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Science: Measles Outbreak Traced to Fully Vaccinated Patient for First Time

Firestormm

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5,055
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Cornwall England
Don't Panic!! :)

Measles Outbreak Traced to Fully Vaccinated Patient for First Time
11 April 2014 12:00 pm

Get the measles vaccine, and you won’t get the measles—or give it to anyone else. Right? Well, not always. A person fully vaccinated against measles has contracted the disease and passed it on to others. The startling case study contradicts received wisdom about the vaccine and suggests that a recent swell of measles outbreaks in developed nations could mean more illnesses even among the vaccinated.

When it comes to the measles vaccine, two shots are better than one. Most people in the United States are initially vaccinated against the virus shortly after their first birthday and return for a booster shot as a toddler. Less than 1% of people who get both shots will contract the potentially lethal skin and respiratory infection. And even if a fully vaccinated person does become infected—a rare situation known as “vaccine failure”—they weren’t thought to be contagious.

That’s why a fully vaccinated 22-year-old theater employee in New York City who developed the measles in 2011 was released without hospitalization or quarantine. But like Typhoid Mary, this patient turned out to be unwittingly contagious. Ultimately, she transmitted the measles to four other people, according to a recent report in Clinical Infectious Diseases that tracked symptoms in the 88 people with whom “Measles Mary” interacted while she was sick. Surprisingly, two of the secondary patients had been fully vaccinated. And although the other two had no record of receiving the vaccine, they both showed signs of previous measles exposure that should have conferred immunity.

A closer look at the blood samples taken during her treatment revealed how the immune defenses of Measles Mary broke down. As a first line of defense against the measles and other microbes, humans rely on a natural buttress of IgM antibodies. Like a wooden shield, they offer some protection from microbial assaults but aren’t impenetrable. The vaccine (or a case of the measles) prompts the body to supplement this primary buffer with a stronger armor of IgG antibodies, some of which are able to neutralize the measles virus so it can’t invade cells or spread to other patients. This secondary immune response was presumed to last for decades.

By analyzing her blood, the researchers found that Measles Mary mounted an IgM defense, as if she had never been vaccinated. Her blood also contained a potent arsenal of IgG antibodies, but a closer look revealed that none of these IgG antibodies were actually capable of neutralizing the measles virus. It seemed that her vaccine-given immunity had waned.

Although public health officials have assumed that measles immunity lasts forever, the case of Measles Mary highlights the reality that “the actual duration [of immunity] following infection or vaccination is unclear,” says Jennifer Rosen, who led the investigation as director of epidemiology and surveillance at the New York City Bureau of Immunization. The possibility of waning immunity is particularly worrisome as the virus surfaces in major U.S. hubs like Boston, Seattle, New York, and the Los Angeles area. Rosen doesn’t believe this single case merits a change in vaccination strategy—for example, giving adults booster shots—but she says that more regular surveillance to assess the strength of people’s measles immunity is warranted.

If it turns out that vaccinated people lose their immunity as they get older, that could leave them vulnerable to measles outbreaks seeded by unvaccinated people—which are increasingly common in the United States and other developed countries. Even a vaccine failure rate of 3% to 5% could devastate a high school with a few thousand students, says Robert Jacobson, director of clinical studies for the Mayo Clinic’s Vaccine Research Group in Rochester, Minnesota, who wasn’t involved with the study. Still, he says, “The most important ‘vaccine failure’ with measles happens when people refuse the vaccine in the first place.”

Full link to article:
http://news.sciencemag.org/health/2...ak-traced-fully-vaccinated-patient-first-time
 

justy

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I was fully vaccinated against measles as a child. My 4 children did not receive any vaccines and in 2008, came down with measles, one after the other. I nursed them all, having them one a t a time in my bed, not in the least concerned for them or myself.

I contracted measles - without the rash, although I had Kopeks spots in my mouth. I came down with it approx. 3 months after the first child became ill (they got ill one at a time, rather than all together) I then went on to develop pneumonia and pleurisy and eventually a severe M.E relapse that I am still recovering from, 6 years later.

