H T TOPICS IN
Measles: To Vaccinate or Not? Judy A. Beal, DNSc, RN, FNAP, FAAN
F
rom January 1 to March 6, 2015, there have been 173 reported cases of measles from 17 states and Washington, DC (Centers for Disease Control and Prevention [CDC], 2015b). Most of these cases (127 cases [73%]) are part of a large, still evolving outbreak linked to Disneyland in southern California where >26 measles cases were documented with at least 8 of those infected not vaccinated. This is not the fi srt outbreak of measles in recent history. Several months prior, there were 382 cases of measles in Ohio after unvaccinated missionaries returned infected from the Philippines (CDC, 2015b). According to the World Health Organization
So why do some parents refuse to vaccinate their children? The vaccine has clearly demonstrated safety and efficacy (CDC, 2015a), but a 1998 report in the British Medical Journal generated panic and misinformation that immunizations may make children more susceptible to autism. Even though that report was later retracted and labeled fraudulent, fears still linger today among some parents. Another perspective might be helpful in answering the question of why some parents opt not to vaccinate their children. According to Dr. Nathan Litman (2015), professor of pediatric infectious diseases in New York City, “We are victims of our success;
Nurses can promote vaccination by sharing accurate information with parents. (2015), measles is one of the leading causes of death among young children even though a safe and costeffective vaccine is available; in 2013, there were 145,700 measles deaths globally, about 400 deaths per day or 16 deaths every hour; and vaccination significantly reduced deaths worldwide from measles by >75% between 2000 and 2013. The measles vaccine has been widely available in the United States since 1963 and up until recently there have been no known outbreaks. Vaccination rates vary among states and even counties within states. This latest outbreak has resulted in much debate, including among politicians and 2016 presidential hopefuls. California legislators proposed a bill that would mandate all school agers to be vaccinated. Mississippi and West Virginia are the only other states with such statewide policy.
people don’t remember how bad measles was, how frightening it could be... People say, why should I bother (to get my child vaccinated), it’s not around.” What should nurses tell parents? This generation of parents is reliant on the Internet for advice. On-line advice for parents about measles from the CDC (2015a, 2015b) is readily available. The CDC (2015a) fact sheet notes the best way to protect against measles is the measlesmumps-rubella (MMR) shot. The fact sheet includes details of when children should receive the MMR; reasons why children should get the MMR vaccine; rare and very mild, if any, side effects of the MMR; how dangerous contracting measles can be and how it is spread; and is clear there is NO link between the MMR and autism (CDC, 2015a). The Institute of Medicine review of more than 67 studies concluded there was
strong evidence of no significant correlation between the MMR and autism (Maglione et al., 2014). This article, along with CDC (2015a, 2015b) data and new information from the American Academy of Pediatrics (2015), will promote upto-date professional knowledge that can be the foundation of discussions with parents. Measles can be lifethreatening. Some parents are not fully aware of the implications of their children contracting measles. As pediatric nurses, we can help promote accurate parental knowledge and encourage them to vaccinate their children. ✜ Judy A. Beal is a Professor and Dean, School of Nursing and Health Sciences, Simmons College, Boston, MA. Dr. Beal can be reached via e-mail at [email protected] The author declares no conflict of interest. DOI:10.1097/NMC.0000000000000147 References American Academy of Pediatrics. (2015). Early release from Red Book: 2015 Report of the committee on infectious diseases. Elk Grove Village, IL: Author. Centers for Disease Control and Prevention. (2015a). Measles and the vaccine (shot) to prevent it (Fact sheet for parents). Retrieved from www.cdc.gov/vaccines/ vpd-vac/measles/fs-parents.html. Updated February 5, 2015. Centers for Disease Control and Prevention. (2015b). Measles cases and outbreaks. Retrieved from www.cdc.gov/measles/ cases-outbreaks.html Litman, N. (2015). In measles outbreak, we are “victims of our own success.” CBS News (February 5, 2015, 6AM). Retrieved from www.cbsnews.com/news/ measles-outbreak-vaccine-we-arevictims-of -our-own-success/. Accessed February 10, 2015. Maglione, M. A., Das, L., Raaen, L., Smith, A., Chari, R., Newberry, S., ..., Gidengil, C. (2014). Safety of vaccines used for routine immunization of U.S. children: A systematic review. Pediatrics, 134(2), 325–337. doi:10.1542/peds.2014-1079. World Health Organization. (2015). Measles (Fact Sheet). Geneva, Switzerland: Author.
