#DoctorsSpeakUp – Say something positive about vaccines on March 5th 2020

Dr. Nicole Baldwin is a US based paediatrician who published a video on Tik Tok in support of vaccination.

As ZDogg MD has confirmed in his own video, Stop Being Afraid of Antivaxxers and Speak Up! (below) Dr. Baldwin’s effort drew a quite predictable response from the anti-vaccine movement. Driven by belief in conspiracy theories, an obscene sense of self-entitlement and complete disregard for the safety and lifestyle of those who support immunisation, their response was reported in MedPage Today;

Members of the “anti-vax” community discovered it and launched a “global, coordinated attack,” posting negative comments across Baldwin’s social media pages including her Facebook and Twitter.

They also went for the jugular: knowing that a physician’s online presence is critical, they barraged her online review sites, including Yelp and Google Reviews, with one-star reviews to sabotage her practice.

Some even called her practice, Northeast Cincinnati Pediatric Associates, and harassed the staff. One woman — whom Baldwin described as “very angry” — threatened to “come and shut down our practice,” prompting Baldwin to call the police.

But most intimidating was a post from an anti-vax Facebook group that said, “dead doctors don’t lie.”

“Ultimately what the anti-vax community wants is to scare us into silence,” she told MedPage Today.

The hypocrisy of these attacks is breathtaking. Certainly for Aussies who must endure the absolutely manufactured fear mongering designed to defame members of Australian Skeptics Inc. and Stop The AVN. This takes the form of ongoing bogus claims by AVN founder Meryl Dorey that members of either group pose a risk of violence and/or disruption at anti-vaccine events that the group holds.

Tickets are advertised on say, Eventbrite, with a qualifying message such as this one;

The exact venue within Logan City, QLD, will be sent to the email address you used to purchase your tickets, at 4:30pm the day of the screening, Tuesday 6th December, 2016.

Or this rubbish that accompanied Vaxxed II ticket sales to screenings at “Secret Venues” in December 2019;

Due to the well-orchestrated threats of violence and abuse that come from the pro-censorship community, the exact venue will not be announced until the day of the screening.

Oh yes. That’s “pro-censorship community” to you, you evidence retentive, violent, abusive so and so.

Apart from these attacks the AVN uses social media and frequently membership emails to push harassment of grieving parents who promote vaccines, journalists, newspapers, media watchdogs and media authorities. For example note the update at the base of last months post.

Back to Dr. Baldwin. In response to the attacks on her online review sites she got in touch with Shots Heard Round The World. Founded by paediatrician Todd Wolynn, MD, it’s described as;

…a network of vaccination advocates who describe themselves as a “rapid-response digital cavalry.”

You can check out Todd’s interview with ZDogg MD, How to fight back when antivaxxers attack. Or if it suits you better head over to Soundcloud and grab the audio there.

According to MedPage Today;

Baldwin said that since she allowed Shots Heard to take over her Facebook account, they’ve been posting positive comments and blocking commenters from her page; a total of 5,000 accounts have been banned as of Monday night, she said.

Shots Heard is also helping to get the fake online reviews taken down, which is never easy, particularly with Google, Wolynn said. But ongoing media coverage likely pressed the tech giant into taking down the reviews, Baldwin said.

So that’s a promising outcome. But more needs to be done to ensure health professionals and others aren’t constant pawns in the games of vaccine conspiracy theorists. On March 5th, as ZDogg makes clear at the end of his video, is an opportunity to get online in numbers and say something positive about vaccines. Use the tag #DoctorsSpeakUp and see if you can offer some material that educates about vaccines, or indeed exposes antivax material for what it is.

We have calculated ongoing lies about the perceived “pro-censorship” enemies of antivaccinationists, the commanding of “flying monkeys” to attack grieving parents and organised en masse attacks on a professional’s online identity along with death threats. To be sure however, whatever fashion it comes in those of us who support vaccination have witnessed the anti-vaccine lobby target individuals in shocking and cruel detail.

Keep an eye on #DoctorsSpeakUp and remember March 5th.

Stop Being Afraid of Antivaxxers & Speak Up!

 

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Measles in Samoa: Thank the anti-vaccination lobby

The manner in which members of the anti-vaccination lobby have leapt upon the measles tragedy in Samoa identifies their awful, predatory cult quite well.

