After a Debacle, How California Became a Role Model on Measles

By Emily Oster and Geoffrey Kocks

In December 2014 something unusual happened at Disneyland. People came to visit Mickey Mouse, and some of them left with measles. At least 159 people contracted the disease during an outbreak lasting several months. This is more than the typical number in a whole year in the United States.

The leading theory is that measles was introduced in Disneyland by a foreign tourist. That could happen anywhere. Medical experts generally agree that the fact that it took off was probably a result of California’s low vaccination rates, which in turn was a result of an inability to persuade a significant share of Californians that vaccines were important.

The episode made national news, but in the next few years, another development was striking but attracted less national attention: Because of a policy change, California was able to turn it around. Data from a county-by county analysis shows that in many schools with the lowest vaccination rates, there was an increase of 20 to 30 percentage points in the share of kindergartners vaccinated between 2014 and 2016. One law changed the behavior of impassioned resisters more effectively than a thousand public service announcements might have.

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  1. Peddlers of pseudoscience should be publicly shamed and ridiculed especially when it comes to such dangerous conspiratorial beliefs as the anti-vaxxer movement espouses.

  2. jtveg #1
    Jan 17, 2018 at 8:20 pm

    Peddlers of pseudoscience should be publicly shamed and ridiculed

    Indeed so – with trusting gullibles readily accepting instructions and “medicines” from quacks who disparage real doctors and modern effective medicine!

    Police in Guinea say they have arrested a healer for conning hundreds of women into believing they were pregnant.

    N’na Fanta Camara gave women who had been unable to conceive a mixture of leaves, herbs and other medicines that caused them to bloat and look pregnant.

    For her services, patients paid $33 (£24), in a country where the average monthly wage is around $48 (£35).

    Police believe Ms Camara made thousands of dollars a month, though she says she was only trying to help.

    On Tuesday, more than 200 women protested outside the police station in the Guinean capital of Conakry where Ms Camara was held.

    Over 700 women aged 17 to 45 are believed to have been affected by Ms Camara’s pregnancy “cure”.

    “It’s been a year now since we first went to see this woman,” one of the protesters told the BBC’s Alhassan Sillah in Conakry.

    “During our first visit, she gave us some medicines of leaves and herbs that made us vomit. She assured us that this was good for us. As one continues to take these medicines, the stomach starts to rise a bit.

    “After a while, we visited again, she examined us by just touching our bellies and she declared us pregnant.”

    The women added that Ms Camara told them not to go to a doctor, and once she declared them pregnant, they were expected to give her a chicken and fabrics in thanks.

    Some of the women reported looking pregnant for 12 to 16 months.

    A police doctor has examined 47 of the affected women and said they risked long-term complications from the treatment.

    Ms Camara, however, maintains she didn’t do anything wrong.

    “I work very hard to help [the women] realise their dream but the rest is in the hands of God,” she told reporters in Conakry.

    A court is expected to charge her soon with endangering people’s lives through fraudulent means.

  3. I am pro vaccination and am equally irritated by anti-vaxers. This article was great for proving that measles vaccines work but that fact alone will do little to change the attitudes of the anti brigade who I don’t think ever dispute this fact?

    For a fuller picture I would like to know what were the consequences of having measles for those 159 cases? Did any child die? Were there any long lasting effects? How much suffering did not being vaccinated cause those 159 cases?

    And of course the big one. When will it be possible to prove (or refute-remember we are skeptics) that during the decline and then re introduction of respectable vaccination rates, there was no change in the incidence of autism?

  4. Lord Skeptic #3
    Jan 18, 2018 at 11:26 am

    When will it be possible to prove (or refute-remember we are skeptics) that during the decline and then re introduction of respectable vaccination rates, there was no change in the incidence of autism?

    There never was any case or evidence that vaccines caused autism in the first place!

    There was only a flawed, dishonest study, by a rogue doctor disparaging MMR vaccines because he had a financial interest in rival single vaccines!

    He was struck off the medical register by the doctors’ professional body, and barred in the UK, for falsifying his investigation and his fraud, – but was welcomed by the charlatan quacks of America, and has being making profitable US lecture tours promoting his conspiracy theories ever since!