At least I now know that my children will be immune for life - so glad they had measles rather than the vaccine. But this is something people who don't immunise don't realise. Your kids don't want to get ill with measles later in life, so they HAVE to have it as children, that way they will have lifelong immunity.

My GP seemed surprised that this could happen.

Justy
 

natasa778

Senior Member
Messages
1,774
that way they will have lifelong immunity.

cases of repeated wild measles infections are not unheard of, that is people who have had measles still coming down with the virus later on... I'd be interested in possibility of viral mutations, both wild and vaccine types, and if that has anything to do with lack of immunity in all, or some of these cases.
 

barbc56

Senior Member
Messages
3,657
There are two types of measles.
The rubeola virus causes "red measles," also known as "hard measlesor just "measles." Although most people recover without problems, rubeola can lead to pneumonia or inflammation of the brain (encephalitis).The rubella virus causes "German measles," also known as "three-day measles." This is usually a milder disease than red measles. However, this virus can cause significant birth defects if an infected pregnant woman passes the virus to her unborn child
.http://www.emedicinehealth.com/script/main/mobileart-emh.asp?articlekey=58833&page=1

When I was pregnant for the first time, which was before vaccinations were given for measles, a blood test confirmed I only had rubeola and not rubella measles, when a child. I was teaching younger children at the time, so was concerned about getting measles from one of my students. After I gave birth, I was vaccinated for rubella.

If you don't get vaccinated, you not only risk children developing serious medical complications but you are also potentially exposing unborn children to birth defects.

When it comes to the greater good and you consider the minuscule chances of harm from the vaccine, IMHO, the benefits of getting far outweigh the risks of getting vaccinated for measles.

If you are in a risk group,
A special immunization -- immune globulin -- may be necessary for certain high-risk people after they are exposed to measles. These include children younger than 1 year, children with weakened immune systems, and pregnant women. If you have been exposed to measles, contact your physician to determine if you need immune globulin
http://www.emedicinehealth.com/script/main/mobileart-emh.asp?articlekey=58833&page=10

I have a friend who is allergic to eggs. I think you can get a shot a shot available that doesn't contain eggs but am not positive about that. Anyone know about this?
Barb
 
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taniaaust1

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13,054
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Sth Australia
Im glad to read this as I myself had a bad experience with one of my children re the vaccine which had the measles one in it. Its what turned me anti vaccination and caused me to do heavy researching into this after this experience before deciding never to have another child of mine vaccinated.

Our situation was this.. My child had just had another vaccine of measles (she was a toddler at the time) and she got it from the vaccine!! I took her back to the doctors as she was covered in spots and they were very concerned and thought due to when her reaction happened, she could be contagious due to the vaccine (something one isnt told about till one ends up with a child in this kind of state).

The doctors said that they hadnt seen it do this before. Their concern that she may be infectious.. was so great that they told me I had to inform all the other mothers of the mothers and babies group we'd been to, that she may be infectious. This was a very embarrassing, horrible situation for me to be put into as no doctor had told me if a child broke up with like measles due to the vaccine, that the doctors themselves may panic due to this do this and think your child may then be infectious.

I was quite angry about it actually... as they were always like "no vaccination cant cause issues" as a new mother I'd been concerned about vaccination in the first place but the moment something bad does happen due to a vaccination, those same doctors just then want to like run (will tell you to keep your child home and isolated!) and will tell you they are confused and will say they dont know enough about vaccination when faced with a situation like this.

*Note.. I know now that my child had something wrong with her immune system as she had HPV for many years on her vocal cords which she caught from birth from me and her body couldnt fight this common thing which most peoples bodies fight (she was a 1:25,000 case). So went throu about 16-18 bouts of surgery to remove the growths it causes (before i took her for accupuncture which amazingly finally fixed it). So i suspect due to whatever is wrong with her immune system, may of been what allowed her to catch the measles from the vaccine.

I myself have had vaccines which wouldnt "take" so had them done over and over and I still dont know if it worked in the end as I didnt go back to be tested. Had I not been tested, I wouldnt have known the vaccine wasnt working and would of assume I was protected when I are not due to not producing the antibodies to it. (umm I really should get figured out what the immune issue is in me and my family as maybe that could be used to help the ME/CFS in me and family members).