To completely understand why anti-vaccine activists promote such intellectually vicious lies and indeed hatred regarding an epidemic that Samoa has labelled a state of emergency I’d argue we need to first look back. Back to July last year when headlines reported the deaths of two infants following the MMR vaccination. Or rather, what we now know was thought to be MMR vaccine. We need to look back dear reader because antivaccinationists reacted in an “I told ya so” manner that was almost glee.

Despite there never being a recorded death due to vaccination or a vaccine in Australia, anti-vax profiteers who have peddled lies for years contend that death and disability after vaccination not only happens but are widespread. A vaccinologist was quoted in evidence to the No Jab No Pay Bill hearing that in Australian injuries serious enough to require compensation range between zero and five per year. I do apologise for referring to that occasion yet again. I also recommend the government publication Questions About Vaccination.

We must look back because regrettably it was the bogus causation peddled by anti-vax identities that gave them the confidence to begin commenting on this measles outbreak that hit Samoa in October this year (2019). As for facts, genuine health professionals and epidemiologists would be familiar with adulterated, out of date and counterfeit medications and vaccines causing harm in nations with health systems and infrastructure less developed than in New Zealand or Australia. Yet these events occur far less today due to safety procedures instigated across the globe.

Following investigations into the infant deaths in Samoa evidence was collated concluding “a tragic outcome from error preparing MMR vaccine”. The Immunisation Advisory Centre of New Zealand reports;

On 4 June 2019, both nurses pleaded guilty to negligence causing manslaughter. On 2 August, both nurses were sentenced to five years in prison. During the sentencing hearing, it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine. Eight Samoan speaking New Zealand nurses visited Samoa in June to provide training for vaccinating nurses at district hospitals.

The same reference informs us there has never been a death associated with this vaccine in N.Z. It also has a helpful timeline and includes under August 3rd;

Report on RNZ website: The two nurses, who pleaded guilty to negligence causing the manslaughter of two infants, have been sentenced to five years in prison.

The Samoa Observer published a detailed account of the sentencing hearing, where it was confirmed that one of the nurses mixed the MMR vaccine powder with expired muscle relaxant anaesthetic instead of water for injection supplied in a vial with the vaccine.

The entire event effected parent confidence in immunisation. These doubts were magnified by antivaccinationists resulting in a further realisation of their aim: a reduction in vaccination. The Guardian recently reported that the WHO blames the “anti-vaccine scare” for the rise in cases and of course deaths. Kate O’Brien, director of the WHO immunisation department stressed that the rapid spread of measles in Samoa was due to the “very low coverage” of immunisation.

This resulted in the temporary suspension of the country’s immunisation programme and dented parents’ trust in the vaccine, even though it later turned out the deaths were caused by other medicines that were incorrectly administered.

O’Brien said that an anti-vaccine group had been stoking these fears further with a social media campaign, lamenting that “this is now being measured in the lives of children who have died in the course of this outbreak”.

Misinformation about the safety of vaccines, she said, “has had a very remarkable impact on the immunisation programme” in Samoa.

At least 42 fatalities can be attributed to this measles epidemic at time of writing. In the video below anti-vaxxer identity Taylor Winterstein is mentioned as having visited Samoa in June with diehard anti-vaxxer Robert Kennedy Jnr. Winterstein described herself as “pro-science” the narrator tells us. Oh, my.

Please spend some time reading up on this woman who is presently making a living scamming Wellness devotees and the ill out of their money.

Given the harrowing situation in Samoa and the speed at which measles morbidity and mortality is increasing the government has made the measles vaccine compulsory and warned those preventing community members from being vaccinated to stop.

Such as Fritz Alaiasa Neufelt, the oh-so-savvy businessman selling filtered tap water as the measles fighting “Kangen Water”. Lying as he plays with the lives of ill Samoans he claims that after a spray of his magic water;

“They’re feeling good,” he said. “The measles are already … not cured, but it’s already back to normal”.

The ABC recently reported that the “pro-science” Winterstein was a tad concerned about the governments position. No, not the position of vile Fritz spraying measles sufferers like office plants but the government.

In fact her rational, objective, pro-science mind has applied Godwin’s Law. The ABC cite her calm demeanor;

… Australian-Samoan influencer Taylor Winterstein made recent posts on Facebook and Instagram comparing Samoa’s compulsory vaccination program as akin to “Nazi Germany”.

