Sanctimonious Principle

"I would never describe myself as anti-vaccination. I am really behind the idea of informed consent. To me, it is all about the individual person having the right and obligation to research and determine what is the risk to their child."
"I've always considered that we are declining or delaying and we just take our decision as they come. At this point, none of my kids has been vaccinated."
"No mother makes choices like this without thinking things through and having valid reasons. I don't judge other people for their choices. This is just another parenting decision, it's just that it is so taboo, people are afraid to talk about it."
Gina Merlin, Ottawa

Source: American Academy of Pediatrics, Red Book Online Visual Library

This child with measles displays the characteristic red, blotchy pattern on his face and body during the third day of the rash

"Despite the rarity of this disease (measles) in Ottawa, it is very important for all residents to keep their vaccinations up to date and remember to report to OPH (Ottawa Public Health) every time your child is vaccinated."
Ottawa Public Health authority

Ms. Merlin had a difficult time finding a family doctor willing to take on the responsibility of looking after her family's health issues. One of the medical practitioners she had approached had, upon hearing her views on vaccination, stated he had no intention of risking his clinic becoming the "centre of an epidemic."

She has three children attending elementary school, and one child too young yet to attend school. None of her children has been vaccinated against any childhood diseases. She and her husband are counting on a natural progression of events, that unvaccinated, their children will, one by one, become naturally infected with measles, and gain immunity that way, protecting them as they become older when measles can be even more health-threatening.

"I am not out looking for it, but if he got it that would be good", she said, referring to her oldest child.

Canada has seen a recent outbreak of measles, and in Ottawa one child whose family had visited the Philippines which is currently in the throes of a massive measles outbreak, brought measles back home with him, and two of his classmates at primary school contracted measles, as a result. Public health agencies and family doctors all emphasize to parents the need to have their children inoculated.

It's good public health policy and it's sound medical practise, one that protects children from the possibility of exposure to the measles virus ending up with some children experiencing life-threatening and quality-of-life threatening episodes of health failure. Ms. Merlin explained in an interview for publication that she and her husband "were not comfortable" having their oldest son vaccinated as an infant. They decided to delay the decision and it went from there to simply not vaccinating.

Of concern to these parents was the perfectly valid potential relating to the possibility, however remote, of auto-immune reactions. Nor were the other three children vaccinated. She feels that if their oldest son hasn't been naturally exposed to measles by adolescence, her family will at that time re-evaluate the decision they've taken, since they're aware that measles and mumps onset take on a more serious nature after childhood.

Parents are advised when they register their children for school attendance that a full record of specific immunizations must attend the registration to enable their school-age children to attend school. The reason is obvious enough; when children are thrown together in a setting where they are exposed to large numbers of other children on a daily basis, opportunistic viruses have the chance to spread, without the recommended vaccinations having taken place.

There are exemption opportunities available, however. In Ottawa over 1,600 students attending public school have been exempted due to religious, medical or philosophical objections. That represents less than 1.5% of the school population. To admit her children without the requisite vaccinations, Ms. Merlin signed affidavits that officially enabled her children to be given exemptions from inoculations.

As a result of three children attending that elementary school who contracted measles, about a dozen children from St. Stephen Catholic school in Stittsville were advised to remain home until the end of the month, unless they were able to demonstrate proof of vaccination. Those are some of the risks associated with choosing not to have children vaccinated. The other risks are having them vulnerable to exposure to those viruses which may, under extraordinary circumstances, threaten more serious health consequences.

A month ago, a report by Public Health Ontario isolated 56 serious vaccine-related adverse events in 2012 throughout the province in a year when 7.8-million vaccines were dispensed. That represents a rate of 7.2 serious incidents for every million vaccinations, most of them inoculations against the flu.

Ms. Merlin lent her story and her experience with refusing vaccinations to her children in the belief that they were not required, to give moral support to those families whose decisions mirrored hers who may have delayed, avoided or partially immunized their children for reasons similar to her own. Many of those people home-school their children, and are reluctant to speak publicly on their views relating to vaccines for fear of public backlash.

Immunization Action Coalition • Saint Paul, Minnesota • www.vaccineinformation.org • www.immunize.org

www.vaccineinformation.org/catg.d/p4209.pdf •

Item #P4209 (3/14)

Measles: Questions and Answers

Information about the disease and vaccines

Technical content reviewed by the Centers for Disease Control and Prevention

What causes measles?

Measles is caused by a virus.

How does measles spread?

Measles is spread from person to person through

the air by infectious droplets; it is highly contagious.

How long does it take to show signs of measles after

being exposed?

It takes an average of 10–12 days from exposure

to the first symptom, which is usually fever. The

measles rash doesn’t usually appear until approxi-

mately 14 days after exposure, 2–3 days after the

fever begins.

What are the symptoms of measles?

Symptoms include fever, runny nose, cough, loss of

appetite, “pink eye,” and a rash. The rash usually

lasts 5–6 days and begins at the hairline, moves to

the face and upper neck, and proceeds down the

body.

How serious is measles?

Measles can be a serious disease, with 30% of re

ported cases experiencing one or more complica

tions. Death from measles occurs in 2 to 3 per 1,000

reported cases in the United States. Complications

from measles are more common among very young

children (younger than five years) and adults (older

than 20 years).

What are possible complications from measles?

Diarrhea is the most common complication of mea

sles (occurring in 8% of cases), especially in young

children. Ear infections occur in 7% of reported

cases. Pneumonia, occurring in 6% of reported

cases, accounts for 60% of measles-related deaths.

Approximately one out of one thousand cases will

develop acute encephalitis, an inflammation of the

brain. This serious complication can lead to perma

nent brain damage.

Measles during pregnancy increases the risk of pre

mature labor, miscarriage, and low-birth-weight in

fants, although birth defects have not been linked to

measles exposure.

Measles can be especially severe in persons with

compromised immune systems. Measles is more

severe in malnourished children, particularly those

with vitamin A deficiency. In developing countries,

the fatality rate may be as high as 25%.

How is measles diagnosed?

Measles is diagnosed by a combination of the pa

tient’s symptoms and by laboratory tests.

Is there a treatment for measles?

There is no specific treatment for measles. People

with measles need bed rest, fluids, and control of

fever. Patients with complications may need treat

ment specific to their problem.

How long is a person with measles contagious?

Measles is highly contagious and can be transmitted

from four days before the rash becomes visible to

four days after the rash appears.

What should be done if someone is exposed to

measles?

Notification of the exposure should be communi

cated to a doctor. If the person has not been vacci

nated, measles vaccine may prevent disease if given

within 72 hours of exposure. Immune globulin (a

blood product containing antibodies to the measles

virus) may prevent or lessen the severity of measles

if given within six days of exposure.

How common is measles in the United States?

Before the vaccine was licensed in 1963, there were

an estimated 3–4 million cases each year. In the

years following 1963, the number of measles cases

dropped dramatically, with only 1,497 cases in 1983,

the lowest annual total reported up to that time.

By 2004, only 37 cases were reported—a record

low. However, new cases continue to be reported,

primarily in populations that have refused vaccina

tion for religious or personal belief reasons. From

2001 through 2011, an average of 63 measles cases

(range, 37 to 220) and four outbreaks were reported

each year in the United States. Of the 911 cases, a

total of 372 (41%) were imported from outside the

U.S. and an additional 432 (47%) were associated

with importations. Hospitalization was reported for

225 (25%) cases. Two deaths were reported. Most

cases occur among people who declined vaccination

because of a religious, or personal objection.

Can someone get measles more than once?

No.