Page 34 - RU RWJ Medicine Magazine • Winter 2021

The key to virus eradication is a public health strategy known as ‘herd immunity,’ where the ‘herd’ is a community that is
or all immunizations for their children, present a stubborn public health challenge all their own. “MMR vaccine hesitancy started when an article in the British journal The Lancet linked the vaccine to autism,” says Patricia Whitley-Williams, MD, professor of pediatrics and associate dean for inclusion and diversity.
The article, debunked by experts, was subsequently retracted by the journal—
12 years later. Meanwhile, it had fueled a wave of vaccine resistance that caused a 10 percent drop, to 86 percent, in Great Britain’s measles vaccination rate.
“83 to 95 percent immune to a disease—95 in the case of measles,” says Alan S. Weller, MD, assistant professor of pediatrics and president, American Academy of Pediatrics, New Jersey Chapter.
Not only does vaccination protect the “herd,” but by their sheer numbers, the vaccinated population helps protect all children from the disease. This includes those younger than 12 months, who are the most vulnerable, as well as children who have immune deficiencies or cancer, or who are pre- or post-transplant and cannot be safely vaccinated.
The herd immunity strategy was successful in the United States, where greater than 95 percent immunity was achieved by 2000. Four years later, the percentage hit its highest point; however, with ups and downs, the disease began to reappear, mostly in unvaccinated pockets of population. By 2019, measles
cases rose to a 25-year high, with 1,282 cases reported in 31 states, including New Jersey.
It was the highest number since 1992.
Some cases are inadvertent, such as the Disneyland outbreak in 2015, which spread across the country; or two Los Angeles univer- sity campuses, where hundreds of students and staff had to be quarantined after exposure. However, intentional gaps in immunity, created by parents who resist or refuse some
“Anti-vaxxers moved on to cite concerns about Thimerosal, a preservative formerly used in vaccines,” says Dr. Whitley-Williams. “This was disproven. I find it interesting that these same parents were fully vaccinated as children,” she adds. “But they deny their own children the same access to prevention of vaccine-preventable diseases that they received as a child.”
Vaccine hesitancy or outright refusal morphed into a debate over individual choice, that society continues to observe
during the COVID-19 pandemic. Although universal vaccination is not mandated, all 50 states require up-to-date immunization as a condition of public school enrollment, with some allowing religious, personal, or medical
Measles: By 2019,
measles cases rose
to a 25-year
high, with
1,282 cases
reported in 31states, including New
Jersey. It was the highest number
since 1992.
32 Robert WoodJohnson | MEDICINE