“Forcing a medical procedure on an entire country, especially one that is proving to be ineffective, dangerous and making the virus more deadly, is straight up barbaric,” she wrote on Facebook.

So um, check it out, right. A “pro-science”, so-called “influencer” who peddles herself as a health guru has a tantrum claiming that the only known safe and effective preventative for measles is “proving to be ineffective, dangerous and making the virus more deadly”. And yeah, Nazi Germany. Pfft. Oh I’m influenced Tay. Trust me.

I’d say you can’t make this stuff up but that’s exactly what they do. Consider the increase in cases below and the time frame it covers.

© Source: virologydownunder.com

Data: Samoan Government Facebook and Ministry of Health websites and media comments. Last update 27/11/19

Preparation: Ian M. Mackay, PhD

Immunisation rates were previously far higher in Samoa. Four years ago MMR coverage was 84%. By 2017 it had already dropped to 60%. Last year (2018) it had fallen to 31%.

There is no doubt. A drop in MMR vaccination has brought Samoa to a tragedy of shocking proportions. Two doses of MMR is the recommended, clearly life saving, dose.

But still, Meryl Dorey of The Australian Vaccination Risks Network tweeted this dishonest evidence free nonsense (left) just recently. Just as Winterstein pushes the piffle that the vaccine makes the virus more deadly, Dorey tries to convince her cult that malpractice is the cause.

I would urge Meryl Dorey to have another look above at the facts and follow some of the links. Revisit what is known about these deaths. Understand that it was not the expected MMR vaccine they received before dying.

Accept two nurses are now serving five years in prison for negligence. Know it was a negligent error in preparing the adulterated mixture that led to the deaths, then an eight month suspension of MMR. Admit the facts, admit the reality. Stop your lies.

Stop your negligence.

Fake news and the spreading of measles

“Fake news” isn’t my favourite term for the disinformation spread by antivaccinationists. However it conveys a meaning that is usefully accurate when it comes to labelling deception spread with the aim of misrepresenting the facts about vaccines.

The narrator in the US video below asks the question, “Is fake news making people sick?”. He notes that the country has broken a 25 year old record for measles cases this year. At the time of making the video there were over 700 cases across 22 states since the beginning of 2019. In states where population density is high we can expect to see the impact of vaccine induced immunity and herd immunity (or the lack thereof) in their unmistakably predictable manner.

New York city has had over 400 cases since October 2018. Some – not all – members of the orthodox Hasidic Jewish community have been avoiding vaccines. The narrator tells us this is due to “rampant misinformation around vaccines”, even though the orthodox community “overwhelmingly” believes in vaccines. One woman seems to doubt vaccine safety and efficacy. She argues that “some people question why would I subject my three year old to toxins when it’s not going to protect him or her”.

There is an increase in insular socialising habits in close orthodox communities. This ensures the successful spread of misinformation by The Vaccine Safety Handbook. Packed with the most well constructed vaccine myths, it targets these communities with well debunked anti-vaccine conspiracies, codswallop and even commentary from rabbis, specific to Jewish religious law.

WhatsApp groups have been set up to push anti-vaccine disinformation further, with some orthodox members reporting that their only source of news is via WhatsApp.

If this reminds you of the Somali community in Minnesota in 2017 and 2011, you’re not alone. 80% of reported measles cases in 2017 were of Somali children whose parents had been convinced of the risk between autism and MMR. It was the largest measles outbreak for 30 years.

What’s this got to do with orthodox Jews in New York? Well I mentioned the insular nature of close communities. In an article headed Minnesota’s measles outbreak is what happens when anti-vaxxers target immigrants, it is noted some of these Somali Americans had concerns about higher than average rates of autism amongst their children. This entire episode is indicative of the impact that calculated disinformation can have. Particularly when provided in an area of uncertainty and despite the effort and funding from health experts and government authorities.

In 2008 Somali parents stressed that there appeared to be more 3-4 year old Minnesota Somali children enrolled in the public preschool special education program for Autism Spectrum Disorder, compared to the overall percentage of Somali children enrolled in public schools [page 4].

Also a couple of years before this time MMR vaccine coverage had started to decrease in Minnesota-born Somali children from 2006 at which time rates had been above 90% [Figure 2].

