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Everything You Need to Know About Measles and Vaccinations

Recently a disease that we thought we had left behind in the 1950s has been making the headlines. In 2014, the number of measles cases in the United States shot up to over 600, compared with 50 cases in 2012. And according to the Centers for Disease Control and Prevention (CDC), 2015 is looking to continue that upward trend.


This is still happening, despite the fact that measles is extremely preventable with the measles, mumps and rubella (MMR) vaccine. Here's what you need to know about measles and vaccinations:

How do vaccinations work?
Vaccinations are a way of taking advantage of something your body already does pretty well: creating antibodies and other defenses to protect itself from invading microbes.

[Read More: Vaccines – Victims of Their Own Success]

In the case of measles, the MMR vaccine exposes our immune systems to a weakened version of the virus -- one that can't make us sick. This is like a training camp for our bodies. The immune system recognizes the foreign invader and starts making antibodies to the virus. Because the virus in the vaccine is harmless, the immune system can do all of this without us getting sick. And the beauty of the human body is that it maintains a memory of what the vaccine showed it.

So when the deadly version of the measles virus comes along, our body can fight it off before it causes any harm. When it comes to vaccines, MMR is extremely effective. According to the CDC, the first vaccination, generally given at around 1 year old, provides 93-percent protection against measles, and after the second shot (at around 5 years old), that goes up to 97 percent. That's an amazing success rate.

Are vaccinations dangerous?
Like all vaccinations, drugs and other therapies, there are risks and side effects. But the risks associated with contracting measles itself is much higher than those associated with the vaccine.

Measles is one of the leading causes of death worldwide and is especially dangerous in children. Beyond the classic rash, measles can cause coughing, fever and severe diarrhea, which carries the risk of dehydration. And one of the most serious complications is swelling in the brain, which can cause permanent damage and death. The numbers are clear: From the MMR vaccine, there is a one-in-a-million chance of a serious side effect. But the risk of dying from measles is one in 300 (CDC).

Is measles really still a problem in the United States?
The overwhelming majority of deaths due to measles are in Africa and India and other low-income countries. When the MMR vaccine was introduced in 1963, the United States quickly adopted it, the rates of measles went down rapidly, and it was considered eliminated from this country in 2000. However, we do not escape the virus completely. Visitors and immigrants are always entering our country, and some from places where measles is not so well under control. If the majority of the U.S. population is vaccinated, the infected visitor will be ill, but the infection stops with them. However, if there are holes in our vaccinations, the virus will begin to spread and we get outbreaks like the one at Disneyland.

Isn't vaccination a personal choice?
In short, no. Parents have a right to decide what goes into their children's bodies, yes. But the right to leave a child unvaccinated ends when they leave the house. That's because there's is a certain percentage of the population that can't get the measles vaccine. This is either because they're too young or have complicating conditions, such as an immune disorder. They rely on what's called "herd immunity."

Herd immunity occurs when enough of the population is vaccinated that the virus can't find a new host to spread to and the infection dies out. But if enough people choose not to vaccinate, the virus has the opportunity to infect the most vulnerable, such as infants and pregnant women. So the decision to vaccinate is not a personal decision -- it is a public health concern. Requiring vaccinations should not be seen any differently then rules preventing smoking in public places, for example.

There are just a handful of medical advancements that have had such a powerful impact on the course of human health. Vaccinations sit near the top of that list, alongside antibiotics and the knowledge that smoking causes cancer. There are so few biomedical procedures that have such a positive outcome for so little effort. Whether you are a parent yourself or not, it's important to understand how deadly this measles virus is and why the vaccination is so important.

--Dr. De Silva

Readers -- Do you think parents should be required to vaccinate their children? Do you think it's a personal choice or public-health issue? When do you think for the good of public health trumps personal choice? Leave a comment below and let us know.

Dr. Gretchen De Silva has a Ph.D. in virology from Johns Hopkins University and an M.P.H. in epidemiology from Columbia University. Her research career has spanned everything from studying viral protein interactions in a laboratory to evaluating how to get HIV-positive patients in Kenya the medication they need. She's currently a professor of Public Health Science at the University of Maryland's School of Public Health.

Follow her on Twitter to learn more about science, public health and related policy.

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