Another Needless Measles Death

Many years ago I was at the University of Chicago for a medical school interview. The pediatric oncologist who I met with asked if I wanted to go on hospital rounds to which I gave an enthusiastic “yes!”. I don’t remember much but I do remember visiting the room of a young girl, maybe 7 or 8 years old, lying in bed playing with a toy, hooked up to an IV. She looked up and smiled at us and said, “Hi Doctor! How are my counts today?”1 I knew then and there that I was not going to be a pediatrician.

Taking care of sick adults doesn’t have the same weight as caring for sick kids. Kids don’t get to make their own decisions. They are subject to the whims of the adults around them, and if the doctor thinks the parents are making bad choices, there’s little they can do.

If you watched The Pitt last week, you saw a critically ill child brought into the emergency department. The medical team figures out that the child has measles and asks the parents permission to get a spinal tap to confirm the diagnosis and start saving his life. One of the parents hesitates, consulting “Dr. Google”2 while her kid inches closer to a preventable death.

What we are seeing in the current measles outbreak is tragic on many levels. The New York Times is reporting that another child has died of measles in Texas. The total case count nationally is over 600 (the true number is likely much, much higher). About 12% of people have been sick enough to be admitted to a hospital, most of those under 5 years old. And most of the measles victims are unvaccinated.

Who’s to blame for all this? It seems, in once sense, a stupid question: it’s a disease; no one’s to blame for an “act of G-d”. But in this case there is plenty of blame to go around—but not as much as you’d think. We discussed Andrew Wakefield, the disgraced English former-doctor who helped start the modern anti-vaccine movement. Robert Kennedy, the current HHS secretary, not only carries some of the blame, he is taking on a bigger burden of it every day, continuing to spread false information, preventing experts from getting out good information, and promoting dangerous and ineffective treatments.

But here’s a crazy fact: the majority of online disinformation on vaccines comes from just 12 people. So while there’s plenty of blame to go around, it’s not as much as you’d think. It is, I think, a distraction to focus on parents whose kids are sick due to their failure to vaccinate. Low vaccination rates are a public health problem, and while individual decisions are important, policy is more so. We need to remove so-called “philosophical vaccine waivers”; these waivers have been shown to reduce vaccination rates significantly. All children who want to enter public schools need to get all the recommended childhood vaccinations unless there is a medical reason not to (and I mean a legitimate medical reason. There are plenty of doctors who will improperly give out exemptions, sometimes without even seeing the patient.) When we allow philosophical, or “personal belief” exemptions, kids get sick, and those kids get other kids sick.

So there’s plenty of blame to go around for the current outbreak and for the deaths of of kids who should never have gotten ill much less died. But really, we can focus our efforts in a few places: speaking out against the Director of HHS Mr. Kennedy; countering vaccine misinformation from the few online sources responsible for most of it; and cracking down on fake or philosophical vaccine waivers.

Stay well.

-pal