
The Washington State Measles Outbreak - WisNorCan
https://www.washingtonpost.com/national/health-science/it-will-take-off-like-a-wildfire-the-unique-dangers-of-the-washington-state-measles-outbreak/2019/02/06/cfd5088a-28fa-11e9-b011-d8500644dc98_story.html
======
b_tterc_p
Quote from a mom on the fence in the article

“On one side, they make you afraid, and the other side they make you feel
stupid, and you get stuck in this middle where you feel beat up by both
sides,” she said.

Not trying to be condescending but this frustrates me even more than anti
vaxers who have an identity in supporting their idiotic parade.

This woman is sincerely trying to figure out what is best for her child and
she couldn’t do it until she had a 2 hour one on one conversation with her
doctor. She has no agenda. And she can’t figure it out with honest effort even
with the internet. Our society lacks clear trusted authorities on important
basic issues. And our citizens lack critical reasoning skills. Why is she so
bad at this? serious question. How is our general population so poorly
equipped?

I’m glad she did go have that 2 hour conversation, but that feels like the
kind of solution we can’t reasonably provide to all people. It shouldn’t
require that.

~~~
walrus01
My theory? The virulent strain of anti-intellectualism / anti-elitism that has
run through American society in the last 20 years. "These fancy educated
people in their ivory towers telling me what to do with my children...".

There's a point at which you should simply defer to the critical mass of
thousands of people with doctorates in the subject matter, such as about 99.9%
of epidemiologists on the planet.

~~~
FooHentai
But it begs the question. What's underpinning that as the root cause for what
we're now seeing?

My money's mainly on the loss of prestige surrounding the teaching profession,
and loss of the elite status of high education. It's simply not valued as it
once was, and as a result everyone's 'highly' educated while simultaneously
quite poorly educated, at least outside of stuff that is scored on tests. As
the parent post says, 'Critical' reasoning/thinking skills are demonstrably
lacking.

Reading back what I just wrote, I'm certainly entering 'old man yells at
cloud' years of my life it seems :)

~~~
torpfactory
I think the reason is the vast change in communication technologies (i.e. the
internet) in the last 20 years. People used to mostly be exposed to only the
pro-vax side which was available from their doctor, in person. There simply
wasn't an efficient avenue for anti-vax sentiment to spread. Now any yahoo
with a Facebook account can post their zany ideas. In fact, these technologies
are almost tailored to spread the zaniest ideas. People are exposed to these
ideas often in social media, making them believe they are also common. This
breaks down the barrier which might have previously prevented people from
believing in fringe ideas: they are now exposed to them frequently.

As for the 'average citizen', I don't think the general public has EVER really
had critical thinking or reasoning skills. I would bet only 5-10% of the
population has the scientific literacy skills to really make sense of the
statistics and scientific reasoning which so strongly supports vaccination.
Without the ability to make sense for themselves, many are left with appeals
to emotion or authority for guidance. As authority loses ground in a sea of
new voices on social media, only emotion and fear (much of it unfounded)
remains.

------
giarc
Not to downplay measles, but wait until mumps start spreading. The 10% male
infertility rate and enlarged scrotums might change some parents minds.

~~~
koheripbal
My wife and I were watching Boardwalk Empire, when in one scene one of the
children contracted polio and became permanently paralyzed. My wife was in
tears and turned to me to ask how we can make sure the kids don't get it.
"Luckily, the kids are vaccinated against that. It's one of the very first
shots they get."

Little things like that educate parents. Most of these traumas have
disappeared from movies and TVs because we've most eliminated them.

------
entee
It's a simple fact that vaccines are safe and perhaps the best medical tool we
have along with antibiotics to prevent mass death. Only 0.0001% of vaccination
doses result in significant complications (roughly 3,800 compensated injuries
out of 3.4B doses over ~30y, something like 5,600 total filed injuries [1]).
It's also true that they work in part through herd immunity, the concept that
if most people are vaccinated, diseases can't spread to those who aren't or
can't be.

Still, enough people find this controversial, resorting to conspiracy-minded
thinking. It's another example of how science doesn't seem to sink through,
and repeating facts doesn't seem to help. Maybe figuring out how to
communicate more empathetically through people's perceived values can help
[2]. But honestly I'm at a loss, and it's deeply tragic to see so much
needless suffering.

[1] [https://www.hrsa.gov/vaccine-
compensation/data/index.html](https://www.hrsa.gov/vaccine-
compensation/data/index.html)

[2] [https://slate.com/technology/2019/02/antivax-measles-
outbrea...](https://slate.com/technology/2019/02/antivax-measles-outbreak-
moral-foundations-theory.html)

~~~
fossuser
I think the only reason the conspiracy can exist is because of the
effectiveness of vaccines - we don't routinely see or know people with the
disease anymore.

I read that in poorer countries where vaccines are hard to get and the disease
is still common people will travel far distances to get to clinics in order to
vaccinate their children.

