By Amy Adams
Since the beginning of 2019, Washington state has had 71 (and climbing) confirmed cases of measles, but so far no deaths — thank goodness. I’ve been following these numbers closely since the epidemic began in part because of my own history with the disease.
In 1986, during the summer before my senior year of high school, I developed measles as part of a smaller epidemic in Washington state. It was the sickest I’d ever been, and have ever been since. (It was also when I first received codeine cough syrup, which I LOVED, and is why I now routinely turn down opioid pain killers, but I digress.)
What haunts me about that experience is a worry I’ve always had about my own role in spreading the disease.
Measles is incredibly easy to transmit — virtually anyone unvaccinated who is exposed to the virus will get sick. What’s more, the first few days of the disease feel like nothing more than a bad cold. As a teenager, a bit of a fever was not going to keep me from a Nordstrom sale. Packed among strangers, touching clothing and myriad surfaces, I’ve always wondered how many people I might have exposed to my burgeoning illness. And how many of those people might have been children too young to be vaccinated, pregnant women — whose babies could be harmed by the virus — or people with immune disorders who can’t be vaccinated and are particularly susceptible to disease.
I’ve done some reading since then, and found that there were no measles deaths in the United States that year, which is a relief. Before the vaccine was introduced, the World Health Organization reports that there were about 2.6 million deaths globally each year, and 110,000 people died of the disease in 2017.
I was vaccinated as a child, but with only one dose, which was standard at the time. According to pediatric infectious disease expert Yvonne Maldonado, MD, that gave me about 95 percent protection. Now, kids get two doses and much higher levels of protection.
Maldonado also had measles as a child because she was born before the vaccine existed. “I still remember being really sick,” she told me. “My parents had to put me in a dark, quiet room and everyone had to leave me alone.”
She and I both survived the disease with nothing worse than bad memories — as most people do. (Roughly one to three people die for every 1,000 who get the disease.) That low death rate is something people opposed to vaccination point to as a reason not to worry. But Maldonado asked why death should be the only outcome worth avoiding. “It’s clear that young children are at the highest risk and we know that it’s not a good disease. Why would you want to subject your child to that if you can avoid it?”
In terms of possible bad outcomes, I’d add my own — years of worrying about your role in spreading the disease, and the susceptible people you may have harmed. When most people are vaccinated it protects the most vulnerable, which seems like a goal worth pursuing.
Photo by Becca McHaffie
This story was originally published in Stanford’s Scope Blog.