Cultural differences meant that the most genuine efforts to assist the Somali-American community with this issue proved difficult. There is no word in Somali for “autism”. Indeed there is no grey area as one Somali parent put it. Mental health is seen as either “crazy” or “sane”, and this leads to the fear that a child may be called an unhelpful name within the community. A name used behind the parents’ back [page 4].

The Minnesota Department of Health (MDH) worked to re-examine enrollment data for pre-school aged children in the special education program. The results were published in a report which tended to focus on participation rates only. The report [pp 4-5];

…did not attempt to measure the true occurrence of ASD in all children, and it did not attempt to identify possible causes or risk factors for ASD. Instead, the focus was on developing a better understanding of reported differences in program participation rates among preschool-aged children enrolled in this MPS program.

The three main findings in the report confirmed parent’s observations and also raised questions as to better outreach services to Somali children vs genuinely higher levels of ASD, compared to non-Somali children accessing ASD services outside of the MPS. The proportion of Asian and Native American children participating in ASD programs was significantly lower. The cause for this remained elusive. Participation rate differences between Somali pre-school children and pre-school children from other ethnic backgrounds decreased “substantially” over the three years studied. The basis for this final point remained unclear.

Following the 2009 MDH report advocates for the Somali community called for further research. The CDC, NIH and Autism Speaks provided technical assistance and funding to the University of Minnesota. The aim was to focus on ASD in Minnesota and within Somali vs non-Somali communities. The MDH and the University of Minnesota’s Institute on Community Integration added in-kind staff and funding.

Still, we need to remember that it was 2008 when Somali parents first raised their concerns about ASD with the Minnesota Department of Health.

Enter disgraced fraud, data falsifier and ex-gastroenterologist, Andrew Wakefield, who was struck off the U.K.’s General Medical Council 21 years ago and the many-faced Organic Consumers Association. Wakefield targetted and set about convincing Minnesota’s Somali Community that MMR could not be trusted as health authorities claimed. It caused autism he lied. The rumour spread through the community. During the 2017 measles outbreak Wakefield insisted he didn’t feel responsible at all.

In short Wakefield and fellow antivaccinationists spread his anti-vaccine lies with the result that MMR vaccination fell in the Somali community for a number of years. Immigration status can be a risk factor with respect to immunisation status and this fact played very well into the hands of antivaccinationists.

Nonetheless, no vaccines cause autism.

It’s important to remember, and realise, how much damage antivaccinationists can do to public health. Yes, “fake news” is making people sick. Cities with high density and insular communities that are convinced to skip vaccination will constantly face the possibility of outbreaks. The anti-vaccine lobby and their minions will continue to spread misinformation and where possible it must be refuted.

I read a comment recently dismissing the need for any vaccine and contending that only three people had died since 2000. Forgetting that this US citizen is ignoring the rest of the world, it is just such complacency that helps drive the luxurious nonsense that vaccines are more harmful than the diseases they prevent.

Because after all, in the developed world vaccines are a victim of their own success.

 

 

Anti-vaccination campaigners: Misleading and Unsafe

When it comes to public advocacy this year, one of the most effective announcements came in December.

The NSW Health Care Complaints Commission issued a public warning under s94A of the Health Care Complaints Act 1993 with regard to the “misleading and unsafe practices by anti-vaccination campaigners”.

The HCCC had received numerous complaints about individuals and associations and is concerned about the risk they pose to public health and safety.

The anti-vaccination lobby pushes messages which;

have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals.

 

PUBLIC WARNING UNDER S94A OF THE HEALTH CARE COMPLAINTS ACT 1993:  MISLEADING AND UNSAFE PRACTICES BY ANTI-VACCINATION CAMPAIGNERS

The NSW Health Care Complaints Commission (“the Commission”) has received multiple complaints regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Immunisation is a simple, safe and effective way of protecting people against harmful diseases before they come into contact with them. Immunisation protects individuals and the community by reducing the spread of preventable diseases.

Complaints have been received in relation to individuals (including registered and unregistered health practitioners as well as academics) and organisations engaged in the widespread promotion of dangerous anti-vax messages.

Why is this warning being issued?
Misleading and inaccurate information communicated by anti-vax campaigners has the potential to engender fear and alarm in the community and result in fewer people being vaccinated. This information commonly quotes scientific research and studies in support of anti-vax claims, but is often selective, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the true evidence-base on which independent and government bodies worldwide make vaccination recommendations.