~~~
henrikschroder
This was the case for our grandparents generation as well. When they grew up,
kids commonly died of childhood diseases, so when they had kids and vaccines
became available, they fucking rushed to have their kids vaccinated, because
they had seen the bad effects of the diseases.

I was born in the 1970's, and noone from my generation or younger in the west
has really seen the bad effects, noone we knew died of measles or got
paralyzed by polio, so we have no fear of the diseases.

And that's why the fears of the anti-vax movement are so strong, there's no
counter-balance to them. Everything is a risk, having a vaccine is risky, but
if people value the risk of the diseases as 0, of course some people are going
to object to the vaccines, because they think it's the bigger risk.

~~~
jostmey
> "having a vaccine is risky"

That risk is for all practical purposes, zero

~~~
henrikschroder
Yes, but it's not actually zero, even if you remove all the false vaccine
side-effects like autism and mercury poisoning. And that's where the
irrational fear of vaccines attach itself.

But the actual non-zero risk of death or other horrible side-effects from the
diseases, they have nowhere to attach to. We don't get regular stories in the
media of kids dying of measles, because we almost eradicated it.

So given this, some parents weigh one risk incorrectly way higher than 0, and
the other risk incorrectly at 0, and then they make the _rational_ decision
not to vaccinate their kid.

And I think it's important to understand that anti-vax parents actually don't
make irrational choices, they make rational choices, but they're made on the
grounds of an incorrect and horribly wrong risk analysis.

Hopefully, news stories like this increase the general awareness that measles
is a terrible disease, which then can change the risk analysis that people are
doing. It just sucks that a bunch of kids have to suffer needlessly because of
stupid fearmongering.

------
agumonkey
got me to learn about the oldest known record of measles symptoms
[https://en.wikipedia.org/wiki/Muhammad_ibn_Zakariya_al-
Razi](https://en.wikipedia.org/wiki/Muhammad_ibn_Zakariya_al-Razi)

------
hprotagonist
Measles is especially pernicious, too.

Not only is having measles deeply unpleasant at best and fatal at worst,
surviving it leaves you more susceptible to other knock-on diseases for
something like two or three years. Widespread measles vaccinations cratered
the measles death rate, obviously, but it _also_ cratered the deaths from
pneumonia and the like.

Per [0][1][2], the epidemiological data is suggestive of this -- but
sequencing the virus and poking around at its RNA is starting to figure out
exactly how sneaky of a thing the virus is.

[0][https://www.npr.org/sections/goatsandsoda/2015/05/07/4049634...](https://www.npr.org/sections/goatsandsoda/2015/05/07/404963436/scientists-
crack-a-50-year-old-mystery-about-the-measles-vaccine#.WO0uRq8Zu-0.facebook)

[1][http://science.sciencemag.org/content/348/6235/694.abstract](http://science.sciencemag.org/content/348/6235/694.abstract)

[2][https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997572/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997572/)

~~~
jaggederest
Yes, this is something I was unaware of. Essentially, after getting the
measles, you end up needing to be revaccinated for just about everything.
Nobody had ever mentioned that.

------
jedi3335
I was in the Seattle Childrens ER this morning (unrelated issue with my son,
hes fine) and chatted with a pediatrician about the outbreak. He said the ER
has been inundated with parents bringing (unvaccinated) kids with related
symptoms to rule out measles, and STILL refusing to vaccinate at that point.
At a certain point public health needs to take priority. Vaccines need to be
treated like any other basic norm around health/hygiene that we have societal
and legal expectations around.

------
peterwwillis
At some point you should not be able to opt-out of preventing an epidemic.
When will we stop coddling the stupid?

------
PhantomGremlin
This has been all over the local Portland news for weeks.

Here are a few more details (but from memory so I could be slightly off):

About 50 kids in Clark County have come down with measles so far.

49 of kids with measles were unvaccinated.

1 kid with measles received one dose of the vaccine. SOP is for two doses.

No kid that received both doses has contracted measles.

I haven't seen any reports of adults contracting measles.

One vaccine dose is about 93% effective, 2 doses are about 97% effective.

In Washington State (not sure if state as a whole or just Clark County) about
22% of kids aren't vaccinated.

In Oregon about 11% of kids aren't vaccinated.

\---

When I was a kid smallpox vaccine was very common and polio vaccine was coming
into use. People took vaccination very seriously. Read some history of those
two diseases and you will quickly understand why.

In various settings (e.g. family doctor, various school nurses, etc) I
probably received 2 doses of injected polio vaccine and 5 doses of oral
vaccine. At least that I can remember. The number was probably higher. That's
how serious the effort was to prevent polio. One high school teacher (polio
victim) needed some metal contraption around his leg to help him walk. I.e.
there were visible reminders of how serious polio was.

Smallpox vaccine was easier to keep track of. It left a slight scar on many
peoples upper arm. So if you had the scar, it meant you had the vaccine!

------
jedberg
When my daughter was born four years ago, the anti-vaccine movement in SF and
the north bay was in full swing. Despite living only 40 miles south, she
didn’t go to SF for the first time until after she was one.

She went to Budapest at 7 months old. I felt more comfortable taking her to
Eastern Europe than San Francisco.

------
CaliforniaKarl
As I was reading, I started thinking, “What if all insurance plans budgeted 45
minutes for a Primary Care Provider visit instead of 15?”

(To be clear, I don’t know if ‘15 minutes’ is hard-codes anywhere, I just know
that most appointments I’ve gone to are budgeted that much time.)

I say this, because of the multiple mentions of doctors spending multiple
hours talking with patients.

If there was more time budgeted for PCP visits, then there would be time to
have these conversations, and maybe address issues (real or perceived) before
bad things happen.