When they give people vaccines they are assuming those people have normal immune systems.
.......

Then when my second daughter was at preschool and also in after school childcare at the childcare centre (completely unvaccinated as I said I was put off of vaccination after my incident with my first child). There was a so whooping cough outbreak in my country town. They made a big media thing about it and it made states news. This was a con! What was going on was, yes there was a couple of children here who had whooping cough but then my local doctors started diagnosing any child was any kind of cough as having whooping cough without even testing.

My own child got a mild cough and so I took her to the doctors to see if I could get her tested in case it was the start of it, they wouldnt but diagnosed her with whooping cough so adding her to the tally of it in our town and give me meds for it. I refused to give her the meds as her cough didnt sound anything like whooping cough (my sister had had whooping cough as a baby).. my daughters cough was gone in 2 days, it was just an ordinary cough.

But the media was used for a state wide false vaccination campaign using our town as a focus!! it was bullshit..
.................

So my sister (this is my sister who has CFS) with her 3 children.. due to my experiences and my discouragement of it, she didnt get them vaccinated. When her oldest child turned 8 thou, due to pressure at her youngest childs childcare, she finally decided she'd take all 3 kids (aged 8, 6 and 4) to get them the first vaccine.

Crazily not one but all 3 of her children developed issues after the vaccine. One had an asthma attack for the first time so then needed a puffer (neither my sister or her partner has asthma), the other one developed a chest problem, developed croup and needed antibiodics.. the other one developed a rash (I think it was), fever and was crying. Anyway.. all 3 ended up with issues after the vaccination. They were still getting issues from the vaccination for months.

Needless to say my sister is now very strong in her views on vaccination after this and her children wont be getting their 2nd vaccinations. It very upsetting for her to see what the vaccination did to her childrens health.

They were vaccinated a while ago, probably near 2 years ago. Those kids arent right.. Ive been quite worried about them.. vomiting attacks, 2 of them were throwing up xmas day before we'd ate xmas lunch. One of them is always sick ..their health seems to be worsening. We've been trying to work out what is wrong with her kids.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Immunization is not total protection. However, presuming you don't lose the protection, the severity and duration of the illness should be better if you contract it. Also there is an issue of strains. If a new or different strain is involved, one you were not immunized against, the immunization wont work well. This is particularly a problem with influenza.
 

PNR2008

Senior Member
Messages
613
Location
OH USA
I was part of the pandemic 1962-1965 of German measles, my first year of high school. I hated being so sick as a teenager. The two high schools in my town sent home 300-500 kids a day for a week. Even though I had regular measles, mumps and whooping cough as a child, this was no protection from German measles and so many mothers lost their babies or gave birth to ones with birth defects.

I would be vaccinated in a New York minute.
 

Martial

Senior Member
Messages
1,409
Location
Ventura, CA
There was a huge outbreak in Orange County about an hour away from where I reside this past month. Everyone was urged to get vaccinated or to be made sure they were current with shots.

I think I got measles when I was like 7, was bed ridden watching cartoons for a week or two before going back to school lol, got vaccinated after that as well.. If memory serves right. Idk why the bother vaccinating me after though, I am actually shocked how easy the school systems missed certain things in New Jersey where I grew up.
 

justy

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U.K
considering the discussions on other forums about the dangers to PWME of vaccinations, and considering my family history of M/E I am glad I did not have my children vaccinated at a young age for all the many things they now get jabbed for.

We are considering, now they are older having the rubella for my daughter, and the tetanus and polio for both. My eldest two children are now grown up and know the importance of having select vaccines if they wish to travel - it is now their decision.

In terms of developing measles more than once, all the information I have seen shows that having the wild strain of measles confers lifelong immunity. Can anyone post links to any info that says otherwise?

My local health authority were also pushing us to vaccinate AFTER they had had measles, but we refused.

