Disneyland, Measles, and Blame

Right now, and sadly not for the first time in recent years, the United States is looking at an outbreak of a dangerous yet nearly entirely preventable disease.

We’ve had pockets of measles outbreaks here and there in the past few years—the last one was in Michigan, just a few weeks ago—but this new one is gaining a lot of attention, no doubt because ground zero was traced back to Disneyland.

This one is particularly worrisome because of the location: A tourist attraction means people come from all over the world, from places where measles may not yet be eradicated, and it also means that once infected people scatter and spread it around even more. As just one example, 1,000 people are under observation in Arizona, including nearly 200 children, because the measles was brought to a Phoenix medical center from someone infected at Disneyland. Other examples abound.

Social media has exploded with attacks on anti-vaxxers because of this, which doesn’t surprise me at all. But I want everyone to be careful here. This is more subtle and complicated than most people are aware.

For one thing, as Keith Kloor at Discover magazine points out, overall in this country vaccine rates and acceptance of vaccines have not declined in recent years. So it’s not just that people are listening to the anti-vax movement and rates are dropping.

It’s more about pockets of unvaccinated people, communities at risk because herd immunity has been lowered locally. California has many of these regions. But to add another layer on to this, it’s not just left-leaning upper-class hippies behind this. Vaccine denial is nonpartisan. So we have to be careful not to throw blame at someone just because of their political ideology.

In fact, several GOP politicians have stepped in it in just the past few days, including Chris Christie and Rand Paul, both of whom made incredibly foolish and grossly inaccurate claims about vaccines. Shame on them.

There are many reasons for locally low vaccination rates. Yes, anti-vaxxers are clearly one reason. But as social scientist Julie Leask says in Kloor’s article, there are other reasons, too:

It’s not just the haves, but the have-nots who don’t fully vaccinate. … There will be children whose parents refused vaccination; children whose parents were unwittingly not up to date for lack of access; affordability or awareness; adults and travellers who didn’t get a needed booster; and babies who are too young to be vaccinated.

But what about anti-vaxxers? I for one try not to castigate parents for this. What people forget is that most parents who don’t vaccinate aren’t dumb, and they don’t think they’re being selfish. They simply love their children, and don’t want them to be hurt. This belief is quite mistaken, of course, but it doesn’t change the fact that they believe it. And yes, there is that cardiologist in Arizona who went on a creepy rant about keeping his kids pure, but he also has a lot of crackpottery he says, and I don’t think he’s representative; he’s just someone the media like to go to because of his man-bites-dog beliefs.

Exposing people who vocally make false claims about vaccines is another matter. Jenny McCarthy, Robert F. Kennedy Jr., and others like them deserve to be taken down when they say outrageous things we know are completely false.

And am I angry at parents who don’t vaccinate their kids? For me it's more of an intense frustration than anger. But calling them stupid and yelling at them for endangering other children won’t help. I’m not sure calmly explaining things will either, but it’s a damn sight better than mocking them. That only makes them dig in, and then you’ve made it worse.

Throwing a huge blanket over everyone who doesn’t vaccinate isn’t likely to suddenly make them decide you’re right. Remember, the evidence is overwhelming that vaccines are extremely low risk and extremely high benefit, yet people still aren’t vaccinating. Clearly there are other factors going on here than rational evidence-based behavior.

Those of us who are pro-vaccination claim to be evidence-based. Well, then look at the evidence and base your actions on it.

So what can be done? That too is complicated. Certainly we need the government to take this matter up. Given what Paul and Christie said, and other Congresscritters who have made profoundly ignorant claims, we should have a care. But we do need to study why people are hesitating to get their vaccinations and develop tactics to counter that hesitancy.

On a personal level, getting the facts out there may not be all we need, but we do need it. So I will continue to write about this and make sure the evidence is available for people to see. And I will direct queries I get to doctors who know their stuff and to websites I know have trustworthy information.

In fact, Slate has a new landing page filled with articles about vaccinations. You’ll find a lot of my own work there.

I will continue to call out anti-vaxxers, but I will also tread carefully when doing so. I always point out that I too am a parent, and my family is always up-to-date with our vaccines and boosters. I love my family too, and that’s one reason why I vaccinate. The other is that I know what these diseases can do to the elderly, to babies too young to be vaccinated, and to people who are immunocompromised (on chemotherapy, for example, or with autoimmune disorders and taking immunosuppressants).

Measles is one of the most infectious diseases known, and if the number of infected rises, we will start seeing disastrous effects from it. We eradicated measles in the United States years ago; there are no native reservoirs in this country. Outbreaks occur when people travel internationally and bring it back. Our best defense is getting as many people vaccinated as possible. Disneyland isn’t the first, nor will it be the last outbreak. But we can minimize them, and save a lot of lives doing so.

So please, talk to your board-certified doctor, find out what vaccines you need, and if they recommend you get vaccinated, do so.

Read more of Slate’s vaccines coverage.