First came the recommendation for administration of
of measles vaccine, the prediction generally being it would last a
(Never mind that a lifetime of measles vaccine use had not and has not
Next came the recommendation that we get a
(According to the textbook "Vaccines"
and the American Academy of Pediatrics
and others, the reason
for the second dose is to catch the 5% or so for whom the vaccine never
worked in the first place [primary vaccine failure], and not because of
waning immunity [secondary vaccine failure]. However, this
position is a puzzling one to take because a) waiting until age 4-6 or
10-12 to give the second dose doesn't make sense in those cases where
the vaccine is thought to have never worked, and 2) there appears
to be enough evidence of
immunity to consider it a genuine risk. Thus an argument can
be made that it was the fact that the prediction for long-term immunity
had been premature, as much as any problems associated with primary
failure of the vaccine, that led to the new recommendation.)
At any rate, we are now vaccinating the approximately 95%, who
allegedly got lifelong immunity immunity from the first dose, a second
time. And at the same time are still being told the vaccine probably
lasts a lifetime.
Meanwhile, predictions about when and if measles
will occur continue to be revised.
So far, so "good". You get two measles shots, you're (extra)
protected for life, even if measles isn't ever eradicated. Worse
case scenario, you get vaccinated again. No problémo.
There are actually serious problémos
with this scenario, however. But first we need to understand a
bit about measles epidemiology, before it will make sense.
When measles and other infectious diseases first hit a "virgin"
population, almost everyone
gets sick. In the case of measles, many infants and adults, for
whom measles can frequently be a serious disease, die, while most
otherwise healthy children, for whom it usually is not, survive.
From that point on, almost everyone who had the measles has life-long
immunity (until fairly recently,
conventional wisdom being that immunity automatically is
lifelong). Mothers go on to pass on immunity
to their infants, protecting them during that dangerous infancy
period. And children grow into adulthood and ordinarily do not
experience it again. (For an interesting, contrary explanation
for the high death rates in "virgin populations", click
Nature has provided a pretty good system, one that usually works
quite well, at least in developed nations, where living
conditions and overall health are generally good.
One of the first signs of trouble was when it was discovered that
moms do not protect their infants the way moms who had the
measles do. To compound the problem, whenever there was maternal
protection, it interfered
with the effectiveness of the measles vaccine. (The disaster in
Africa when trying to deal with maternal antibodies was discussed in an
Now we find that measles may not be able to be eradicated or
controlled on a long-term basis, the biggest impediment possibly being
that it circulates among the vaccinated,
vaccine-induced immunity and causing
or subclinical cases of the disease. All of which means that
if the vaccine is not life-long, we are probably looking at adults
getting the measles, unless they are (repeatedly?) vaccinated.
But what if repeated vaccination is not safe?
And what if re-vaccination does not work? There is clearly
that it may not. Even Dr. Samuel
one of the developers of the measles vaccine, and his coauthors admit
as much in their chapter on measles in the textbook "Vaccines",
when they write, “Boosting of antibody titers appears to be
transient, with several investigators finding decay of antibody levels
to the pre-revaccination level within months to years”.
So instead of a world free of measles with an extra measure of
vaccine protection, we may be looking at infants
and adults getting and dying from the disease. And it would
seem that the only way to avoid such a disaster, given current
knowledge of immunity and the measles, is to get the measles as a
child (when it is usually quite harmless in developed nations), with
repeated exposure to it during one's lifetime.
Just the opposite of what vaccination policy is trying to achieve.
And exactly what Mother Nature was doing in the first place.
Maybe Mother Nature really does, at least sometimes, know best.