Public Health, Then and Now: Don't Let the Scary Times Come Back/Facts Over Fear
It’s critically important that we learn from history and apply the lessons to today’s practice. IPHA is fortunate to have both retirees and young professionals within our membership. The synergies that come from combining wisdom and experience with innovation and systems thinking is what is necessary to meet the challenges of today’s public health challenges.
For this article, I asked two IPHA members with different generational experiences to share their thoughts on the increase in vaccine hesitancy and resulting measles outbreaks. I hope you find insight in their words. Look for this Then and Now format in future newsletters.
Don’t Let the Scary Times Come Back
By: Dr. Ron Eckoff, IPHA Past President (1972)
The Fall 2014 newsletter had an article with the same title. It focused on polio, but at the end mentioned measles, pertussis and other diseases were making a comeback. Since that time the comeback of childhood diseases has accelerated. The World Health Organization is calling vaccine hesitancy, the reluctance or refusal to vaccinate despite available vaccines, one of the top ten global health threats. It is a problem all around the world, including the United States.
As I started to write this a few months ago, the State of Washington had just declared a public health emergency due to a measles outbreak. I was also in the middle of reading: “The Cruelest Miles”; the story of getting Diphtheria antitoxin to Nome Alaska by dogsled in 1925. Heroic efforts were made to combat the epidemic. There was no hesitancy. Many individuals risked their lives in the effort.
As of June 20, 2019, the Centers for Disease Prevention and Control reported 1,077 cases of measles so far this year, an increase of 33 from the previous week. The total for all of 2018 was 372. In 2017 it was 170. The May 28, 2019 issue of the Journal of the American Medical Association includes an interesting commentary “Safe Vaccinations for a Healthy Nation” by Gostin, Ratzan, and Bloom.
People with no experience with so-called “common childhood diseases” like measles, pertussis and diphtheria may consider them to be no threat. These same individuals would probably think of smallpox and polio as dreadful, deadly diseases. However, biennial reports of the State Board of Health document that between 1908 and 1937 there were many more deaths in Iowa due to measles, diphtheria and pertussis than due to Polio or smallpox. I hope this data may be of use in combating vaccine hesitancy in Iowa.
Please visit the IPHA history website to learn more about the history of public health in Iowa, around the world, and of IPHA.
Facts Over Fear
By: Danielle Pettit-Majewski, IPHA Board Members & APHA Representative
Memorial Day is often seen as the kick off to summer, but in 2019, it marked the worst measles outbreak the United States has seen since it was eradicated from the country 19 years ago.
There’s been generational amnesia about the seriousness and severity of measles, and fear about the fallacy that there’s a link between measles and autism. We at the local public health agencies have been doing our part to be on the front lines of dispelling misinformation by spearheading campaigns to share factual information with our communities.
Fact: Measles is not a benign disease. The health consequences include pneumonia, brain damage, and deafness. Additionally, 1-2 out of 1,000 will die from this disease. Given the numbers of cases to date, many in public health expect there to be a measles death this year.
Fact: Young children are more likely to suffer these consequences.
Fact: In under vaccinated communities, one individual can infect up to 18 others.
Fact: There is no link between the MMR vaccine and autism. The UK physician who published the original article was stripped of his medical license and the Lancet retracted the paper and it is no longer considered part of the scientific record.
As public health professionals, we cannot let the fear speak louder than the facts. Parents naturally want what is best for their children, and we have the privilege and responsibility of sharing the facts and the potential consequences associated with the growing trend of “vaccine hesitancy.” This requires relationship building at the local level and honest, evidence-based conversations with parents.