Mihail Kagan Measles Roots Anti-vaccination could push Russia into measles epidemic 03/16/2023, 08:12

During the COVID-19 pandemic, tens of millions of children around the world have been denied life-saving measles vaccines in rich and poor countries alike. Restriction of access to health centers, lack of personal protective equipment for health workers and fear of contracting the coronavirus have caused major disruptions in vaccination programs. As a result, in November 2022, the World Health Organization declared measles “an imminent threat in all parts of the world”.

Measles is rarely seen as a danger in Russia, a misconception that the disease is not as serious as it actually is. In reality, the measles never went away. At a petri dish level, the measles virus, one of the most stable and unchanging infectious agents, looks exactly the same as it did in the pre-vaccination era. Measles is one of the most contagious diseases on the planet. The virus remains active and contagious in the air for up to two hours and can be transmitted from an infected person up to four days before and after the rash appears. The stability of the measles virus is what makes the measles vaccine so effective. Many viruses mutate heavily, such as the flu or covid virus, but this virus is very stable and there is actually only one strain of the measles virus. And although Russia successfully eradicated this disease during the Soviet era, there is no guarantee that it will remain so in the future.

Measles is certainly serious and could return for a long time, and its emergence in Russia this year seems to have started with worker immigrants from Central Asia, where the prevalence of the disease is high. This points to a broader problem: Unvaccinated Russians face an increased risk of infection due to falling vaccination rates in countries surrounding Russia. However, even in our country, fewer children are vaccinated than in the past.

Why are more and more parents refusing to vaccinate their children, thus contributing to the resurgence of a disease that has killed hundreds of people each year in the past? One answer is that contemporary Russia suffers from a dangerous lack of historical memory. Most parents today who skip or delay their child’s measles vaccination have no memories of living with measles. They also do not remember how other diseases eradicated by vaccines, particularly smallpox and polio, cost lives and cause disability. The decline in vaccination rates not only reflects historical amnesia, but also shows the population’s overconfidence in their own unprofessional knowledge. It’s one thing to google cooking information to learn how to cook certain foods. It’s one thing to ignore decades of research on the benefits of vaccines just because you’ve watched a few YouTube videos. Some anti-vaccine activists call themselves “researchers,” making these statements the equivalent of searching the Internet for the work of scientists published in peer-reviewed journals.

Measles is not trivial. This is the most severe of the once common childhood infections. It is highly contagious and difficult to detect in the first days of the illness before the rash appears.

Even the usual course of measles, even in the absence of complications, causes significant suffering to a sick child and his family for 7-10 days. There are no antiviral drugs to treat the disease or its complications. The infection starts in the airways with stuffy nose, sore throat, red eyes and worsening cough. Unlike the common cold, measles worsens over a few days, causing increasingly high temperatures (usually up to 40 degrees Celsius) and putting children to bed with nausea, vomiting, chills and headaches. This stage of the disease, before the onset of the rash, lasts for about four days, during which the infected person releases a large amount of virus into the environment, which explains the high contagiousness of measles. Unlike acute respiratory infections, measles infection spreads beyond the respiratory tract to the skin and other organs through the bloodstream. The measles rash occurs when the child’s immune system catches and attacks viruses in the skin. Any delay in immune activation that can occur in immune disorders prolongs viral infection and increases tissue damage. Hospitalization rates for measles are highest among children under the age of five, ranging from 9% to 25% in Western countries. Complications occur in one in three children with measles. Common complications include middle ear infection (otitis media) in 14% of reported cases, diarrhea with risk of dehydration in 8%, and pneumonia in 9%. Inflammation of the brain or encephalitis with convulsions and coma is the most dangerous complication, occurring in one in a thousand cases. One in three encephalitis survivors now have brain damage.

It should be reminded once again that measles is not insignificant. At best, it will bring a lot of trouble, and at worst, it will endanger life. Parents should be afraid of this. Given the excellent safety and protection record that measles vaccine offers, a reasonable alternative is to ensure that children are fully vaccinated against measles. Parents who do not vaccinate their children are not only putting their own children at risk, but also putting the most vulnerable children at risk. We can eradicate this ancient disease with a highly effective and safe “old” vaccine.

The author expresses his personal opinion, which may not coincide with the editors’ position.