January 20, 2015
By Renee Morad, BioSpace.com Breaking News Staff
Disneyland is a place where dreams come true. However, this past December, the Anaheim, Calif., theme park was the epicenter of a measles outbreak that has since reached at least 51 people in four states and one in Mexico.
While the devastation of those affected, including two infants too young for immunizations, casts a shadow on the anti-vaccination movement, it also shines light on more economical ways to get people, particularly in developing countries, protected.
Between Dec. 15 and Dec. 20, 2014, an unvaccinated California woman in her 20s apparently visited Disneyland or the adjacent California Adventure Park while she unknowingly had measles. Since then, there have been 45 cases in California, three in Utah, two in Washington state, one Colorado, and one in Mexico—of a 22-month-old girl.
All of the cases involved people who visited Disneyland or were infected by people who traveled to Disneyland during that timeframe in December. Health officials said the outbreak has become the worst in California in 15 years, in part because it occurred at a major travel destination that draws people from all over the world.
“The recent outbreak of measles in Disneyland is a good example of why it’s important to continue to vaccinate, even if over time the incidence of disease has been significantly reduced. In order for vaccines to be most effective, an estimated 85 percent to 95 percent of the population must be vaccinated,” said Deb Wambold, spokesperson for Merck Vaccines. “Decreasing vaccination rates may contribute to outbreaks of diseases for which vaccines have been developed. For this reason, it’s very important for people to continue receiving recommended vaccinations.”
Why Measles Is So Concerning
In the U.S., measles infections have skyrocketed. There were 644 cases from 27 states reported last year, the highest number since 2000, according to the Centers for Disease Control and Prevention (CDC).
The severity of measles rests on how highly contagious the virus is and how dangerous its complications are. Measles, spread through coughing and sneezing, can live up to two hours on a surface or in an airspace, and if one person has it, 90 percent of the people close to that person who are not immune will also become infected, according to the CDC. Complications of measles include pneumonia, brain damage or deafness. The virus can take up to 12 days to appear.
“There is currently nothing unusual about this outbreak,” said Jason McDonald, spokesperson for the CDC.
The Disneyland cases come months after another outbreak that involved travelers returning from the Philippines.
The Risks Associated with the Anti-Vaccination Movement
The latest measles outbreak demonstrates the harmful consequences that stem from the rising trend of parents opting not to vaccinate their children, due to fears, of which there has been no scientific link, that the MMR vaccine (against measles, mumps and rubella) can increase the chances of developing autism, a febrile seizure or other reactions.
Last year in California alone, parents turned in more than 13,000 “personal beliefs exemptions” notifying the state that their children would be opting out of recommended vaccines.
The MMR vaccine has proven to be 99 percent effective. The vaccine is sold by Merck as M-M-R II, GlaxoSmithKline Biologicals as Priorix, Serum Institute of India as Tresivac and Sanofi Pasteur as Trimovax and is generally administered to children around the age of one year, with a second dose before starting school.
According to a report published by the World Health Organization, the global vaccine market increased from $5 billion in 2000 to nearly $24 billion in 2013. In the third quarter of 2014, Merck, the industry leader for measles immunization, reported combined sales of measles-related vaccines ProQuad, M-M-R II and Varivax reaching $421 million, which was flat compared to third quarter 2013.
A 12-year study of two measles-containing vaccines, published this month in Pediatrics, revealed that seven main adverse outcomes are unlikely after either vaccine.
The study, conducted by the Kaiser Permanente Vaccine Study Center, included children aged 12 to 23 months who received MMRV (measles-mumps-rubella-varicella) or MMR + V vaccines. Both groups showed no increased risk of seven main neurological, blood or immune system disorders.
“This study did not identify any new safety concerns comparing MMRV with MMR +V or after the MMRV or MMR + V vaccine. In fact, there were few or zero events for several outcomes following vaccination,” said lead author Dr. Nicola P. Klein, co-director of the Vaccine Study Center.
“This level of safety monitoring for vaccines can give the public confidence that vaccine surveillance is ongoing and that if a safety problem existed, it would be detected,” Dr. Klein said.
Advancements in Measles Vaccines
While the recent measles outbreak emphasizes the importance of being vaccinated, industry leaders working on advancements in immunizations, particularly geared for developing countries, say the importance of publicizing vaccination is increasingly pertinent.
Robert Sievers, a professor in the University of Colorado Boulder’s Department of Chemistry and Biochemistry, has been working on a new measles vaccine, in dry powder form, that has shown promising results in early clinical trials. The powder requires no painful needle pricks, but a puff of air that is inhaled.
The dry powder vaccine doesn’t require as much refrigeration or control of temperature as other vaccines, eliminates the need for needles, contains lower risk of contamination and provides lower cost for delivery.
“It’s a startling fact that more people continue to be killed by measles than the disease of the day, which is Ebola,” added Sievers. “Around 500 people die each day around the world due to complications from the measles.”
Sievers said the dry powder vaccine targets countries like India, where measles remains a leading cause of death for young children. Particularly in a tropical climate, a dry powder vaccine can be safer and more economical than injectable vaccines.
“A 10-dose vial of dried powder that you add water to for injection is then stored in the refrigerator and needs to be used by the next day. Otherwise it can develop bacterial contamination, like staph,” Sievers said. “There’s also hope that the dry powder concept will be applied to vaccines for other viruses like influenza or Ebola in the future.”
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