    Andrew Jeremy Wakefield (born 1957)[1][2] is a British former gastroenterologist and medical researcher who was struck off the UK medical register for his fraudulent 1998 research paper and other misconduct in support of the now-discredited claim that there was a link between the administration of the measles, mumps and rubella (MMR) vaccine, and the appearance of autism and bowel disease.

    On 28 January 2010, a five-member statutory tribunal of the GMC found three dozen charges proved, including four counts of dishonesty and 12 counts involving the abuse of developmentally challenged children.[14]
    The panel ruled that Wakefield had “failed in his duties as a responsible consultant”, acted both against the interests of his patients, and “dishonestly and irresponsibly” in his published research.[15][16][17]
    The Lancet fully retracted the 1998 publication on the basis of the GMC’s findings, noting that elements of the manuscript had been falsified.

  5. Yup I’m very aware of those facts. All I’m saying is that when it can be shown that absolutely nothing changed during this quite interesting ‘experiment’ it just further substantiates the lack of credible causality.

  6. There is a 0.3% chance of death per measles case. So there was a fifty fifty chance someone died from the 159 needless cases. There was certainly a good chance of a lot of suffering and possibly a few severe cases with complications.

  7. Lord Skeptic #5
    Jan 18, 2018 at 11:57 am

    Yup I’m very aware of those facts.
    All I’m saying is that when it can be shown that absolutely nothing changed during this quite interesting ‘experiment’ it just further substantiates the lack of credible causality

    Other doctor researchers already tried to repeat his experiments – which was how the fraud was initially discovered – and then investigated further.

    Professional researchers really do have better thibgs to do with their time and resources, than carry out “refutations” of every false claim made by any crook who wants to start a con. – or set about “disproving” some groundless assertions made by the unqualified ignorant! The matter was settled years ago as far as the medical experts are concerned!

    The UK doctors’ disciplinary panel, thoroughly investigated, and the Lancet medical journal, withdrew and disowned the original article when they discovered the fraud.
    The fact that the charlatan fraudster is unrepentant and is still profiting from his deceptions, is simply a property of the disreputable American media reporting – which sells stories to the gullible, and pays rogues, regardless of facts or truth!!
    Many crooks continue to deny their guilt after conviction! – Nothing new there!


    Thirty-five people have died in the past year from measles outbreaks across Europe, the World Health Organization has warned.

    It described the deaths – which can be prevented with vaccination – as an “unacceptable tragedy”.

    The elimination of measles has been achieved in the UK for the first time, the World Health Organization says.

    The global health body classes a country as having eliminated the disease when it has stopped it freely circulating for at least three years.

    While there are still small clusters, many of these are brought in from abroad and they are not spreading.

    But health experts said there should be no complacency, warning there were several large outbreaks across Europe.

    The news comes just a week after it was announced England had achieved the target of getting 95% of children to have had the first dose of the measles, mumps and rubella vaccine by their fifth birthday.
    Wales, Scotland and Northern Ireland were already achieving it.

    That figure is considered important because it ensures herd immunity, meaning the disease cannot spread because of the high level of vaccination rates.

    MMR vaccination rates dipped after a panic caused by discredited former doctor Andrew Wakefield, who falsely claimed in the late 1990s that the jab caused autism.

    Before that the UK was on track to achieve measles elimination.

    People travelling to Europe over the festive period have been advised to make sure they are up to date with vaccines due to a measles outbreak.

    Public Health Wales (PHW) said Romania, Italy, Germany and Greece had the highest rates of the virus this year.

    Outbreaks of measles have been confirmed in five areas of England and now total more than 120 cases.

    Public Health England says the cases in West Yorkshire, Cheshire and Liverpool, West Midlands, Surrey and Greater Manchester are linked to ongoing large outbreaks in Europe.

    Some people just don’t listen to expert advice – or listen to idiot quacks, – and then cause problems for everyone!

  9. Meanwhile another group of religion-affiliated, pseudo-science conspiracy theorists, are obstructing the elimination of Polio!

    Gunmen in Pakistan have shot dead a mother and daughter who were administering polio vaccinations in the south-western city of Quetta.

    Sakina Bibi, 38, and her daughter, Rizwana, 16, had been giving drops to children when two gunmen on a motorcycle opened fire, police said.

