Lock them up

Last night, the heated debate on vaccination reached a boiling point.

On March 26, 2019, in Rockland County, NY, unvaccinated children were barred from public places. Not only schools.  Restaurants, supermarkets, worship places. They’re practically on house arrest. What about doctor’s offices and the ER? I don’t know.

This is unprecedented.

Rockland County is a 300K strong suburb of New York City. Almost a third are Jewish, many Orthodox. The anti-vax movement found a sweet home here. Less than 73% of the kids under 18 are vaccinated. That\’s the end of herd immunity.

Herd immunity is a form of community immunity that occurs when enough of the population is vaccinated. It’s essential for the protection of those who can’t tolerate immunization. For measles, which is highly contagious, the HIT, heard immunity threshold is 92-95%. At 73%, there is no herd immunity.

Measles was declared extinct in the US in 2000. Eighteen years ago. The lack of horrific deaths helped perpetuate a laissez-faire attitude towards immunization. It boosted the anti-vax movement, allowing more and more Internet educated parents to forgo immunizing their kids with impunity. The anti-vax movement spread like a forest fire.

Measles is now doing the same.

The New York Times: “Measles was proclaimed eliminated in the United States in 2000, but a handful of outbreaks have spread in recent years. There have been 314 confirmed measles cases in the United States in 2019, as of March 21… In addition to New York, there have been recent measles outbreaks…in Washington State, Texas, Illinois and California. Rockland County, with a population of more than 300,000, has had 153 confirmed cases of measles since October. Of those, 48 have occurred in 2019.”

CDC: “Measles is among the most contagious of the infectious diseases. The virus can live for up to two hours in the airspace where an infected person has breathed, coughed or sneezed, and up to 90 percent of nonimmunized people who are exposed to the virus will also become infected. The M.M.R. vaccine, when given in two doses, is about 97 percent effective against measles.”

Got that? If an infected person sneezed an hour ago on the apples you’re looking at, you have a 90% chance of getting it. Same with your kid! Unless you’re immunized!

Those who get measles may suffer from severe complications, such as pneumonia and encephalitis. They may need to be hospitalized. Some will die. As per CDC:

• As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
• About one child out of every 1,000 who get measles will develop encephalitis. That can lead to convulsions and can leave the child deaf or with intellectual disability.
• For every 1,000 children who get measles, one or two will die from it.
• Measles may cause a pregnant woman to give birth prematurely, or have a low-birth-weight baby.

Does vaccination work? Yes, it does. Still, nothing in life is 100% certain. Except death. As per CDC, the confirmed cases of measles in Rockland County had the following vaccination rates:

• 82.1% had 0 MMRs: That means NONE! No vaccinations. Zero! 
• 4% had 1 MMR
• 4% had 2 MMRs
• 9% unknown

As for Jenny McCarthy, the  sweetheart of the antivaxx movement – this is what her pediatrician, the one who supported the insanity, tweeted recently: “If you are living in the midst of a measles outbreak and you have an older unvaccinated child to whom you have been reluctant to give the MMR, now\’s the time. There are personal AND public health considerations.”

Let’s say you didn\’t vaccinate, and your kid got measles. It was rough, but now he’s looking good. You’re proud of yourself. You feel superior to those who vaccinated their kids.  You’re golden.

Not so much, sparky.

Subacute sclerosing panencephalitis (SSPE) is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. SSPE generally develops 7 to 10 years after a person has measles, even though the person seems to have fully recovered from the illness. There is no cure.

Seven to ten years. That’s a long time to watch.

On Tuesday, in an unprecedented step, the Rockland County executive, Ed Day, declared a state of emergency, effective at midnight, that bars children and teenagers who are not vaccinated against measles, from public places. He said: “we do not plan on “chasing people down” and asking for proof that they are vaccinated. The prohibition will be enforced retroactively, with parents facing up to six months in jail or a fine of up to $500, or both, if they are found to have allowed unvaccinated children in public spaces.”

As per The New York Times, reactions have been mixed. Rabbi Yakov Horowitz, the dean of a community at the center of Rockland County’s measles outbreak supports vaccinations, but he is worried that the county’s declaration might lead to potential harassment, attacks, and discrimination against ultra-Orthodox Jews.

Some public health experts expressed concern that the county’s order infringes on civil liberties. Lawrence O. Gostin, professor of global health law at Georgetown University, found Rockland County’s emergency order problematic. “This is virtually imprisonment of a child, and certainly significantly restricting the child’s liberty.”

Is this a good idea? Should we practically imprison these children who have done nothing wrong and have no say as to choosing to be vaccinated or not? Does the government have a right to restrict their freedom?

I say YES.

First, it’s for their own sake. Measles is nasty. It’s dangerous. It can kill. If they stay home, they\’re less likely to ever catch it.

But of course I wouldn’t restrict them just for that. If their parents are willing to take the risks, I, as a libertarian, would allow them to do so. If they die, they die. You, Internet educated parents, should know better. It’s Darwin at work.

But there are all the others.

The other kids. The ones who can’t get vaccinated – they’re too young, they’re allergic, they’re immunocompromised. They depend on herd immunity. They need to be sheltered.

The pregnant women.

The immunocompromised: Cancer patients. Transplant patients. Patients with autoimmune diseases. It may be your grandma, your aunt, your neighbor.

They should stay home, you say? But they have to live. They have to eat. They have to shop. They don’t know you’re not immunized, and that elevator you just sneezed in has become an execution chamber.  They don’t know you’re a ticking bomb. You do.

So yes.  Lock them up, I say.

They’re a danger to society, and to people who can’t protect themselves. Their freedom to go out interferes with their neighbor\’s freedom to stay alive.

Lock them up.

Rada Jones, MD is an Emergency Doc in Upstate NY, where she lives with her husband, Steve, and his deaf black cat Paxil. Her thriller, OVERDOSE, is now on Amazon.