Running Header: MEASLES VACCINES

Measles Vaccines: Breaking Through Incorrect Beliefs

Name Withheld
University Withheld

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Abstract
The purpose of this paper is to educate its readers, specifically the students and Professor of
English Composition II, about Measles, Mumps, Rubella (MMR) vaccinations and the
controversy surrounding them. They will learn about why parents choose not to vaccinate their
children, and how that choice endangers not only their own children, but most everyone around
them as well. It will discuss the false belief of a connection between the MMR vaccine and
Autism Spectrum Disorder (ASD), and where this originated. In writing this, my hope is that the
reader leaves with an understanding of the importance of proper vaccinations, and why a parents
opinion about their childs vaccinations is secondary to societal safety.
Keywords: Measles, Mumps, Rubella (MMR), Autism Spectrum Disorder (ASD)

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Measles Vaccines: Breaking Through Incorrect Beliefs

Around December 20th, 2014, a person or family believed to have originated either in
Europe or the Philippines, went on a vacation to Disneyland, in California. They, knowingly or
not, were infected with measles. A large number of park-goers and employees that day, and in the
weeks to come, were subsequently infected by the same strain of the virus. According to Center
for Disease Control (CDC) statistics, from December 28, 2014 (The first reported case) to
February 20, 2015, about 133 people across seven states were identified as having this particular
strain of measles. At 77% of all national cases of measles, this is a textbook definition of an
outbreak (CDC a, 2015, para. 1). Measles outbreaks in America today happen because many
parents, through lack of information or willful denial of facts, still refuse to vaccinate their
children- a highly irresponsible decision to make.
But how did this happen? Didnt the United States declare measles to be eliminated from
the county in 2000? In short- yes. The definition of an eliminated virus is the absence of
continuous disease transmission for 12 months or more. (A specific strain of) Measles is no
longer endemic (constantly present) in the United States (CDC b, 2015, para. 2). The virus can
still enter the country by a carrier from any other nation, especially those with substandard
medical and hygiene practices. Immediately following the elimination in the early 2000s, the
annual number of people reported with measles was between 35 and 45. However, that number
has been steadily growing every year, culminating with a high of 644 reported cases in 2014.
This is a disturbing trend.
How important has this vaccine been to the public as a whole? Before the start of the
National Measles Vaccination Program in 1963, it is estimated that there were approximately 3 to
4 million people getting measles each year in the United States. Out of those, between 400 and

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500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (swelling of the brain)
every year from measles. Compare that to 2013, when there were just 159 confirmed cases and
no deaths (CDC b, 2015, para. 11).
Measles is both a highly contagious, and easily preventable virus that can have dangerous
and sometimes deadly results. Between seven to 14 days after infection, the infected person will
display high fever, cough, runny nose, and conjunctivitis. (Red, watery eyes) Two or three days
after symptoms begin, tiny white spots may appear inside the mouth. Three to five days after
symptoms begin, a rash breaks out, usually starting on the face at the hairline, and spreading
downwards to the neck, trunk, arms, legs and feet. Small raised bumps may also appear on top of
the rash, which may become joined together as the rash spreads across the body. When the rash
appears, a fever may spike to more than 104 Fahrenheit. After a few days, the fever subsides,
and the rash fades (CDC c, 2014, para. 1, 2). Opposition to vaccination will often cite their own
childhood experiences saying they were merely kept out of school for a few days until the rash
went away, and that was the end of it. Unfortunately, this is not always the case.
One out of every 10 children with measles will develop an ear infection, which can result
in permanent hearing loss. In less than one in ten patients, severe diarrhea can be experienced. As
many as one out of every 20 children with measles will get pneumonia, the most common cause
of death from measles in young children. About one child out of every 1,000 who gets measles
will develop encephalitis (swelling of the brain), that can lead to convulsions, and can leave the
child deaf or with intellectual disability. For every 1,000 children who get measles, between one
and two will die. Measles can also cause pregnant women to give birth prematurely or have a
low birth weight baby (CDC d, 2014, para. 2-4).
With all the complications that can happen, it would seem that the sane decision for any
parent would be to vaccinate their child as soon as they are able. And yet, unsurprisingly, the

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largest amounts of outbreaks in America seem to always coincide with areas that have a high
concentration of parents who have personal objections to vaccination. This is irresponsibility at
its worst, and it is my opinion that this should be classified as child endangerment.
Why would any parent refuse to vaccinate their child from a nearly completely
preventable virus? There are a few reasons, some holding slightly less logic than others. The
first is the misbelief that the Measles, Mumps, and Rubella (MMR) vaccine can cause autism in a
small percentage of children. This belief stems from a single 1998 research paper in The Lancet;
a highly respected, peer-reviewed English medical journal. In reality, the authors practices were
brought into question even before the paper was published. Subsequent investigations revealed
that the author had several conflicts of interest, had manipulated evidence, and broken other
ethical codes. The Lancet partially retracted the paper in 2004, and fully retracted it in 2010; the
same year that the papers author was stripped of his medical license by the English Medical
Register. Following the initial claim in 1998, multiple large studies were conducted to look for a
connection between Autism Spectrum Disorder (ASD) and the MMR vaccine. Reviews of the
evidence were conducted by the Center for Disease Control, (CDC) the American Academy of
Pediatrics, the Institute of Medicine of the US National Academy of Sciences, the UK National
Health Service, and the Cochrane Library. All found no link between autism and the vaccine.
And yet because of the widespread reporting of the claims in the original paper, vaccination rates
fell sharply in the western world. One 2011 journal article even went so far as to refer to the
Lancet paper as the most damaging medical hoax of the last 100 years (Flaherty, 2011, p.
1302-1304).
Additionally, the vaccine additive that the paper pointed to as the supposed culprit, a
mercury-based preservative named Thiomersal, was phased out of all routine childhood vaccines
due to the controversy, despite no legitimate evidence being found to substantiate the claims