~~~
lotsofpulp
It's not a good use of a doctor's time to educate the public about how
vaccines work. That is high school biology stuff. And if you didn't learn it
in high school, visit the CDC website or watch a Khan Academy video or just
try getting your information from somewhere outside an uneducated person's
Facebook page.

~~~
thomasmeeks
That's true. But what about the people that never do take the time to educate
themselves on their own? Could it be worth the extra expense to society to
have a (presumably) trusted individual take a bit of time to explain some
basic concepts about health?

I don't know the answer, but I do think it is an interesting question.

~~~
roywiggins
The problem are the people who do educate themselves and after reading the CDC
decide to try and get a "balanced view" and fall down an Internet hole into
the antivaxx Upside Down. If they hadn't educated themselves and just done
what their pediatrician recommended it wouldn't be a problem.

~~~
masonic

      decide to try and get a "balanced view"
    

I think this is myth. Nobody weighs opinions in search of a "balanced view" in
other realms of medicine: "treat cancer, yes or no?" "Smoking bad, yes or no?"
"Meth bad, yes or no?" "Splint and cast broken bone, yes or no?"

------
im_down_w_otp
We currently have a 3-year old who's vaccinated and a 5-month old who isn't
because she can't be yet.

We also live near the epicenter of this outbreak, and it's enormously
irritating how grossly irresponsible both lawmakers and people in the
community have been around this issue.

Some of the kids at our eldest's preschool weren't vaccinated, which by proxy
put all the families who also have much younger children at much, much higher
risk. Thankfully a responsible amount if peer pressure was able to cajole
those families to get their kids vaccinated finally.

But, the waves of anti-science BS that we're all wading through are growing in
frequency and amplitude, and it's not clear how to ebb it.

~~~
vegannet
I’ve heard that a 5 month old child can be vaccinated (it’s just not standard
practice) so in a situation where there are serious concerns about infection
you are not without options.

~~~
thomasmeeks
This is true with regards to measles. It is also true that babies tend to have
some level of immunity for the first year (assuming their mother is), which is
why the vaccine isn't given until the 12 month mark.

[https://www.nhs.uk/common-health-questions/childrens-
health/...](https://www.nhs.uk/common-health-questions/childrens-health/how-
long-do-babies-carry-their-mothers-immunity/)

~~~
masonic

      (assuming their mother is)
    

Is that conveyed en utero or through the mother's milk? If the latter, that
would depend on being breastfed, wouldn't it?

------
mirkules
> “It shouldn’t be called an outbreak,” Seattle-area mother Bernadette Pajer,
> a co-founder of the state’s main anti-vaccine group, Informed Choice
> Washington, said of the measles cases, arguing that the illness has spread
> only within a small, self-contained group. “I would refer to it as an in-
> break, within a community.”

This person has a serious lack of understanding about how outbreaks and
epidemics work. All it takes is one plane ride, one cough at a public place,
and you can infect dozens of people. Even if you infect just two people, this
can grow _exponentially_ over a few days, especially given that you are highly
contagious four days before symptoms and four days after.

> I would refer to it as an in-break, within a community.

In-break with an _unvaccinated_ community.