This is likely to have a detrimental effect on the health care decisions of individuals and may lead them to make decisions not to vaccinate which pose an avoidable risk to their own health and to the safety of the wider community.

It is unfortunate that anti-vax campaigners are also known to target particularly vulnerable members of the community, including impressionable young parents who are concerned about making the right health decisions for their infants.

The spread of misleading and false information by anti-vax campaigners presents an ongoing challenge for government agencies, particularly due to the rise in use of social media and the proliferation of information concerning vaccinations available via the internet.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach. Some persons and associations will go as far as to distance themselves from “anti-vax” campaigners, while essentially promoting the same message.

What should consumers do to protect themselves?
The Commission strongly urges consumers to exercise caution in relying on information concerning the safety and efficacy of vaccinations which is promoted via social media and websites that are not government affiliated or endorsed. Further, consumers should be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events.

In all cases the following factors should be considered by consumers when presented with any information or advice concerning the safety and efficacy of vaccines and immunisation programs in Australia.To ensure that you are receiving reliable information concerning the safety and efficacy of vaccinations and to assist you in making an informed decision concerning the benefits and risks of particular vaccines, it is recommended that you consult a registered medical practitioner (e.g. your family GP or paediatrician).

Health consumers should be particularly wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccines or immunisation programs in circumstances where they do not hold relevant medical qualifications and are not a registered health practitioner.
Consumers should be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx

Health professionals play a role in health education and administration of vaccines, however it is not appropriate for health professionals to promote anti-vax messages via their personal social media pages or other online forums.  Consumers should avoid placing any reliance on “comments” made via social media that are not from a reliable and trusted source.

When researching online, it is recommended that you visit trusted government websites including the NSW Health and Commonwealth Department of Health websites and also the National Centre for Immunisation Surveillance and Research (NCIRS) website, which provide reliable information concerning immunisation and Immunisation Programs:

https://www.health.nsw.gov.au/immunisation/Pages/default.aspx

https://beta.health.gov.au/health-topics/immunisation

http://www.ncirs.edu.au/

 

The Health Care Complaints Commission (“the Commission”) has issued a public warning under s94A of the Health Care Complaints Act 1993 regarding Misleading and Unsafe Practices by Anti-Vaccination Campaigners.

The Commission is concerned about a number of complaints it continues to receive regarding misleading and unsafe practices by anti-vaccination (“anti-vax”) campaigners and the potential risks that such persons and associations pose to the public health and safety.

Anti-vax messages have the potential to engender fear and alarm in the community, often targeting vulnerable members of the community through misinformation which may have a detrimental effect on the health care decisions of individuals. Anti-vax campaigners will often selectively quote scientific research and studies in support of anti-vax claims, including exaggerating the risks and minimising or discrediting the benefits of vaccines. The research presented does not align with the evidence-base on which independent and government bodies worldwide make recommendations.

Given the continuing efforts of anti-vax campaigners to mislead and misinform members of the public, the Commission considers it necessary to warn all health consumers of the danger of relying
on information that is not from a reliable and trusted source. This can include websites that appear to be “professional” and groups that are well-organised in their approach that often use popular mechanisms like social media to promote their messages.

What should consumers do to protect themselves?

The Commission strongly urges consumers to:

  • Exercise caution when relying on vaccination efficacy information which is promoted via social media and websites that are not government affiliated or endorsed;
  • Be cautious of persons or groups spreading anti-vax messages via other means, including face-to-face information sessions and other public events;
  • Be wary of persons claiming to be “experts” or to have conducted “research” into the safety and efficacy of vaccination programs;
  • Be wary of persons holding themselves out to hold qualifications that cannot be verified. If you wish to ensure that the person providing advice is a registered health practitioner you should check on the National Register of health practitioners – https://www.ahpra.gov.au/Registration/Registers-of-Practitioners.aspx;
  • Consult a registered medical practitioner concerning the benefits and risks of vaccines;
  • Visit trusted government websites when researching online, including the NSW Health and Commonwealth Department of Health websites and the National Centre for Immunisation Surveillance and Research (NCIRS) website.

 

Further Information

For further information, contact the Executive Officer of the Health Care Complaints Commission, on 9219 7444 or send an email to media@hccc.nsw.gov.au.

