Herd immunity benefits each and every one of us
It is ironic that four years ago in March of 2020 we were closing down our country due to COVID19. The measles outbreak so far has been sporadic and in clusters; fortunately, we already have a proven, effective vaccine for it. For those who will wisely avail themselves and their families of the vaccine, everyone — including anti-vaxxers — will benefit due to herd immunity. This protection also extends to those individuals who cannot take a vaccine due to age (newborns) or health reasons. Even some businesses and services may have to lockdown if herd immunity is not achieved.
“Always serious, often fatal.” Such were the words uttered in 1861 by Union Army surgeon J.J. Woodward as 4,000 troops were felled by an outbreak of measles. The decades between 1912 and 1958 saw large outbreaks numbering in the tens to hundreds of thousands. Unfortunately, the common denominator was that there was no measles vaccine.
Once an effective vaccine was licensed in 1963, with later improvements as the years progressed, measles could be controlled and virtually eliminated. However, and it still stands today, there were and are many people and sectors who do not seek its protection. Reasons may be cultural, religious or more frequently, mixed messages from social media. These are a few of the reasons why and how measles, and other viruses, can find a niche in a population, large or small, and cause extreme discomfort or even death.
Former U.S. Surgeon General C. Everett Koop once said, “pills don’t work in people who don’t take them.” The same goes for people who do not get vaccinated. Why and what causes people to decide not to get themselves or their children vaccinated? How do people rationalize and respond when they are encouraged to receive a measles vaccination and are otherwise disease free?
This phenomenon falls into what we in public health and other medical sectors call the Health Belief Model (HBM). The Health Belief Model uses a series of social constructs that help explain and predict how people will adopt health behaviors, particularly in matters of initial adoption, compliance and adherence. This is where the Health Belief Model really plays out into several distinct steps. The first is called Perceived Susceptibility or the likelihood of contracting the disease. It goes against one’s natural tendency to get treated for a disease they do not have and have convinced themselves they are not going to get. So, do I get the vaccine or not? Another is Perceived Benefits and is among one of the important set of decisions to be made. How sick will I get if I come into contact with the measles virus? Maybe I’ll escape it or only have a mild case. Financial conditions come into play and may cause the individual to consider cost, accessibility or the possibility of erroneous information that would result in unnecessary treatment and costs.
Thus, the final part of the model, Cues to Action, falls upon not the individual, but to the healthcare professionals to provide sound educational campaigns, community awareness and stakeholder/business and political leaders support. Having a keen understanding of these steps, an effective pro-vaccination program can address these various concerns and help the medical providers write the “measles message” to best answer and minimize the hesitant vaxxer’s fears. Studies have shown most people will seek the opinion of a medical professional when trying to decide a health care action.
Since 1963 we have had an effective measles vaccine. Let’s not go back to the days where children’s health and life are unnecessarily at risk.