The Eagle Mountain International Church in Newark, Texas, promoted National Immunization Awareness Month through tragic irony. Twenty-one children and adults connected to the church contracted measles, a highly contagious, incurable viral infection of the respiratory system that causes death in one to two of 1,000 cases. Ninety percent of people who are not immune or not vaccinated will become infected if exposed. None of the 11 children were vaccinated, and the majority of adults had only one of two shots recommended by the Centers for Disease Control and Prevention (CDC).
An unconscionable twist of faith contributed to the health tragedy: Church leaders had been advising congregants against vaccination because of a scientifically unfounded belief that vaccinations could cause autism. Unfortunately, the church leaders' views are endorsed by an anti-vaccination public figure who speaks frequently against immunization and claims to have "cured" her son of questionable autism. While we cannot turn back the hands of time on unvaccinated lives affected by measles outbreaks, all members of society must urgently come together to stop the irresponsible voices that mock medical breakthroughs and place the public at risk of illness, disability and death.
The U.S. eliminated indigenous sources of measles in 2000. In its first 20 years the vaccine prevented 52 million cases, 5,200 deaths, and 17,400 cases of retardation. The 159 cases reported this year are more than double what they were in 2012 and are on track to pass the 15-year high of 222 in 2011. 2013 is the 50th anniversary of the vaccine's availability in the U.S. The nation should be celebrating the disease's eradication, not its reintroduction.
Five years before the vaccine first became available, I contracted measles along with thousands of other children. I was fortunate. I recovered after suffering from severe fever, rash, cough, coryza and conjunctivitis. Hundreds of other children perished. As an infectious disease physician, I cannot bear the thought of the country returning to those horrific times of despair. In this day and age it is shameful that measles is a leading cause of vaccine-preventable childhood mortality.
The church crisis also highlights a serious threat to the nation's health security: importing measles into the U.S. The cases link to a man who was exposed to the virus in Asia, brought it back to the church and infected unvaccinated congregants, staff and children in their daycare center. This most recent outbreak highlighted an alarming trend among 2011 cases in the U.S.: Ninety percent were associated with other countries, including U.S. residents returning from abroad and foreign visitors to the U.S. Most infected persons (86 percent) were unvaccinated or had unknown vaccination status. The CDC warns that "increased numbers of outbreaks and measles importations into the U.S. underscore ongoing risk for measles among unvaccinated persons and the importance of vaccination against measles."
The Texas cases, this year's third major measles outbreak in the U.S., demonstrate how critical it is to avoid health complacency. Together we must diligently protect the nation's public health achievements. We must prevent the acts of a few from defeating hard-won health victories. We must commit to forever honoring the thousands of professional and voluntary medical and public health organizations and individuals who came together to find a measles vaccine and spent decades implementing a profoundly successful nationwide immunization program.
We must learn from the lessons of the measles vaccine experience, and we must extend those lessons to all vaccines. The CDC's Aug. 30 "Morbidity and Mortality Weekly Report" found troubling gaps and varied rates among states in vaccination coverage for adolescents and teens. Only 36 states have achieved Healthy People 2020 targets for Tdap, 12 for meningococcal meningitis and nine for chickenpox. No state met the national target for human papillomavirus vaccination coverage among girls. Clinicians, public health agencies, parents, educators and other stakeholders are missing substantial opportunities to assure that all children are fully vaccinated.
Now is the time -- and recent outbreaks demonstrate how quickly it can become too late -- for all members of society to join forces and voices in leveraging vaccines to help provide health safety to everyone who lives in the U.S. Adults who opt out of vaccination, either for themselves or their children, betray all we stand for as a socially responsible, united nation. Denying children life-saving vaccinations violates the most fundamental principles of morality, disregards the core tenets of human decency and breaks the contract of ethical responsibility between generations. Everyone has the chance to do the right thing.