 

Measles makes a slow start to 2018 in Australia

According to the Australian Government’s Department of Health;

Measles is a highly infectious disease caused by the Morbillivirus. The virus is spread from person to person through droplets in the air. Symptoms take between 10 and 14 days to show after infection and include rash, fever, cough, runny nose and inflammation of the eye. Complications of measles include ear, brain and lung infections, which can lead to brain damage and death. Approximately one child in every 1,000 who contracts measles will develop inflammation of the brain (encephalitis). Immunisation rates of up to 95% are required for the sustained control of vaccine preventable diseases, such as measles.

The description above was last updated on March 20th, 2014. As evidenced in the National Notifiable Diseases Surveillance System table below, 2014 was a frightening year for measles infection. The year’s total of 339 was the highest for 16 years and each of the first three months had higher notifications than any other month of the year. Although June and July notifications were only two and four less, respectively.

Numbers of measles notification per State and Territory are tabulated here.

In fact 2014 saw measles outbreaks across the globe. Australia experienced an influx of cases from Asia, Indonesia and the Philippines which resulted in unvaccinated children in Australia being infected according to the Department of Health. There were over 58,000 cases in the Philippines and 110 deaths, reported in February 2015. The USA experienced an outbreak with a similar cause.

The Disease Daily reported in Outbreaks of 2014;

Over the course of the last year, there have been 610 reported cases of measles across twenty states.  The reemergence of measles can be attributed, in part, to increased international travel where infected travelers have imported the disease into the United States. Particularly for 2014, many measles case clusters were traced back to the large ongoing measles outbreak happening in the Philippines. However, those in the United States who have become infected are generally unvaccinated, often by their own volition.

Further highlighting the role the unvaccinated play in sparking measles epidemics, one notes that the CDC also highlighted the role of unvaccinated Amish communities;

2014: The U.S. experienced 23 measles outbreaks in 2014, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak.

The Public Health Agency of Canada also raised concerns of measles infection and unvaccinated children;

Widespread use of the measles vaccine has dramatically reduced the numbers of cases in Canada over the past 45 years. But the recent outbreak in British Columbia is underscoring how the highly contagious virus can very effectively seek out groups of unprotected children.

With respect to The Netherlands a paper by Woudenberg, et al, entitled Large measles epidemic in the Netherlands, May 2013 to March 2014: changing epidemiology examined two measles epidemics (1999-2000 and 2013-14) that primarily effected orthodox Protestants. In the second epidemic, 27 May 2013 – 12 March 2014, 2,700 cases were reported. Molecular typing of the outbreak strain indicated a sequence indistinguishable from a strain first identified in Wales UK in the second half of 2012: the Taunton sequence.

The first Dutch case was identified with the Taunton sequence in May 2013. By this time 900 identical sequences had been reported from the UK, France, Ireland and the Russian Federation, making a source country difficult to identify. The Netherlands outbreak was indicated as the source of outbreaks in Belgium and Canada and from Canada to the USA. Social ties between orthodox Protestants in the Netherlands and Canada leading to the spread of vaccine-preventable disease such as polio, measles, mumps and rubella to Canada has been previously reported.

Reinforcing the importance of national herd immunity to international control of measles the authors of this study conclude in part;

The number of individuals refraining from vaccination is insufficient to sustain endemic measles transmission in the Netherlands. Nevertheless, this situation does pose a risk to public health in the Netherlands and contributes to the worldwide spread of measles, thus forming an impediment to the elimination of measles in Europe and elsewhere.

Amish communities and orthodox Protestants had a documented impact on reducing measles herd immunity in the USA, and Europe and Canada respectively and this was reflected in the 2014 outbreaks. In Australia whilst small numbers struggle to meet immunisation requirements due to social hardship, the anti-vaccination lobby have for years worked hard to spread disinformation, driving down immunisation rates nationally.

In June 2015 the ABC reported that the “surge” of measles the year before resulted in health authorities calling on Australians to ensure they were up to date with immunisations. If we compare this month’s present number of 4 notifications to the 78 for January 2014 it is clear measles notifications for the first month of this year are just over 5% of January 2014. The figure may rise slightly as further notifications for January reach the NNDSS but at this stage such a low figure is comforting.

Still, there have been warnings specific to measles this year and late last year. Victoria issued a measles health alert (Confirmed measles case in Melbourne) on December 5th 2017. This was a single case acquired overseas and fortunately the national total for December 2017 remains at 2. The alert is now resolved. An identical measles health alert for Melbourne, differing only in where the individual travelled when infectious was issued on January 17th 2018 and remains active.

