Disclaimer: This is a personal opinion piece. I am not a doctor. This article is not intended to be medical advice.
PLEASE NOTE: The statistics and risks in this post were updated on April 16, 2014 to more accurately reflect the risks of the MMR vaccine when taking the CDC-prescribed two dose course. If you only receive one dose of the vaccine, your risks are less. If you require a booster beyond your first two doses, your risks of complication will be higher. I also updated the rate of infection of wild measles to reflect data available in 2014, which was not available when the post was first written in September 2013.
This morning, CNN ran a news story: U.S. measles cases in 2013 may be most in 17 years. Even though the outbreak was sparked by someone from Indonesia bringing measles to Texas, CNN's conclusion is still this: Unvaccinated children are bringing measles back from extinction and are a threat to us all. Smart parents get their kids vaccinated.
Now, before we get started, let me make something clear: I believe it is a parents fundamental right to make their own health choices for their kids. Which also means if you think it is best to vaccinate your child for measles, I still want to be your friend. In fact, I'm mostly sure my best friend is going to vaccinate her child for measles. I am not here to judge you. Truly.
I want to make clear that I do not have a medical background. I am a mom. And I'm not just a mom. I'm a skeptical mom. My husband and I both have strong research backgrounds. If you're going to start making assertions about something that goes beyond opinion, you better be able to back it up if you want us on your side. I'm also the granddaughter of two highly regarded scientists (they were chemists and rocket scientists. literally). Science and medical facts get extra scrutiny. All that to say: "fluffy" science does not fly here. None of the information below is from a pseudo science or conspiracy theory website.
Measles by the Numbers
I am only going to talk about measles in the United States. I live in the United States and this article is about why my family is choosing not to vaccinate for measles. These are the numbers I will base my math on for the rest of the article. If you live anywhere other than the USA (except maybe Canada, which I would bet has similar numbers), these numbers will not apply to you.
How many people get measles: According to the CDC, on average less than 100 people get measles in the USA each year(source). In 2013, 189 cases were reported. The worst outbreak in the last 20 years was in 1996 when 500 cases were reported.
Measles complications: About 30% of people who get measles will get pneumonia, an ear infection, or diarrhea. For the most part these things are treatable. Sadly, though, 1 in every 1000 people who gets measles will get encephalitis - which can lead to convulsions, permanent deafness or severe mental disability. Between 1 and 2 children out of every 1000 infected will die. (source)
MMR Vaccination: The MMR vaccination is designed to prevent Measles, Mumps and Rubella. As few as 1 in 6 people will have some kind of reaction to the MMR vaccine. These reactions are usually minor and include things like fever, rash and swollen glands. 1 in 500,000 recipients will experience a severe reaction including deafness, long-term seizures, coma, lowered consciousness or permanent brain damage. I suspect this number may be higher but only 1 in 500,000 were able to be definitively linked to the vaccine. (source)
Wild Measles vs. MMR Vaccine
Of course, what everyone wants to know is: Which is the lower risk option?
Risks of MMR vaccine: We will go with the CDC's conservative estimate that 1 in 1 million doses of the MMR vaccine cause a severe reaction including deafness, long-term seizures, coma, lowered consciousness or permanent brain damage (so if you receive the recommended 2 dose course, your risk is 1 in 500,000). Even though 20% of the people who contract measles have been vaccinated, and therefore assume some of wild measles risks as well, for the sake of simplicity we'll assume the only risk vaccinated children face are from the vaccine itself.
Risks of Wild Measles to my child: Unlike the vaccine which presents a two time risk to the recipient, if you choose not to vaccinate, you put your child at risk every year. Even though the CDC says that 100 people get measles on average every year, let's use 200 as an average number of people infected in order to account for some years with much higher outbreaks as well as the climbing rate of children who are unvaccinated.
During the first 18 years of a child's life, 3600 people in the USA will get measles (18 years x 200 a year). Statistically, 6 of those will have severe complications. The 2010 census determined there are 74,181,467 children in the USA. This makes my unvaccinated child's risk of complication 6 out of 74,181,467 or 1 in 12.4 million.
MMR vaccine vs. Wild measles
1 in 500,000 vs 1 in 12.4 million
So what does that mean for me?
At the end of the day, it seems that the odds are overwhelmingly in favor of letting my kid go without a measles vaccine. Of course, some people might say that makes me a biological terrorist but I can live with that easier than I could live with myself if my kid were the unlucky one in 500,000 to have a severe allergic reaction to the MMR vaccine.
Remember, this is my conclusion about how these stats apply to my family living in Oregon. If I lived in Texas where many of this year's measles cases are popping up and especially if I attended the church that seems to be the epicenter of the Texas outbreak, I might come to a different conclusion. If I lived in Lebanon where the incidence of measles is 587 times higher per capita than the USA(source) I'd certainly reconsider it.
I hope some of this information and how we came to our personal vaccine conclusion informs this debate a bit more.
For further reading, please also see: Eight Questions to Ask Before Vaccinating Your Child
Carissa used to think that people who didn't vaccinate their kids or who ate organic food were elitist hippies. After the birth of her son in 2010, she and her husband used their research backgrounds to learn more about ways in improve and maintain health in children and as a result chose to selectively vaccinate their son, moved to an organic whole foods diet and stopped using plastic in their kitchen. To learn more about some of the changes they made on their journey toward better health, check out her posts on health & beauty.