All the best
Justy.
 

anciendaze

Senior Member
Messages
1,841
The idea that ordinary measles (roseola, but not roseola infantum) is mostly harmless comes from people who have survived the disease. In a population without innate or acquired immunity, and with other burdens of infectious disease, the mortality rate is anything but negligible. Here's a paper on the effect of vaccination in Africa on infant mortality. Of those infected 5% died during acute disease, and another 10% died in 9 months following - a total of 15% of those infected and exhibiting symptoms.

This population had some previous exposure to measles. The effect on a totally vulnerable population would be worse. We don't know exactly when measles first entered European populations because early records did not clearly distinguish measles, chickenpox and smallpox. My own personal guess is that an epidemic in the second century Roman Empire marks this point. That killed between 1 in 5 and 1 in 4 (20% t0 25%). This is consistent with much later reports from isolated populations on Pacific islands exposed to measles by contact with Europeans. In neither historical example is the record keeping adequate, because such an epidemic disrupts an entire society.

Studies like the one above show a substantial reduction in mortality as a result of vaccination. Public health records from the 20th century show a dramatic reduction in mortality in connection with measles vaccination. Another factor is better supportive care in hospitals during acute infection. In a full-scale epidemic or pandemic health care systems are overloaded and break down.

My grandparents saw this happen with the "Spanish flu" following WWI. That flu was about as contagious as measles, in a vulnerable population. Hospitals could not hold all the seriously ill, and patients were housed in places like gymnasiums. A similar strain of influenza hit in 1957, and I remember this. We never saw a doctor because they were all overloaded. They would only hospitalize patients who were in immediate danger of dying.

People like me who remember measles epidemics will not be shocked by a case that was transmitted to four other people. It was once typical to have an entire kindergarten or elementary school class shut down because of measles. A single case could commonly infect 20 other people. What I glean from the report above is that the (presumably mutated) vaccine virus was considerably less virulent than known wild-type measles viruses. If you have to be infected you are better off being infected by a weaker strain. Eliminating the vaccine will not eliminate the wild-type virus. Avoiding vaccination will not prevent you from acquiring limited immunity via contagion from others who have been vaccinated with "live virus". That is likely what happened with Justy's children, who later encountered the wild-type virus and fell ill. To prevent this unnoticed contagion you would have to stop everyone from being vaccinated with "live" vaccines, and that takes us back to the situation in the first half of the 20th century, where records show a significant mortality rate due to measles.

The uncomfortable truth is that protection by vaccines is only a statistical fact, not necessarily true in every individual case. The numbers are about as solid as anything in medicine, but your mileage may vary. Without any better information, I'd have to say you are better off taking your chances with the vaccine than the wild-type virus.

What you should do if you somehow know you are one of those most vulnerable is a conundrum.
 

alex3619

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13,810
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Logan, Queensland, Australia
I survived measles encephalitis, another ME. One in four die. One in two get brain damage. One in four seem to be OK. I am still unsure if I was in the OK group, this might be where it all started, at age 7.

Measles is fairly contagious. When I was growing up, if some kids got it then many kids got it. Vaccination is what changed that.
 

lansbergen

Senior Member
Messages
2,512
If you have to be infected you are better off being infected by a weaker strain. Eliminating the vaccine will not eliminate the wild-type virus. Avoiding vaccination will not prevent you from acquiring limited immunity via contagion from others who have been vaccinated with "live virus". That is likely what happened with Justy's children, who later encountered the wild-type virus and fell ill. To prevent this unnoticed contagion you would have to stop everyone from being vaccinated with "live" vaccines, and that takes us back to the situation in the first half of the 20th century, where records show a significant mortality rate due to measles.

The uncomfortable truth is that protection by vaccines is only a statistical fact, not necessarily true in every individual case. The numbers are about as solid as anything in medicine, but your mileage may vary. Without any better information, I'd have to say you are better off taking your chances with the vaccine than the wild-type virus.
.

It is amazing so few people know this.
 

justy

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I am sorry that you choose to use evidence from countries such as Africa to discuss the dangers of measles. I understand entirely that in countries with inadequate sanitation, limited access to clean drinking water where malnutrition is rife and children die just from not being breastfed that vaccinating against Measles is an absolute necessity.