This was reported in The Age on the same day.

Passengers who flew from Dubai to Melbourne last Thursday have been warned that a fellow passenger has an “extremely infectious” case of the measles.

[…]

Measles has an incubation period of seven to 18 days, so fellow passengers may develop symptoms from Thursday until the end of the month.

As today is the last day of the month this status may change to resolved as of midnight. W.A. Health issued a very similar warning via Twitter on January 11th.

This was reported the same day in Perth Now by Cathy O’Leary.

We have no way of telling what measles notifications will be over the remainder of 2018. September and October last year saw a worrying spike in notifications in Melbourne. However we in Australia can be grateful for No Jab No Pay legislation.

Globally at present measles is proving a problem in developed and developing nations. In the UK the NHS has confirmed well over 100 cases in five regions. The high risk of being unvaccinated and travelling is being stressed to the public. Dr Mary Ramsay, head of immunisation at Public Health England said;

People who have recently travelled, or are planning to travel to Romania, Italy and Germany and have not had two doses of the MMR vaccine are particularly at risk

Countries at risk are evident in this January 12th, 2018 report, Measles in the EU/EEA: current outbreaks, latest data and trends – January 2018. Most cases were unvaccinated or incompletely vaccinated. The report included.

The spread of measles across Europe is due to suboptimal vaccination coverage in many EU/EEA countries: of all measles cases reported during the one-year period 1 December 2016 to 30 November 2017 with known vaccination status, 87% were not vaccinated.

In the first two weeks of January the measles outbreak in the Ukraine has resulted in 1285 cases. Ukraine measles vaccination uptake is regarded as the worst in Europe, being under 50% in recent years according to the Ukraine Health Ministry. It was reported on January 21st that The Acting Health Minister Ulyana Suprun said;

Yesterday it became known about yet another death from measles. This is a child who has not been vaccinated. This is the eighth death case since the start of the outbreak, and this is the tragedy of our society, in which people die from diseases that are prevented by vaccinations […]

In order to achieve the measles elimination goal, the vaccination coverage rates for children targeted by routine vaccination programmes should increase in a number of countries, as the vaccination coverage of the second dose must be at least 95% to interrupt measles circulation and achieve herd immunity.

Presently a tragedy due to neglect, poverty, malnutrition and measles is unfolding in Papua, Indonesia.

AFP reported on January 28th;

Some 800 children have fallen ill and as many as 100 others, mostly toddlers, are feared to have died in what Jakarta called an “extraordinary” outbreak that was first made public this month. […]

When Widodo took office in 2014, he vowed to speed up infrastructure development and services, bolstering hopes for the region, observers said.

“What the government is saying is what we think is important to do (for Papua) is in fact not being done,” said Richard Chauvel, a Papua expert at the University of Melbourne’s Asia Institute. […]

“As measles is easily prevented with a safe and inexpensive vaccine, these deaths should never have happened,” said Freddy Numberi, a former governor of Papua. [He added] that Papua has Indonesia’s lowest life expectancy and highest infant, child and maternal mortality rates.

Without a doubt it is the same pattern across the globe. Measles epidemics will sprout wherever herd immunity is unsuitable. More so it is the unvaccinated who will suffer the consequences of widespread infection, whether in developing or developed nations.

Indeed even with low levels of infection the unvaccinated, with an infection rate of approximately 90%, bear the brunt of infection. Australia’s anti-vaccination lobby has for years pushed fear and disinformation, spreading ignorance and apathy leading directly to low herd immunity and epidemics of vaccine preventable disease.

This has resulted in effective legislative change manifesting as No Jab, No Pay and No Jab, No Play. The policy has been successful in raising vaccination uptake.

According to Immunise Australia;

The disease which requires the highest level of vaccine coverage to achieve herd immunity is measles as it is highly infectious. It is estimated that coverage of 92-94% is required for herd immunity from this virus. For this reason the national aspirational immunisation coverage target has been set at 95%. This target provides sufficient herd immunity to prevent transmission of other vaccine preventable diseases and supports Australia’s contribution to achieving measles elimination in the Western Pacific Region.

Fortunately January 2018 has indicated measles notification the lowest in four years. Whilst measles continues to present challenges around the world, Australia should remain vigilant and ensure we keep ahead of any potential outbreak.