people in the crowd literally screamed at her to shut up and sit down.

I interviewed a few doctors (I run a local news website) about the resistance to vaccines and they say it is generational--those of us old enough to remember our parents freaking out about polio and growing up catching the measles or chickenpox cannot comprehend parents who won't take advantage of vaccines. Or go so far as to remove their children from public schools and then blame the state for it, or threaten to move out of state.

I also spoke to a doctor who said he felt his profession had failed to educate people and overcome the bizarre resistance to expertise that we're witnessing.

The suspicion that people in authority or expertise are lying is everywhere, manifesting itself in the vaccine fight. I was at a meeting recently where the topic of 5G tech and its safety was being fought. The anti-5G people in this case overlap a lot with the anti-vaxxers, and they start out at meetings by crying and shouting. I have absolutely no idea if they're right about 5G's threat but their tactics and the overlap with the anti-vaxxers makes me dubious. At yet another meeting last night, involving the installation of turf fields, a woman referred to what she called the poison in the chemicals used on turf and then drew a straight line to vaccines as another example of the harm we're doing to our children.
posted by etaoin at 4:38 PM on September 13 [2 favorites]


"The medical industry literally teaches that black people over-report pain; it's not surprising that some black parents are nervous about subjecting their kids to a procedure that "only hurts a little."

I thought that polling had shown that that's not where the resistance to vaccination lies, demographically. Black American mistrust of the medical establishment manifests itself elsewhere.
posted by Selena777 at 5:09 PM on September 13 [1 favorite]


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