In countries such as the UK, the dangers of childhood illnesses, such as measles, mumps and now even chicken pox have been overplayed. Rates of infection and rates of serious complications from such diseases where in decline in the UK BEFORE vaccination was introduced due to better living conditions and better nutrition, thereby having stronger immune systems.

I take it seriously that my children should be well looked after as they are not vaccinated so that their immune systems grow strong. We had a serious outbreak of measles when my children became ill, which went through the schools etc like wildfire and not one child developed serious complications. However I believe complications can occur in vulnerable groups, including very young children - under one - and older people. One other factor that is not well known is that younger children will be mainly protected if they are being breastfed .

that's all I can manage for now.
got to go, more later
 
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15,786
I am sorry that you choose to use evidence from countries such as Africa to discuss the dangers of measles. I understand entirely that in countries with inadequate sanitation, limited access to clean drinking water where malnutrition is rife and children die just from not being breastfed that vaccinating against Measles is an absolute necessity.
There was an outbreak last year in the Netherlands among religious communities who don't believe in vaccination. Even with medical treatment, one child died - I don't know how many were hospitalized or have long-term issues. In 1999 150 were hospitalized and 3 died.

It is very much still a deadly disease, even with first-rate medical care in a wealthy country.
 

justy

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perspective:
http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733835814

vaccination was introduced in the UK in 1968.

@anciendaze would you mind clarifying this quote? - sorry I don't understand what you mean

.
Avoiding vaccination will not prevent you from acquiring limited immunity via contagion from others who have been vaccinated with "live virus". That is likely what happened with Justy's children, who later encountered the wild-type virus and fell ill.
 

alex3619

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One thing I keep coming back to with vaccines, is that there are different types. Some have nasty preservatives, or potentially dangerous adjuvants. Some induce a Th1 immune shift, most induce a Th2 shift. Th1 shifts are associated with increased health, Th2 shifts are associated with decreased health. Some vaccines use live vaccines, others don't. Not all vaccines are equal, and I think non-live, non-preserved, zero adjuvant vaccines are where it is headed. The vaccine is usually not a problem (though molecular mimicry can be an issue here), but the preservatives, type of vaccine and adjuvant, and type of immune outcome can radically alter their suitability.
 
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anciendaze

Senior Member
Messages
1,841
...

@anciendaze would you mind clarifying this quote? - sorry I don't understand what you mean.
The phenomenon shows up with the Sabin polio vaccine, which is also a "live" vaccine. The active virus in the vaccine can be transmitted from person to person. In the case of polio, this is generally seen as an advantage, because it immunizes children who did not get the vaccine if they associate with children who were vaccinated. There have even been deaths due to association with recently-vaccinated children. In the case I remember the victim was an elderly man who lived on a farm all his life, and had never been exposed to the virus.

In dealing with polio you need to remember that something like 95% of those infected never see a doctor. Most are not even aware they are ill. You could argue that poliomyelitis is not a serious threat to public health, and that the risks of vaccination are not justified. Lawyers for those stricken by passive immunization have tried this without much success.

We don't really know the incidence of this subclinical infection and passive immunization for measles. The wild-type virus is simply too widespread, and too easy to pass directly between humans via aerosols. (Polio is more commonly transmitted via contaminated water. Infected individuals produce enormous numbers of virions in feces.) We do know this process will generally not produce full immunity to wild-type measles.

The most effective measures of hygiene in control of measles were quarantines of infected children. These were quite common in the 1930s. Today, public health officials are less likely to take legal action, depending more on individual doctors. This is because most of the population is immune. In mathematical models of epidemics (called SIR, for Susceptible, Infected, Resistant) this makes an enormous difference in the danger to the public.

Quarantines not only affected those exhibiting symptoms, but also those susceptible who had been in contact with them. If this policy were reintroduced it would mean quarantining all those children nearby who had not been vaccinated or had measles themselves. I think you can understand that this would be viewed as discrimination, even though there really is an argument based on objective evidence. The problem is that it is a model for an entire population using probabilities. It does not directly address individual infection or immune status.