July/August 2015
MCN
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
263
Measles: To Vaccinate or Not? Judy A. Beal, DNSc, RN, FNAP, FAAN
F
rom January 1 to March 6, 2015, there have been 173 reported cases of measles from 17 states and Washington, DC (Centers for Disease Control and Prevention [CDC], 2015b). Most of these cases (127 cases [73%]) are part of a large, still evolving outbreak linked to Disneyland in southern California where >26 measles cases were documented with at least 8 of those infected not vaccinated. This is not the fi srt outbreak of measles in recent history. Several months prior, there were 382 cases of measles in Ohio after unvaccinated missionaries returned infected from the Philippines (CDC, 2015b). According to the World Health Organization
So why do some parents refuse to vaccinate their children? The vaccine has clearly demonstrated safety and efficacy (CDC, 2015a), but a 1998 report in the British Medical Journal generated panic and misinformation that immunizations may make children more susceptible to autism. Even though that report was later retracted and labeled fraudulent, fears still linger today among some parents. Another perspective might be helpful in answering the question of why some parents opt not to vaccinate their children. According to Dr. Nathan Litman (2015), professor of pediatric infectious diseases in New York City, “We are victims of our success;
Nurses can promote vaccination by sharing accurate information with parents. (2015), measles is one of the leading causes of death among young children even though a safe and costeffective vaccine is available; in 2013, there were 145,700 measles deaths globally, about 400 deaths per day or 16 deaths every hour; and vaccination significantly reduced deaths worldwide from measles by >75% between 2000 and 2013. The measles vaccine has been widely available in the United States since 1963 and up until recently there have been no known outbreaks. Vaccination rates vary among states and even counties within states. This latest outbreak has resulted in much debate, including among politicians and 2016 presidential hopefuls. California legislators proposed a bill that would mandate all school agers to be vaccinated. Mississippi and West Virginia are the only other states with such statewide policy.
people don’t remember how bad measles was, how frightening it could be... People say, why should I bother (to get my child vaccinated), it’s not around.” What should nurses tell parents? This generation of parents is reliant on the Internet for advice. On-line advice for parents about measles from the CDC (2015a, 2015b) is readily available. The CDC (2015a) fact sheet notes the best way to protect against measles is the measlesmumps-rubella (MMR) shot. The fact sheet includes details of when children should receive the MMR; reasons why children should get the MMR vaccine; rare and very mild, if any, side effects of the MMR; how dangerous contracting measles can be and how it is spread; and is clear there is NO link between the MMR and autism (CDC, 2015a). The Institute of Medicine review of more than 67 studies concluded there was
strong evidence of no significant correlation between the MMR and autism (Maglione et al., 2014). This article, along with CDC (2015a, 2015b) data and new information from the American Academy of Pediatrics (2015), will promote upto-date professional knowledge that can be the foundation of discussions with parents. Measles can be lifethreatening. Some parents are not fully aware of the implications of their children contracting measles. As pediatric nurses, we can help promote accurate parental knowledge and encourage them to vaccinate their children. ✜ Judy A. Beal is a Professor and Dean, School of Nursing and Health Sciences, Simmons College, Boston, MA. Dr. Beal can be reached via e-mail at [email protected] The author declares no conflict of interest. DOI:10.1097/NMC.0000000000000147 References American Academy of Pediatrics. (2015). Early release from Red Book: 2015 Report of the committee on infectious diseases. Elk Grove Village, IL: Author. Centers for Disease Control and Prevention. (2015a). Measles and the vaccine (shot) to prevent it (Fact sheet for parents). Retrieved from www.cdc.gov/vaccines/ vpd-vac/measles/fs-parents.html. Updated February 5, 2015. Centers for Disease Control and Prevention. (2015b). Measles cases and outbreaks. Retrieved from www.cdc.gov/measles/ cases-outbreaks.html Litman, N. (2015). In measles outbreak, we are “victims of our own success.” CBS News (February 5, 2015, 6AM). Retrieved from www.cbsnews.com/news/ measles-outbreak-vaccine-we-arevictims-of -our-own-success/. Accessed February 10, 2015. Maglione, M. A., Das, L., Raaen, L., Smith, A., Chari, R., Newberry, S., ..., Gidengil, C. (2014). Safety of vaccines used for routine immunization of U.S. children: A systematic review. Pediatrics, 134(2), 325–337. doi:10.1542/peds.2014-1079. World Health Organization. (2015). Measles (Fact Sheet). Geneva, Switzerland: Author.
July/August 2015
MCN
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
263
