Olympic bound? Make sure your measles vaccination is up to date!


The end of July is just around the corner and more than a million people from around the world are expected to make their way to London for the 2012 Summer Olympic Games. 

Both the BC Centre for Disease Control (BCCDC) and the Public Health Agency of Canada have issued alerts advising travelers of ongoing measles outbreaks in Europe.  Measles has been on the rise in many regions of the world over the last few years.  In Europe, it had been under control until a 1998 study claimed to show a link between the MMR (measles, mumps, and rubella) vaccine and autism.  Immunization rates declined after this study gained wide-spread publicity. Fortunately this study has now been discredited, and retracted by the British Medical Journal who determined it to be an “elaborate fraud”.  Yet despite this, immunization rates in several European countries are still too low to effectively control measles. This has been highlighted by the European Centre for Disease Prevention and Control’s recent report that over 30 000 people in Europe became infected with measles last year. This year, approximately 3000 cases were reported between January and April. 

Measles is highly contagious and spreads through the air very easily.  People can easily spread the virus while on a plane, train or in a crowded sports venue even before they know they are infected. With travelers from around the world congregating in one place and at one time during the Olympic Games, there is a risk of measles outbreak, both at the Games and in travelers’ home countries, if individuals return home with the virus. According to the BCCDC, an outbreak of almost 800 measles cases in Quebec in 2011 resulted from infected European travelers visiting the area. In 2010, B.C. had an outbreak of about 80 cases following the Winter Olympic Games in Vancouver. 

Are anxious parents putting everyone at risk?

Keep your baby- and everyone else's- safe with vaccination.In 2011, Quebec experienced the worst measles outbreak that North America had seen in 20 years. Measles, which has been rare in North America since the introduction of the measles vaccine in the 1970s, and North America was declared measles-free in 2002. But with immunization rates falling, communities with low immunization coverage are left vulnerable to the re-emergence of preventable diseases including measles, mumps, whooping cough, and others.

Across Canada, the Public Health Agency of Canada estimates that 62% of 2-year-olds are up to date on their recommended immunizations- far below the 95% coverage that public health specialists estimate is required to maintain herd immunity. As we've discussed on this blog, the low rates are due to several factors. One is that young parents aren't as worried about preventable diseases as previous generations of parents, who grew up with frightening outbreaks of disease. Another is that rumours and speculation about the risks of immunization have led people to skip or avoid immunizations; prior to the now-discredited Wakefield study alleging a link between MMR immunizations and autism, the rates of immunization fell drastically. Today, fear of autism caused by vaccines is one of the top reasons parents delay or refuse immunzations, even though no casual relationship has ever been established.

Unvaccinated individuals put others at risk; the LA Times compares refusing immunizations to drunk driving or smoking in restaurants. If education fails, is the next step enforcement? Should parents who refuse to immunize their children be fined (or, as Australia is doing, refused tax benefits?) Should parents who don't immunize their children be allowed to send those children to public schools? For that matter, should unvaccinated adults be allowed to work in schools, hospitals, or anywhere they put others at risk? The LA Times reminds us that "risk perception is ultimately subjective, a combination of the facts and how those facts feel, and sometimes our fears don't match the evidence. The dangers that sometimes arise because of the way we perceive risk must be managed too. But we must act in the face of this threat to public health."

Currently, the individual's right to refuse immunizations out of fear and speculation is overruling the public's need for safety and security, especially for the most vulnerable: the sick, elderly and very young. Is there a better way to reconcile these differences than strict regulation? Can education make a difference?