9 ms·

The Washington State Measles Outbreak

88 points by WisNorCan 8y ago

im_down_w_otp 8y ago
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.
- deleted 8y ago
  [deleted]
- anth_anm 8y ago
  > 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. have some rich dumbass's kid die of measles.
  - i_feel_great 8y ago
    It is never the child's fault.
    - anth_anm 8y ago
      it's a horrible horrible thing, and I think anti-vaxxer parents are awful people who are putting their kids lives at risk. But I think the only way these people will learn is if some kid they know ends up dead because of their selfishness.
- ransom1538 8y ago
  "Most of those infected are unvaccinated children under 10, health officials said." Making it worse, the non-vaccinated group also endangers the vaccinated group! Just because your vaccinated doesn't mean it will work. So now with it spreading, there is %5 odds (or whatever the odds are) you get the virus EVEN IF you are vaccinated. So even if you are doing the right thing and ARE vaccinated you are still screwed by these non-vaccers.
- masayune 8y ago
  The greatest irony is that if an outbreak occurs, the government and public health organizations will somehow be culpable. “You’re making my kids autistic” will quickly morph into “why did you let my child die?”
- vegannet 8y ago
  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 8y ago
    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/how-long-do-babies-carry-their-mothers-immunity/ https://www.nhs.uk/common-health-questions/childrens-health/...
    - masonic 8y ago
      (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?
randomacct3847 8y ago
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
- pnw_hazor 8y ago
  "'Sad reality': Handful of WA measles outbreak sites are in Russian-speaking communities" https://komonews.com/news/local/sad-reality-handful-of-wa-measles-outbreak-sites-are-in-russian-speaking-communities https://komonews.com/news/local/sad-reality-handful-of-wa-me...
- bitcoinmoney 8y ago
  What’s granola hippies?
  - randomacct3847 8y ago
    Hippies that eat granola. It’s just used to describe the kind of person that wears Patagonia, goes on weekend hikes in their hiking shoes and cargo pants, buys organic, probably a vegan, and eats granola/trail mix.
  - jfoutz 8y ago
    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.
- rootusrootus 8y ago
  Antivaxxers are pretty evenly distributed across the ideological spectrum.
- roywiggins 8y ago
  There's a cluster of antivaxx sentiment in the Minnesotan Somali community. They're also an autism hot spot, and after that was noticed their fears were fanned by Andrew Wakefield etc. https://www.statnews.com/2017/05/08/measles-vaccines-somali/ https://www.statnews.com/2017/05/08/measles-vaccines-somali/
entee 8y ago
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-outbreak-moral-foundations-theory.html https://slate.com/technology/2019/02/antivax-measles-outbrea...
- fossuser 8y ago
  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 8y ago
    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.
hprotagonist 8y ago
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/2015/05/07/404963436/scientists-crack-a-50-year-old-mystery-about-the-measles-vaccine#.WO0uRq8Zu-0.facebook https://www.npr.org/sections/goatsandsoda/2015/05/07/4049634... [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 8y ago
  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.
mcdoh 8y ago
> 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 8y ago
  Seriously. I'm an infectious disease epidemiologist, and measles is amazingly transmissible.
  - Johnny555 8y ago
    As an infectious disease epidemiologist, could you elaborate on that? What is it that makes it so contagious?
    - Fomite 8y ago
      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/
agumonkey 8y ago
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
CaliforniaKarl 8y ago
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 8y ago
  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.
  - el_benhameen 8y ago
    The primary care/family doctors I know seem to think that education and proactive counseling is very much a part of their jobs and a good use of their time.
  - thomasmeeks 8y ago
    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.
    - lotsofpulp 8y ago
      If they trusted the doctor, they would have gotten the vaccine already. I think doctors need to stop seeing people that refuse vaccines (I only visit provider groups whose policy is to refuse unvaccinated people), and also a government initiative to educate people about how a vaccine works and the history of its development, use, and efficacy. And removing any non medical exemptions. We have thousands of people watching out for terrorist attacks, when the biggest biological threat is our neighbor.
deleted 8y ago
[deleted]
todipa 8y ago
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 8y ago
  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.
  - thomasmeeks 8y ago
    Yeah, though it is bad form to comment on up/downvotes, the voting in this thread is super weird for hacker news. It is putting some other conversations on the site recently in a new light for me, though.
  - GijsjanB 8y ago
    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.
    - deleted 8y ago
      [deleted]
    - wlll 8y ago
      I understand your issue here, but at the same time people not getting vaccinated causes significant health risks to me and my family. Given the risks involved I'm happy for people to be either made to have them or be excluded from society.
    - o10449366 8y ago
      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.
ericdykstra 8y ago
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-requirements https://www.uscis.gov/news/questions-and-answers/vaccination...
- bleriot 8y ago
  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 8y ago
    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)
    - bleriot 8y ago
      How was his statement incorrect or unjustified? (tip: calling something incorrect and unjustified just because you don’t like it is a bad way to start a conversation)
- aaronharnly 8y ago
  According to this World Bank data[1], the measles vaccination rates in the countries that are the top sources [2] of illegal immigration in the US: * United States: 92% vaccination * Washington State: 90.6% vaccination * Mexico (55% of illegal immigrants): 96% vaccination * El Salvador (6% of illegal immigrants): 85% * Guatemala (5% of illegal immigrants): 86% * India (4% of illegal immigrants): 88% * Honduras (3% of illegal immigrants): 97% * Philippines (3% of illegal immigrants): 89% So I’d say that theory is not strongly supported by the evidence. But it’s entirely appropriate to evaluate the possibility, and there could very well be a lower vaccination rate among illegal immigrant populations. Had you phrased your point differently — as a matter of inquiry into the epidemiology — it likely would’ve been received better. Also, your post made no real attempt to quantify the real and well documented phenomenon of philosophical/cultural objections to vaccination among the citizen population in Washington, which is surely relevant! [1] https://data.worldbank.org/indicator/SH.IMM.MEAS?view=map https://data.worldbank.org/indicator/SH.IMM.MEAS?view=map [2] https://www.dhs.gov/sites/default/files/publications/Unauthorized%20Immigrant%20Population%20Estimates%20in%20the%20US%20January%202014_1.pdf https://www.dhs.gov/sites/default/files/publications/Unautho...
PhantomGremlin 8y ago
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 8y ago
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.
chronotis 8y ago
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 8y ago
  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.
walrus01 8y ago
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.
b_tterc_p 8y ago
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 8y ago
  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.
  - mindslight 8y ago
    I've been thinking a lot on the anti-intellectualism lately. Lower intelligence people are less able to judge whether an idea is sensible on its own merits. Furthermore, they are likely to be outwitted by people with higher intelligence. So their mode of operation becomes to not even attempt judging an idea by its merits, lest they end up fooled. Rather, they judge based solely on the perceived stature of whom the idea is coming from. The breakdown of our media institutions furthers the problem - rather than presenting an opinionated application of common sense that condemns poor ideas, they've devolved into giving "each side" equal time to obscure their true power of defining what subjects are talked about. So once these memes get out there, they keep circulating as folk wisdom continually re-validated by appearances in mainstream media.
giarc 8y ago
Not to downplay measles, but wait until mumps start spreading. The 10% male infertility rate and enlarged scrotums might change some parents minds.
- koheripbal 8y ago
  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.
peterwwillis 8y ago
At some point you should not be able to opt-out of preventing an epidemic. When will we stop coddling the stupid?
jancsika 8y ago
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.
jedi3335 8y ago
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.
hyeonwho4 8y ago
Seems like a problem that can be totally cured by insurance agencies raising premiums on unvaccinated children.
- masonic 8y ago
  The ACA (Obamacare) made that illegal in 2010.
mirkules 8y ago
> “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.

