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Measles anywhere is a threat to kids everywhere

Dr. Orin Levine: Vaccinations are a collective responsibility

ABOUT THE AUTHOR: Dr. Orin Levine is the Director of Vaccine Delivery at the Bill & Melinda Gates Foundation. He leads the Gates Foundation's efforts to accelerate the introduction of new vaccines and related technologies to increase access to immunization in poor countries. The views expressed in this piece are those of the author.


What would you wait in line for? A concert ticket, a slice of pizza? How about a vaccine? For many parents around the world, ensuring their kids are protected from debilitating and devastating illnesses requires them to travel long distances and wait — sometimes for many hours — to get their kids immunized. 

As an epidemiologist and the director of the Vaccine Delivery team at the Bill & Melinda Gates Foundation, I see a lot of these parents. On one trip to Nigeria, I met a woman at a remote health clinic. She had walked for miles with her malnourished 17-month-old son to get him a measles vaccine and nutritional supplements. When she finally arrived, she insisted that she would not leave until her son got the measles shot. I waited with her and watched until the boy was successfully immunized, all the while marveling at the act of a mother's love that brought this boy to this clinic.

Last week, Governor Jay Inslee declared a state of emergency in response to a growing measles outbreak in Washington State. There have been 50 measles cases so far — including one in King County where I live with my wife and two teenage daughters. This, along with outbreaks in New York State and cases in eight other states, has had me thinking more about the Nigerian mother I met and the millions more like her. Because unlike measles outbreaks in Nigeria, our homegrown outbreaks in the U.S. aren't caused by lack of access to a vaccine, but because parents in this country are choosing not to get their kids vaccinated.   

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A Nigerian woman who walked for miles with her malnourished son to get him a measles vaccine and nutritional supplements. Dr. Orin Levine

These outbreaks are scary for kids and parents. They're also frustrating because they're entirely preventable. Vaccines are a marvel of modern medicine. They are proven safe and effective. Before the measles vaccine was introduced in the U.S. in 1963, an average of 400,000 cases were reported each year. Because of widespread vaccination in the U.S., those numbers dropped dramatically and, in 2017, there were only 120 cases. But, as more kids go unvaccinated, outbreaks are inevitable. One particularly sobering statistic is that there are 96 countries in the world with higher measles vaccine coverage than the U.S. — many of which are low-income countries. 

Anti-vaccination movement helps measles outbreak spread

Deciding to vaccinate your child is not just an individual choice, it's a collective responsibility. The more vaccinated people there are in a community, the more protection they offer to vulnerable populations — like babies who are too young to get vaccinated or people with weak immune systems. The last person to die of measles in Washington State was a woman with a weakened immune system that would have limited the vaccine's ability to protect her directly. She needed protection from the herd of vaccinated people around her and unfortunately that herd wasn't strong enough.  

When immunization coverage drops, everyone is more vulnerable. In today's interconnected world, it's easy for an international traveler to bring back a disease like measles that can then spread in our communities – the reason for the three current outbreaks in the U.S. That's why outbreaks of infectious diseases anywhere are a threat to us everywhere.  

The good news is we can stop outbreaks.  

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Dr. Orin Levine (center) and a delegation from the Bill & Melinda Gates Foundation traveled to the Tarauni Local Government Area in Nigeria to visit the cold storage facility and see vaccine stock. Courtesy of Gates Foundation

How? First, by following the advice of trusted doctors and experts who spend their careers researching the safety and efficacy of vaccines. As a trained scientist, I can point to countless studies that illustrate how the benefits of vaccination far outweigh the risks. I can give you figures on how over 90 percent of children who get the shot are protected from measles. And I can share facts that show side effects from vaccines — like pain and fever — are exceedingly rare. But, most importantly, I can tell you with certainty that getting a vaccine is the best way to be protected from dangerous, debilitating and potentially deadly diseases

However, we know that facts alone aren't enough to change our minds. If they were, I'd never skip a day at the gym or eat a cheeseburger instead of a salad. Open dialogue with people you trust is key to helping us prevent further outbreaks. Now, more than ever, people need to share their stories about why they vaccinate their children and get vaccinated themselves and listen to the concerns of those who don't. The more we engage each other in a conversation that respects one another's views, the more likely we are to advance the conversation.  

Though the woman I met in Nigeria and the parents I talk to in my own community have different experiences and circumstances, some things are universal. As parents, as community members, as doctors and teachers and caregivers, we all want the same thing: to make sure every child has a shot at a healthy future. We all have an important role to play in making that happen.