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(Bigham, 2005, p 89-101). Also, a new paper just released in the top neuroscience journal,
Neuron, (Lin et al, 2015, p. 742-754) describes how the genes known to be connected to autism
are active during fetal brain development. In simple terms, there is an extremely good chance
that autism is something youre born with, not something caused by an external source later in
life- especially one as inconsequential as a preservative.
Another reason some parents would refuse vaccinating their child from something
preventable is the resurgence of the holistic, all-natural lifestyle. These parents want all natural
foods for their children, all natural soaps for them to clean with, and as few additives,
preservatives, pesticides and chemicals in their lives as possible. These are the same parents who
will talk endlessly about the dangers of genetically modified organisms, (GMOs) without ever
even stopping to consider that virtually all food we come in contact with today has been
genetically modified. They simply feel that the chemicals in the vaccine are unproven, despite
countless peer-reviewed studies on the vaccine since its release in 1963. They often feel that the
human immune system is powerful enough to overcome any virus it encounters. (Black Plague,
anyone?) If this were the case, one in 1,000 children would not be dying from measles
complications every single year.
A common argument from anti-vaccination campaigners claims if they choose not to
vaccinate their child, it shouldnt matter to those of us who do vaccinate. How could our family
be at risk if we vaccinate? Thats a valid enough question. Regarding measles, there are four
groups of people.
In the first group, two doses of the vaccine provide immunity for most who receive it.
In group two, roughly three percent of vaccinated children do not develop a lasting
immune response. This group is not fully protected against measles, and if exposed, will likely
contract the illness.

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Group three is the unvaccinated; whether by refusal or because they are too young to
receive it. Exposed, unvaccinated children have a 90% chance of becoming infected with
measles.
Fourth, there are people- especially children- who cant be vaccinated. Those with cancer.
Those who are immunocompromised. Those who are truly allergic to all or a part of a vaccine.
(Such as anaphylaxis to egg) These people remain at risk. They cannot be protected, except by
vaccinating those around them. This is called herd immunity, when the general population of a
group reaches a certain percentage of vaccination and is therefore immune to true outbreaks
within the group. This is why refusal to vaccinate is so critically damaging. Not only are those
parents putting their own childs life in danger, but also the lives of children and adults around
them as well.
Effective herd immunity for measles requires vaccination of approximately 95% of an
able population. This is one of the highest herd immunity requirements of all diseases or viruses,
simply because it is so easily transmitted. Measles is a highly contagious virus that lives in the
nose and throat mucus of an infected person. It can spread to others through coughing and
sneezing. Also, the measles virus can live for up to two hours on a surface or in an airspace
where the infected person coughed or sneezed. If other people breathe the contaminated air or
touch the infected surface, then touch their eyes, noses, or mouths, they can become infected.
Measles is so contagious that if one person has it, 90% of the people close to that person who are
not immune will also become infected. Infected people can spread measles to others from four
days before to four days after the rash appears (CDC e 2014, para. 1).
The vaccine used to prevent measles today is a live attenuated vaccine; that is; it was
developed using a live measles virus that was weakened (attenuated) and therefore could no
longer cause the disease. It has been modified several times to make it safer (further attenuated)
and today is extremely effective in preventing measles outbreak. Anti-vaccination parents act as

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though they believe vaccines are thought up in a board meeting and released that same day onto
an unsuspecting public. In reality, nothing could be further from the truth. Before any
vaccination is released to be used on a public scale, it is tested and retested so thoroughly that the
process would make even the most difficult Obsessive-Compulsive Disorder patient smile to
observe. Peer review takes new meaning when it comes to anything to be injected into ones
body. With all this in mind, all anti-vaccination parents should reconsider their position on the
issue, and decide if digging their heels in is really worth putting their childs life in danger as
well as the lives of those around them.

References
Bigham, M., & Copes, R. (2005). Thiomersal in vaccines: balancing the risk of adverse effects
with the risk of vaccine-preventable disease. Drug Safety, 28(2), 89-101.
doi:10.2165/00002018-200528020-00001
In this paper, Bigham and Copes discuss the movement to remove thiomersal from
vaccines as a precautionary measure. They comfortably use highly credible references
like the World Health Organization, and effectively use facts and numbers to enhance
their position.
The First Author is a Clinical Professor at the University of British Columbia. He is
commonly approached when an expert in blood services, vaccines and pathogens is
needed. He brings credibility to this paper simply by the background he has established.