------
hyeonwho4
Seems like a problem that can be totally cured by insurance agencies raising
premiums on unvaccinated children.

~~~
masonic
The ACA (Obamacare) made that illegal in 2010.

------
chronotis
I was living in Orange County (CA) when my son was born. It would have been
_very_ easy to find a midwife and a pediatrician that were totally fine and
all-in on "alternative vaccination schedules." I can't speak for all other
metros where this has played out, but I suspect the same is true in many
places. Lack of knowledge (or holding on to provably false beliefs) isn't
something that physicians are immune to.

~~~
lotsofpulp
I would say those physicians are selling out. I don’t see how one can make it
through med school and ignore the mountains of evidence for vaccination.

------
todipa
I don't know much about this outbreak but in some parts of the world you are
required to have your vaccinations up to date if you want access to public
services.

Can't that be implemented at a state/local level?

~~~
seattle_spring
I think it's really weird and sad that this comment and another pro-vaccine
comment were downvoted to almost dead within minutes of being posted.

~~~
GijsjanB
I did not downvote and will not, because the post is phrased as a question.
But, I do oppose compulsory vaccination because it harms bodily integrity.

~~~
o10449366
By that criterion, you should support vaccination because as scientific
research has shown over and over again, individuals who serve as vectors of
disease end up harming the bodily integrities of their communities.

------
mcdoh
> In fact, health officials say the virus is so contagious that if an
> unvaccinated person walks through a room two hours after someone with
> measles has left, there’s a 90 percent chance that an unvaccinated person
> will get the disease. People can spread measles for four days before the
> rash appears and for four days after.

Yikes!

~~~
Fomite
Seriously. I'm an infectious disease epidemiologist, and measles is
_amazingly_ transmissible.

~~~
Johnny555
As an infectious disease epidemiologist, could you elaborate on that? What is
it that makes it so contagious?

~~~
Fomite
A couple reasons:

\- While it enters via the lungs, the virus emerges in the trachea, which
positions it really well to be aerosolized through coughing. This aerosol and
droplet transmission is _really_ efficient.

\- Measles is relatively stable in the environment, so lingers for a fair
amount of time.

\- It also appears to have a relatively small infectious dose.

Other highly contagious diseases, like norovirus, share fairly similar
properties - you make a lot of virus, it hangs out for awhile, and you don't
need to come in contact with much of it.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997572/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997572/)

------
walrus01
Fuck, if only a bunch of clueless helicopter parents hadn't decided that Jenny
McCarthy was an authority on vaccine safety, and had listened to the advice of
every immunologist and epidemiologist on the planet.

You want to see the result of not vaccinating your children, en masse? Go
visit a poor part of Pakistan, where you'll see people still afflicted by
polio.

------
jancsika
Is there anyone here on HN who reads a story like this and wonders to
themselves, even if for a brief moment,

"Hm, the software system I get paid to develop just _might_ be making a
situation like this worse..."

Genuinely curious.

------
randomacct3847
Having grown up in the Seattle area (now in SF since after college) I can’t
say I’m surprised the Pacific NW is where anti-vaccination parents would
cluster to create an epidemic. There’s the right mix of pseudo-intellects,
granola hippies, and helicopter parenting to make it all so unsurprising

~~~
bitcoinmoney
What’s granola hippies?

~~~
jfoutz
Pejorative.

In context I’d say they would take magic mushrooms, because they are natural.
But they would avoid lsd, because that’s chemicals.

Sorry for the definition by example, can’t think of an obvious definition, but
hopefully gets the idea across.

------
ericdykstra
Maybe it's because it's taboo to say so, but I haven't even seen it speculated
that the rise of these diseases be partly, or even mainly attributed to
illegal immigration.

How many anti-vaxxers are there compared to those illegally crossing the
border? There's a battery of vaccine requirements for any immigrant[1], but if
tens of millions of those living in America skipped that part, it seems like a
huge potential source of the problem.

1\. [https://www.uscis.gov/news/questions-and-
answers/vaccination...](https://www.uscis.gov/news/questions-and-
answers/vaccination-requirements)

~~~
bleriot
Looks like you got downvoted by the usual anti-science politically-correct
contingent here on HN, but you’re right to investigate that possibility.
Here’s an analysis of the last major outbreak in the early 90s that shows how
huge a factor unvaccinated undocumented Hispanics were :
[https://www.cdc.gov/mmwr/preview/mmwrhtml/00001675.htm](https://www.cdc.gov/mmwr/preview/mmwrhtml/00001675.htm)

~~~
wrsh07
It's a bit ridiculous to call people who downvoted an incorrect and
unjustified statement "anti science"

If the original post had contained the link yours does, that would be one
thing entirely. Instead, neither post invites discussion (tip: insulting
people is a bad way to start a conversation)

