False information and fear-mongering promoted in social media has played a big part in the constant rise of infectious disease cases.
Once thought to have been eliminated back in 2000, measles – a rather contagious disease is back again. Several outbreaks of measles have been reported in 2019 in New York, Texas, and Washington State, including overseas and Canada. One of the most significant reasons for this comeback would seem to be false information about vaccines, running rampant through the social media.
Most of the measles cases that have been reported are among unvaccinated individuals, even though a highly-effective vaccine is already available. According to a report from the Centers for Disease Control and Prevention (CDC), a dose of said measles vaccine has an effectiveness of 93% in disease prevention, while two doses of the vaccine have shown a 97% effectiveness in people that were exposed to the measles virus. Even with this degree of effectiveness, the anti-vaxxer debates is running at high speeds.
Alan Melnick, MD, a public health director at Clark Country, Washington said that “there’s a lot of misinformation going on in social media, and some of it looks pretty sophisticated and almost scientific, but it’s really horrible misinformation.”
“We have a disease that can be deadly and is exquisitely contagious, but we have a vaccine that is incredibly safe, effective, and cheap,” he adds. “You will not only protect your children with the vaccine but also everybody else around you, like infants and people with immune suppression who are at risk for complications. So vaccinate not only to protect your kids but to protect the community as well.”
Starting as of February 21st, 2019, the Washington State Department of Health has reported 65 measles cases, and 64 of those were found in Clark County. Dr. Melnick’s calculations showed that 1 in 4 children in this county are not vaccinated.
Unvaccinated travelers help spread the virus
Such measles outbreaks are most commonly linked with travelers that bring the measles virus from their point of origin usually countries where the virus is not rooted out. Therefore, it is the CDC’s suggestion that everyone should get immunized before leaving the country.
“We have a lot of different communities who are unvaccinated; and as long as measles is a car or plane ride away, we have to address vaccine hesitancy,” Melnick says.
For example, the most recent measles outbreak that happened in Vancouver, British Columbia, is thought to have been caused by a family returning from a trip to Southeast Asia.
Emmanuel Bilodeau informed CBC News that his three children most likely caught the virus while they were traveling in Vietnam, spreading at the schools they attended. He told the reporters that the reason why he didn’t vaccinate his children was because he was afraid the vaccines might cause autism, even though there is not a single shred of evidence that supports this claim.
Last year, the CDC reported 372 measles cases in the U.S. During 2019, there have been more than 120 cases across the nation, while some other countries have even worse numbers.
The Philippines reported over 4,300 measles cases from the start of 2019. Europe’s measles cases have increased three times over, from 25,500 in 2017, to approximately 83,000 in 2018, Ukraine having the greatest number recorded – over 54,000. In Japan, the National Institute of Infectious Disease reported an astoundingly large number of measles cases, the greatest in a decade.
There’s more to measles than rashes
An increasing number of people choose to refuse immunization against measles, even though the vaccine is highly effective. According to a study published in the medical journal Pediatrics, the number of pediatricians that reported parents refusing immunization has increased from 74.5% in 2006 to 87% in 2013.
Even though immunization for public school students is mandatory in every U.S. state, it doesn’t help much since all of them allow parents to refuse due to medical, religious, or personal reasons.
The doctors that were surveyed said that parents have been refusing immunization because in their opinion – they’re unnecessary.
William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee, warns that people are unaware of the risks measles bring.
“A mother recently said to me, ‘Gee, measles is just an illness with a rash,’” says Dr. Schaffner. “Some have no idea that before we had a measles vaccine in the United States, hundreds of thousands would fall ill from the disease, and 400 to 500 would die each year.”
A big number of people that contract measles can expect a full recovery. However, the virus can have some very serious consequences like ear infections, that might lead to permanent hearing loss, blindness, and encephalitis, while 1 out of 20 children that contract measles also get pneumonia – a fatal disease.
Anti-Vaxxers fear interference and possible side-effects
Measles outbreaks in some communities have been connected to fear mongering from outsiders, and sometimes even health workers. An example of this is the recent outbreak among Orthodox Jews in New York, traced back to travelers from Israel, where the number of measles cases has been increasing.
“That idea has been debunked a long time ago,” says Melnick. “There is absolutely no connection between the vaccine and autism,” he adds.
A study published in 2015, in the Journal of the American Medical Association, encompassed 95,000 children, and the results showed that MMR vaccines don’t have any connection to autism.
Schaffner suggests that parents shouldn’t trust as much what they read on the internet. “If you search measles and autism, you will be led to a whole array of things on the internet that promote the notion that those two entities are related,” he says. “Sometimes the internet is a very imprecise and misleading source of information, and it fuels the concerns of vaccine-hesitant parents.
Darla Shine, wife of the White House communications chief Bill Shine, joined this debate on Twitter, where on the subject of children health she said, “keep you healthy and fight cancer.”
How does misinformation spread?
A large number of online information is intentionally spread so as to create confusion and promote misinformation as to the benefits and risks of immunization.
The Guardian recently reported that “Facebook search results for groups and pages with information about vaccines were dominated by anti-vaccination propaganda, and that YouTube’s recommendation algorithm steers viewers from fact-based medical information toward anti-vaccine misinformation.”
Another study published in October 2018 in the American Journal of Public Health showed that Russian trolls (defined as “individuals that misrepresent their identities with the intention of promoting discord”), including bots (“accounts that automate content promotion,” according to the study's authors) are greatly responsible for spreading online misinformation in order to elevate the vaccine debate.
David Broniatowski, PhD, the lead author of the study and a research professor at George Washington University’s School of Engineering and Applied Science in Washington, DC, said that “given that we found these troll accounts to be the same as those identified by the [special counsel Robert] Mueller investigation [into the Russian government for] trying to interfere in U.S. elections, the tweets seem to be part of a more general pattern of stirring the pot, spreading discord in U.S. discourse.”
There was another surprising fact, though – the ratio of pro-vaccine and anti-vaccine tweets was almost 50-50.
“There is solid evidence that if you expose people to the idea that there is a debate, that increases their hesitation,” Broniatowski says. “Creating this 50-50 exposure between pro-vaccine and anti-vaccine forces can cause people not to vaccinate or at least delay vaccination. As a result, that exposes us all to the risk of epidemics,” he added.
A cautious degree of optimism for vaccination
Despite the fact that measles cases have been on the rise, and remaining a big public health concern, there might be some light at the end of the tunnel.
The number of people that are being immunized in Clark County in 2019 is increasing with every new week, compared to the last five years. Melnick reports that during the third week of January, 644 children were vaccinated. In comparison, the five-year average for that week was 189. During the fourth week, that number increased to 1,073 immunizations, as opposed to 222, and 1,002 to 219 during week five.
There are also reports of teens and young adults rejecting their families’ anti-vaccination stances and getting vaccines they didn’t receive while they were children.
Even though Washington is still under a state of emergency from measles outbreak, Melnick said that he is “cautiously optimistic that the outbreak is winding down here, but we’re not out of the woods yet. My concern is that when this is over, we’ll go back to complacency and the vaccination numbers will drop again, especially with all the misinformation that is out there on the internet and social media.”
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