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CDC a: Center for Disease Control., (2015). Measles cases and outbreaks
http://www.cdc.gov/measles/cases-outbreaks.html para. 1
The Center for Disease Control is the American subject matter expert agency concerning
any virus, infection, or disease currently known to man. The cases and outbreaks they
reference on their page reflect the most accurate information available in the United
States today.
Despite having some of the most technically adept scientists on staff, the Center for
Disease Control never fails to present all data and information in a highly user-friendly
format that is accessible to any American. The goal of their website is education and
advocacy, and allows me to piece critical data into a single report much more easily.
CDC b: Center for Disease Control., (2015). Frequently Asked Questions about Measles in the
U.S. http://www.cdc.gov/measles/about/faqs.html para. 1, 2, 11
CDC c: Center for Disease Control., (2014). Signs and Symptoms of Measles
http://www.cdc.gov/measles/about/signs-symptoms.html para. 1, 2
CDC d: Center for Disease Control., (2014). Complications of Measles
http://www.cdc.gov/measles/about/complications.html para. 2-4
CDC e: Center for Disease Control., (2014). Transmission of Measles
http://www.cdc.gov/measles/about/transmission.html para. 1
Flaherty, D., (2011). The vaccine-autism connection: a public health crisis caused by unethical
medical practices and fraudulent science. Annals of Pharmacotherapy, 45(10), 1302-1304
doi:10.1345/aph.1Q318
A slightly more argumentative paper, Flaherty nevertheless maintains professionalism
while deftly navigating the Andrew Wakefield paper and the highly damaging effects it
has had on society in the western world as a whole. Flaherty is careful not to restrict his
discussion of the damage done to just the United States, but to places like England as
well.

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The Wakefield paper, while devastating for parental confidence in vaccinations, is an

extremely important piece of MMR vaccination background today, and Flahertys
methodical and thorough explanation is just the right amount of information I was
seeking for my own paper.
Lin, G., Corominas, R., Lemmens, I., Yang, X., Tavernier, J., Hill, D., Vidal, M., Sebat, J.,
Iakoucheva, L. (2015). Spatiotemporal 16p11.2 Protein Network Implicates Cortical Late
Mid-Fetal Brain Development and KCTD13-Cul3-RhoA Pathway in Psychiatric
Diseases. Neuron, 85(4), 742-754 doi:http://dx.doi.org/10.1016/j.neuron.2015.01.010
In the paper referenced in this highly-touted neural psychology journal, much groundbreaking neural hypothesis and discoveries are discussed. The study focused on copy
number variants (CNVs) in particular regions that have previously been connected to
ASD. However, they learned that not all CNVs were activated during the same growth
period. Activation of various CNVs was staggered throughout fetal development. The two
genes, known as KCTD13 and CUL3, have ASD-associated mutations, and become
activated around the middle of development. These genes regulate the protein RhoA,
which is crucial to brain development. RhoA is responsible for the development and
maintenance of neurons, while also assisting in the regulation of their migration.
This collaborated group of researchers, headed up by Lilia Iakoucheva, has expertise and
credibility in surplus. Dr. Iakoucheva holds a Ph.D. in molecular biology and
immunology. An assistant professor at the University of California, San Diego; she has
previously worked with the Pacific Northwest National Laboratory as well as the
Rockefeller University. The paper is very transparent and specific about their methods,

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and there is a high likelihood that the results of this paper can ultimately lead to groundbreaking therapies.

Self-Reflection Discussion
This essay was a good and bad for me. Good because I had researched the
material previously for my informative essay, and bad because I felt a degree of burn-out
on the subject matter. However, the only other topics I feel passionate about enough to
write an argumentative essay about would have likely been too controversial, for example
various aspects of religion in society. In this essay it was important for me to focus on my
position of the argument- that MMR vaccines are extremely important and antivaccination beliefs are not only dangerous to the family of the parent refusing treatment,
but dangerous to everyone in contact with them as well. I wanted to be able to present the
facts about the issue without resorting to speculation. I wanted to show, in simple terms,
that a belief in a link between MMR vaccines and Autism is entirely unfounded and
counter-productive.

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I would like to think the argumentative aspect of the paper came slightly easier for
me, since even my original draft of my informative paper took a side at one point. Thats
the difficult part when writing about a topic you feel passionate about- getting too
passionate. I wanted to raise the points that you regularly hear in the media from the antivaccination camp and address them all individually as briefly but effectively as possible.
In hindsight, I had intended to more clearly define the oppositions beliefs; I wanted to
format it in a line them up and knock them down delivery method. I didnt achieve this,
but I think I did a fairly good job discussing the beliefs of the opposing side.
A big concern for me was using so many references from the Center for Disease
Control website. I didnt want my reference page to become too top-heavy. After
making final adjustments though, I think I did a fair job of balancing references.
Regarding the final question of this reflection; how well I believe I accomplished
the tasks asked of me in this assignment; I would only say that while I know I have a
large margin of room for improvement, I think for my first informative and argumentative
essays in 21 years I did a very good job.