Demand for measles vaccines has overwhelmed some pediatricians in California — even the doctor best known for treating anti-vaccine activist Jenny McCarthy’s son.
More than 70 cases of measles in seven states and Mexico have been reported in the outbreak linked to Disneyland, and doctors expect to find more.
State and federal health officials say unvaccinated people are helping spread the sometimes deadly infection. They’ve been urging people to get vaccinated, and people are responding.
“I’ve given more measles, mumps, rubella vaccines in the past 10 days than I gave in the entire 12 months previously, and I can’t make a strong case against giving it,” says Dr. Jay Gordon of Santa Monica, California.
“I’ve given more measles, mumps, rubella vaccines in the past 10 days than I gave in the entire 12 months previously.”
Gordon’s perhaps best known because of his relationship to McCarthy, and because he’s written in favor of letting parents choose not to vaccinate their kids, or to choose the timing of the vaccinations.
Critics say doctors like Gordon enable an ill-informed anti-vaccine movement. “You can fill your practice full of people who want to believe those things. It gives them a lot of attention,” says Dr. Richard Rupp, a pediatrician who helps develop vaccines at the University of Texas Medical Branch.
Gordon denies he’s anti-vaccine and says he’s happy to be vaccinating kids against measles.
“Some of the parents in my practice chose to get that vaccine later than 12 months of age, with my support,” Gordon told NBC News. “And very recently since this outbreak began, I’ve had a lot of people who wanted that vaccine.”
The latest case, according to the Los Angeles Times, is a Santa Monica high school football coach.
California, especially, has pockets of parents who question the need for vaccines. It’s usually affluent, well-educated parents — people who feel comfortable questioning the expertise of their doctors. And Gordon says he feels comfortable accommodating such parents, even against the advice of the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the National Institutes of Health.
Measles has been just about eliminated in the United States by vaccination. Before the vaccine was available, measles infected about 500,000 people in an average year, and it killed around 500 of them. Globally, measles kills more than 145,000 people a year, the World Health Organization says, 400 every day.
The virus is highly contagious and spreads easily through the air. It causes fever and a rash, and of every 1,000 people who get measles, one to two die from pneumonia, encephalitis or other complications.
U.S. vaccine experts say kids should get two doses at 12 months and 15 months.
Public health experts rely on what’s called herd immunity to protect babies too young to be immunized or people with conditions that prevent immunization, and to prevent outbreaks like the current Disney outbreak.
That way, if an infected person happens to visit a public place, there won’t be other vulnerable people to spread the virus to.
Gordon is among a minority of doctors who say it’s OK for some parents to choose not to vaccinate, even as he agrees that vaccination is necessary.
“I really do believe that vaccines work,” he said. “I really do believe that vaccines are not dangerous.”
In 2004, the Institute of Medicine released a report saying a careful review showed that complications from vaccines are rare. Certain vaccines can cause rare and transient effects including seizures, inflammation of the brain, and fainting. The Institute found that the measles-mumps-rubella or MMR vaccine can cause fever-triggered seizures in some people, although rarely with lasting effects.
MMR vaccines also can cause a rare form of brain inflammation in some people with severe immune-system deficiencies; which is why experts say other people should be vaccinated to protect this subgroup of vulnerable patients.
Gordon doesn’t question this. “I have never given an MMR vaccine and have a child develop autism or anything else wrong — ever,” he said.
While some pediatricians refuse to treat families who won’t vaccinate, Gordon says he’d rather work with them. He allows parents to choose the timing of vaccines, for instance, even though vaccine experts say timing can be crucial.
“The timing and spacing of vaccine doses are two of the most important issues in the appropriate use of vaccines,” the CDC says.
Medical practice is complicated and it’s hard to be an expert in multiple fields. That’s why even CDC relies on the advice of expert panels, which include people who have studied the effects of vaccines on the human immune system.
Although parents cringe at the sight of multiple jabs going into a tender baby’s thigh, it really is best to get it over with at once, the CDC says. And there’s no evidence that this in any way strains the baby’s immune system.
“When you are infected with bacteria or a virus you are exposed to hundreds of antigens in that infection,” says Rupp. “With most all of the vaccines, you are just exposed to just one or two.” An antigen is a substance that stimulates the immune system.
Immune system experts note that a newborn child is exposed to many more antigens at birth and in a mother’s breast milk than they ever get in vaccines. Vaccine advocate Dr. Paul Offit of Children’s Hospital of Philadelphia says the average child’s immune system has the capacity to handle up to 100,000 vaccines at once.
“The thing that parents worry about is that their kids are so vulnerable, and they are right.”
And Rupp says it’s a mistake to think that spacing vaccines over a longer time period is a good idea.
“I want my child protected as soon as possible, so when you start spacing the vaccines, it delays how long it takes until that child is protected,” he said.
Infants actually have lousy immune systems, which is why it takes a series of vaccines to protect them, usually at 2 months, 4 months and 6 months. “A lot of parents think the child is protected with the first set of shots,” Rupp said. But that’s not the case.
“The thing that parents worry about is that their kids are so vulnerable, and they are right. The babies are vulnerable,” Rupp said. “They need the vaccines to protect them against the germs. It is because the immune system isn’t that great. The measles vaccine shows that because it doesn’t really work at all if you give it under 6 months of age.”
And giving vaccines at once ensures that the children get vaccinated as soon as possible. It’s easy to fall through the cracks otherwise.