SALUD: Dr. Deborah Ann Mulligan Explains The Impact of Measles in the Latino Community
The World Health Organization listed measles vaccinations on its biennially updated Model List of Essential Medicines, and with good reason.
Before widespread vaccinations, measles caused an estimated 2.6 million deaths annually. And in modern times, the resurgence of the highly contagious virus has greatly impacted Latino and low-income communities, particularly the infants in those populations.
Twenty-five years ago, a measles outbreak hammered the Latino population of California. The number of measles cases soared, and Department of Health Service officials cited "poverty, the fear of deportation and ignorance [for] responsible for the failure of many Latinos to seek vaccinations against the disease," according to a piece by LA Times staff writer Joerdan Legon, published May 1990.
Fast-forward to 2015. With the presence of immunizations and measles vaccinations, history isn't likely to repeat itself. Yet, 102 people from 14 states were reported to have contracted measles from Jan. 1 to Jan. 30, 2015, according to the CDC. The ongoing multi-state outbreak can be linked to Disneyland, located in Anaheim, California. This, however, could have been prevented.
"Basically, immunizations are the greatest public health miracle of the 20th century," Dr. Deborah Ann Mulligan, Director of the Institute for Child Health Policy and Clinical Professor of Pediatrics at Nova Southeastern University, said to Latin Post. "Before the advances of immunization, the mortality rate was shockingly high. People with big families, their children, were quickly infected. For that reason, it's truly a miracle that the measles vaccine is 99 percent effective at preventing measles. Without the measles vaccine, and if you're exposed, then you're 90 percent likely to get the measles. I can tell you from personal experience, the measles epidemic that happened in California [during the 1990's] was horrible."
More than 2,200 measles cases were reported in Los Angeles County when that Times article was published, and only six people had reportedly died. But numbers continued to rise, and the Latino community was greatly marked by the disease. According to the same piece, 70 percent of reported cases in Los Angeles were among the Latino population, and most likely children from 12 months to 5 years of age. The resurgence of measles during the early 90's was four to seven times higher among blacks and Hispanics than non-Hispanic whites.
"It's significant to note that Hispanics have the highest uninsured rate of any racial or ethnic group in the U.S., and that's an important route to understanding access to vaccinations. When we had an epidemic in California between '89 and '91, the fight to eradicate measles didn't come without difficulty. There were over 55,000 people who fell ill with the measles, and there were 123 deaths," said Mulligan. "Ninety percent of them had not been vaccinated, and the majority were children. Sadly, during that same period, the infected children were disproportionately Hispanic, low-income and children under the age of five who were not vaccinated.
"There was an essay that said there was a 16 times greater risk [of becoming infected] when you're a Hispanic child, compared to a non-Hispanic white child. In order to protect those beautiful children, a response came from VFC, the Vaccine for Children Program in 1993, which was developed to eliminate the cost of vaccines as a barrier. And that was immediately done to prevent this from ever happening again."
The program provides vaccines at no cost to children who might not otherwise be vaccinated due to an inability to pay. This resulted in recovery throughout the country, and actively eliminated some of the health disparities. Vaccinations among Hispanic children increased from 87 percent in 1995 to over 92 percent in the last year, according to Dr. Mulligan. In some states, like Florida, the vaccination rate for Hispanic children is higher than the rate for non-Hispanic whites. The program proved to effectively reach Latino inner-city youths, including undocumented children.
The CDC issued a health advisory on Jan. 23, at which time the airborne virus had already spread to Arizona, California, Colorado, Illinois, Minnesota, Michigan, Nebraska, New York, Oregon, Pennsylvania, South Dakota, Texas, Utah and Washington. Both children and adult cases of measles were identified, though at least 30 babies have been put into isolation in California in response to the outbreak.
According to Dr. Mulligan, concerns about adverse effects are based in misinformation. In the past, information was published that suggested measles vaccinations were linked to autism. That announcement was immediately refuted, and deemed as "absolute nonsense and had no truth to it." Also, all nations with access to measles vaccinations have high rates of vaccinated individuals, yet some resistance persists in the U.S. Although only 3 percent of the population consider themselves avid "anti-vaxxers," they produce children who interact with other children at school, at the grocery store and in their community.
"When you're going through your normal routine, going on the subways, into cabs and walking on the street, you can easily be exposed in any of those locations, to a terrible illness that's completely preventable," stated Dr. Mulligan. "People do die from the measles, people do get encephalitis and people do get lesions ... and that wouldn't necessarily happen if everyone got vaccinated."
On a person-to-person level, an outbreak could translate to something as light as a rash or lesions, and it can be severe as death. Fevers are the first signifiers, particularly if it lasts numerous days. And that's quickly chased by a cough, runny nose, conjunctivitis, feeling malaised, tiny white spots (Koplik spots), and a spreading rash that crawls the border of one's face, before moving along the rest of the body. The symptoms appear about 14 days after being exposed to a person who may not know they were ill.
According to the CDC, complications include pneumonia, hearing loss, and swelling of the brain. About one or two people out of every 1,000 people infected with the measles will die. Measles claimed 145,000 lives worldwide last year. Children under the age of 12 months are most vulnerable, as well as pregnant women and immunocompromised individuals.
The U.S. Centers for Disease Control and Prevention recommends that children get two vaccine doses: at 12 to 15 months of age and at 4 to 6 years of age. The bottom line is "vaccinate, vaccinate, vaccinate and make sure people in your environment are vaccinated, to reduce the likelihood of children falling ill before they have a chance for vaccination."
This may be easier said than done for families who may be unable to afford the payments, but the CDC offers a number of resources, such as the federally-funded Vaccines for Children program that provides free vaccines to those in need. The CDC also provides information on where you can get the vaccinations and how you can go about paying for them.
Subscribe to Latin Post!
Sign up for our free newsletter for the Latest coverage!