88 points by WisNorCan 8y ago

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.

deleted 8y ago
[deleted]
anth_anm 8y ago
> 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. have some rich dumbass's kid die of measles.
- i_feel_great 8y ago
  It is never the child's fault.
  - anth_anm 8y ago
    it's a horrible horrible thing, and I think anti-vaxxer parents are awful people who are putting their kids lives at risk. But I think the only way these people will learn is if some kid they know ends up dead because of their selfishness.
ransom1538 8y ago
"Most of those infected are unvaccinated children under 10, health officials said." Making it worse, the non-vaccinated group also endangers the vaccinated group! Just because your vaccinated doesn't mean it will work. So now with it spreading, there is %5 odds (or whatever the odds are) you get the virus EVEN IF you are vaccinated. So even if you are doing the right thing and ARE vaccinated you are still screwed by these non-vaccers.
masayune 8y ago
The greatest irony is that if an outbreak occurs, the government and public health organizations will somehow be culpable. “You’re making my kids autistic” will quickly morph into “why did you let my child die?”
vegannet 8y ago
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 8y ago
  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/how-long-do-babies-carry-their-mothers-immunity/ https://www.nhs.uk/common-health-questions/childrens-health/...
  - masonic 8y ago
    (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?

randomacct3847 8y ago

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

pnw_hazor 8y ago
"'Sad reality': Handful of WA measles outbreak sites are in Russian-speaking communities" https://komonews.com/news/local/sad-reality-handful-of-wa-measles-outbreak-sites-are-in-russian-speaking-communities https://komonews.com/news/local/sad-reality-handful-of-wa-me...
bitcoinmoney 8y ago
What’s granola hippies?
- randomacct3847 8y ago
  Hippies that eat granola. It’s just used to describe the kind of person that wears Patagonia, goes on weekend hikes in their hiking shoes and cargo pants, buys organic, probably a vegan, and eats granola/trail mix.
- jfoutz 8y ago
  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.
rootusrootus 8y ago
Antivaxxers are pretty evenly distributed across the ideological spectrum.
roywiggins 8y ago
There's a cluster of antivaxx sentiment in the Minnesotan Somali community. They're also an autism hot spot, and after that was noticed their fears were fanned by Andrew Wakefield etc. https://www.statnews.com/2017/05/08/measles-vaccines-somali/ https://www.statnews.com/2017/05/08/measles-vaccines-somali/

entee 8y ago

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-outbreak-moral-foundations-theory.html https://slate.com/technology/2019/02/antivax-measles-outbrea...