    No group has said it was behind the attack.

    However, Islamist militants oppose vaccination, saying it is a Western conspiracy to sterilise Muslims.

    Police said that the vaccination team had not been given security as in the past the police presence had drawn attention to their work.

    Police official Naseebullah Khan said the women had been part of a major immunisation campaign in Balochistan province, of which Quetta is the capital.

    Balochistan chief minister Mir Abdul Qudus Bizenjo condemned the shooting as an act of “cowardice and terrorism”.

    “An attack on those working to serve the people is an attack on humanity,” he added.

    Scores of people have been killed in recent years in militant attacks on polio immunisation campaigns.

    In January 2015 a suicide bombing in Quetta killed 15 people outside a vaccination centre in Quetta.
    The Pakistani Taliban and another militant group, Jundullah, claimed to have been behind that attack.

    Pakistan is one of only three countries in the world, along with Nigeria and Afghanistan, that have failed to prevent the transmission of polio, according to the World Health Organization.

    Now let me think! What do those three countries have in common?

  10. There is a 0.3% chance of death per measles case. So there was a fifty fifty chance someone died from the 159 needless cases. There was certainly a good chance of a lot of suffering and possibly a few severe cases with complications.

    Thanks Phil Rimmer. That gives some perspective. Certainly not a statistical risk I’d want to take with my child

  11. Meanwhile there are serious risks to populations which have not vaccinated up to levels achieving herd immunity!

    Brazil’s south-eastern state of Minas Gerais has declared a public health emergency following a deadly outbreak of yellow fever.

    At least 15 people have died there since December. Many areas, including the state capital Belo Horizonte, have been affected.

    A mass vaccination programme is in place in three southern states.

    But queues have formed outside clinics in Rio and Sao Paulo amid concerns that vaccines could run out.

    In neighbouring Argentina, there have also been long queues for the vaccine in Buenos Aires and other cities as thousands of prospective tourists prepare to travel to Brazil for carnival.

    On Tuesday the WHO recommended that travellers to Sao Paulo state get a yellow fever vaccine before visiting.

    Minas Gerais has been the hardest-hit Brazilian state. In the year up to June last year, 475 cases were confirmed in the state and 162 people died.

    The health emergency will be in place for six months and will allow local authorities to commission special services and buy in emergency materials.

    Last minute panics are no substitute for forward planning!
    Vaccines cannot be instantly conjured out of thin air!
    Culturing them and production and distribution, takes time!

  12. phil rimmer #6
    Jan 18, 2018 at 12:19 pm

    There is a 0.3% chance of death per measles case.
    So there was a fifty fifty chance someone died from the 159 needless cases.
    There was certainly a good chance of a lot of suffering
    and possibly a few severe cases with complications.

    Yep! Those anti-vaxxer ignoramuses’ fantasies, are still causing real problems in the real world!

    Europe has seen a massive surge in measles cases in 2017, which the World Health Organization says is a tragedy after a record low of 5,273 cases in 2016.

    Cases increased by 400%, with more than 20,000 people affected and 35 deaths.

    Fifteen European region countries, including the UK, had large outbreaks. Measles cases were highest in Romania, Italy and Ukraine.

    People shunning vaccination is part of the problem, say experts.

    Although research published in 2004 about a possible link between the MMR vaccine and autism has been discredited, the scare it created damaged some people’s trust of the vaccine.

    Measles is a highly infectious viral illness that can be deadly.

    The MMR vaccine can prevent it.

    The WHO says there have been declines in overall routine immunisation coverage, as well as consistently low coverage among some marginalised groups and interruptions in vaccine supply or underperforming disease surveillance systems.

    Dr Zsuzsanna Jakab, from the WHO, said: “Every new person affected by measles in Europe reminds us that unvaccinated children and adults, regardless of where they live, remain at risk of catching the disease and spreading it to others who may not be able to get vaccinated.

    “This short-term setback cannot deter us from our commitment to be the generation that frees our children from these diseases once and for all.”

    The UK saw 282 cases in 2017, linked to the continuing outbreak in Europe.

    The UK recently achieved WHO measles elimination status, meaning that for the past few years the number of cases has been low enough to stop the disease circulating around the country.

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