Which Is The Bigger Problem – Vaccination Rates Or Disease Response?

Not long after the United States reacted…strongly…to a few cases of Ebola diagnosed within its borders, a measles outbreak has prompted another reaction.  Not the panic and problematic quarantines of last summer, but a debate over the ethics of mandatory vaccination.  That politicians weren’t necessarily backing the same kind of reaction depending on the outbreak added to the weirdness.

I wouldn’t fault you for a little cognitive dissonance.  If you’re not sure what I mean, take a look at this Tweet (H/T News.Mic)

(As far as I know, no countries have started screening arrivals from the United States for measles.)

Two diseases, both lethal, have prompted very different responses.  While there is a very reliable vaccine for only one of those diseases, there are likely other causes involved in determining why the two outbreaks (both ongoing, though the Ebola outbreak is no longer an issue in the U.S.) prompted different responses.  They include:

The source.  While measles has been effectively eliminated in the U.S. since 2000, it’s a much more familiar disease to Americans than Ebola. And while many of the post-2000 measles outbreaks in the U.S. have been sparked by people arriving from overseas, The more familiar something is, the less scary it will seem.  Scariness does not necessarily correlate with relative risk.

The kinds of symptoms.  Ebola is harder to transmit, and more rare, than the measles.  But the measles doesn’t get any uglier than a rash.  Ebola’s symptoms can include bleeding, diarrhea and vomiting.  That’s going to bother the average person a lot more.

Press coverage – scariness can correspond to increased media attention, and vice versa.  As it happens, the current outbreak is not the largest outbreak in the United States in the last 12 months.  But you wouldn’t necessarily know that from the current coverage.  (Yes, the current outbreak is not yet contained, but bear with me.)  Nearly 400 cases last year can be traced to unvaccinated communities in Ohio.

There were over 600 cases in the U.S. for 2014, the largest number in two decades.  That we’ve seen much more attention to one outbreak than we did for all of 2014 further emphasizes how inconsistently we can handle public health matters.

So, while the measles outbreak could have been better contained with a higher vaccination rate, increasing that rate is not the only thing that can help manage public risk and expectations around communicable diseases.  Understanding how they feel and think about these diseases can be useful in addressing their response, and designing policies that can better protect us all in the future.





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