fossuser 8y ago
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 8y ago
  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.

hprotagonist 8y ago

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/2015/05/07/404963436/scientists-crack-a-50-year-old-mystery-about-the-measles-vaccine#.WO0uRq8Zu-0.facebook https://www.npr.org/sections/goatsandsoda/2015/05/07/4049634... [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 8y ago
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.

mcdoh 8y ago

> 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 8y ago
Seriously. I'm an infectious disease epidemiologist, and measles is amazingly transmissible.
- Johnny555 8y ago
  As an infectious disease epidemiologist, could you elaborate on that? What is it that makes it so contagious?
  - Fomite 8y ago
    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/

agumonkey 8y ago

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

CaliforniaKarl 8y ago

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 8y ago
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.
- el_benhameen 8y ago
  The primary care/family doctors I know seem to think that education and proactive counseling is very much a part of their jobs and a good use of their time.
- thomasmeeks 8y ago
  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.
  - lotsofpulp 8y ago
    If they trusted the doctor, they would have gotten the vaccine already. I think doctors need to stop seeing people that refuse vaccines (I only visit provider groups whose policy is to refuse unvaccinated people), and also a government initiative to educate people about how a vaccine works and the history of its development, use, and efficacy. And removing any non medical exemptions. We have thousands of people watching out for terrorist attacks, when the biggest biological threat is our neighbor.

deleted 8y ago

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todipa 8y ago

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 8y ago
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.
- thomasmeeks 8y ago
  Yeah, though it is bad form to comment on up/downvotes, the voting in this thread is super weird for hacker news. It is putting some other conversations on the site recently in a new light for me, though.
- GijsjanB 8y ago
  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.
  - deleted 8y ago
    [deleted]
  - wlll 8y ago
    I understand your issue here, but at the same time people not getting vaccinated causes significant health risks to me and my family. Given the risks involved I'm happy for people to be either made to have them or be excluded from society.
  - o10449366 8y ago
    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.

ericdykstra 8y ago

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-requirements https://www.uscis.gov/news/questions-and-answers/vaccination...

bleriot 8y ago
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 8y ago
  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)
  - bleriot 8y ago
    How was his statement incorrect or unjustified? (tip: calling something incorrect and unjustified just because you don’t like it is a bad way to start a conversation)
aaronharnly 8y ago
According to this World Bank data[1], the measles vaccination rates in the countries that are the top sources [2] of illegal immigration in the US: * United States: 92% vaccination * Washington State: 90.6% vaccination * Mexico (55% of illegal immigrants): 96% vaccination * El Salvador (6% of illegal immigrants): 85% * Guatemala (5% of illegal immigrants): 86% * India (4% of illegal immigrants): 88% * Honduras (3% of illegal immigrants): 97% * Philippines (3% of illegal immigrants): 89% So I’d say that theory is not strongly supported by the evidence. But it’s entirely appropriate to evaluate the possibility, and there could very well be a lower vaccination rate among illegal immigrant populations. Had you phrased your point differently — as a matter of inquiry into the epidemiology — it likely would’ve been received better. Also, your post made no real attempt to quantify the real and well documented phenomenon of philosophical/cultural objections to vaccination among the citizen population in Washington, which is surely relevant! [1] https://data.worldbank.org/indicator/SH.IMM.MEAS?view=map https://data.worldbank.org/indicator/SH.IMM.MEAS?view=map [2] https://www.dhs.gov/sites/default/files/publications/Unauthorized%20Immigrant%20Population%20Estimates%20in%20the%20US%20January%202014_1.pdf https://www.dhs.gov/sites/default/files/publications/Unautho...

PhantomGremlin 8y ago

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 8y ago

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.

chronotis 8y ago

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 8y ago
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.

walrus01 8y ago

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.

b_tterc_p 8y ago

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 8y ago
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.
- mindslight 8y ago
  I've been thinking a lot on the anti-intellectualism lately. Lower intelligence people are less able to judge whether an idea is sensible on its own merits. Furthermore, they are likely to be outwitted by people with higher intelligence. So their mode of operation becomes to not even attempt judging an idea by its merits, lest they end up fooled. Rather, they judge based solely on the perceived stature of whom the idea is coming from. The breakdown of our media institutions furthers the problem - rather than presenting an opinionated application of common sense that condemns poor ideas, they've devolved into giving "each side" equal time to obscure their true power of defining what subjects are talked about. So once these memes get out there, they keep circulating as folk wisdom continually re-validated by appearances in mainstream media.

giarc 8y ago

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

koheripbal 8y ago
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.

peterwwillis 8y ago

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

jancsika 8y ago

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.

jedi3335 8y ago

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.

hyeonwho4 8y ago

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

masonic 8y ago
The ACA (Obamacare) made that illegal in 2010.

mirkules 8y ago

> “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.