Having been quarantined for rubella (German measles), I can report that this is a serious inconvenience. Had a vaccine been available at the time I might have graduated from college a year or two earlier, without having to withdraw from a prestigious school. Vaccination would have made sense for me.

You may or may not be aware that the argument you are using about hygiene was previously used by George Bernard Shaw. He was primarily opposing vaccination for smallpox. He even disputed the effect of Pasteur's vaccine in the case of rabies. Smallpox is now part of history. Rabies cases are so rare that doctors missed an example in 2012 where the disease was transmitted along with a transplant. Most involved did not even know that acute rabies in humans may not become apparent for up to a year after infection.

There is a lot we still do not know about immune function, but there is no longer any question that quite a number of vaccines do work. Medicine has done a fairly good job of dealing with acute infectious diseases, but even perception of chronic infectious disease remains poor. The long-term effects on immune function of such common practices as prescribing broad-spectrum antibiotics for undetermined bacterial infections is still very unclear. I have seen cases in which the pathogen turned out to be a virus. What the immune system decides to do based on the bad advice it is getting to attack harmless bacteria is anyone's guess. I would not be surprised if it became thoroughly confused, and less effective. This loss of specific immune response is now turning up in many diseases still listed as of unknown etiology.

Vaccination is one way of manipulating immune response, antibiotics are another. We really need to learn what we are doing. In the meantime, I would go with advice on vaccination, if I have to roll the dice. It is not risk-free, but I can't think of anything that is. I think the greatest dangers are those which are not even on the radar as far as the medical profession is concerned.
 

Martial

Senior Member
Messages
1,409
Location
Ventura, CA
Good post Golden! I would definitely always stay up to date on the important shots like Polio though, among others.
One thing I keep coming back to with vaccines, is that there are different types. Some have nasty preservatives, or potentially dangerous adjuvants. Some induce a Th1 immune shift, most induce a Th2 shift. Th1 shifts are associated with increased health, Th1 shifts are associated with decreased health. Some vaccines use live vaccines, others don't. Not all vaccines are equal, and I think non-live, non-preserved, zero adjuvant vaccines are where it is headed. The vaccine is usually not a problem (though molecular mimicry can be an issue here), but the preservatives, type of vaccine and adjuvant, and type of immune outcome can radically alter their suitability.


God, since learning more about health related topics I feel more and more inclined to question certain things I used ttto just do without a second thought... I
The phenomenon shows up with the Sabin polio vaccine, which is also a "live" vaccine. The active virus in the vaccine can be transmitted from person to person. In the case of polio, this is generally seen as an advantage, because it immunizes children who did not get the vaccine if they associate with children who were vaccinated. There have even been deaths due to association with recently-vaccinated children. In the case I remember the victim was an elderly man who lived on a farm all his life, and had never been exposed to the virus.

In dealing with polio you need to remember that something like 95% of those infected never see a doctor. Most are not even aware they are ill. You could argue that poliomyelitis is not a serious threat to public health, and that the risks of vaccination are not justified. Lawyers for those stricken by passive immunization have tried this without much success.

We don't really know the incidence of this subclinical infection and passive immunization for measles. The wild-type virus is simply too widespread, and too easy to pass directly between humans via aerosols. (Polio is more commonly transmitted via contaminated water. Infected individuals produce enormous numbers of virions in feces.) We do know this process will generally not produce full immunity to wild-type measles.

The most effective measures of hygiene in control of measles were quarantines of infected children. These were quite common in the 1930s. Today, public health officials are less likely to take legal action, depending more on individual doctors. This is because most of the population is immune. In mathematical models of epidemics (called SIR, for Susceptible, Infected, Resistant) this makes an enormous difference in the danger to the public.

Quarantines not only affected those exhibiting symptoms, but also those susceptible who had been in contact with them. If this policy were reintroduced it would mean quarantining all those children nearby who had not been vaccinated or had measles themselves. I think you can understand that this would be viewed as discrimination, even though there really is an argument based on objective evidence. The problem is that it is a model for an entire population using probabilities. It does not directly address individual infection or immune status.

Having been quarantined for rubella (German measles), I can report that this is a serious inconvenience. Had a vaccine been available at the time I might have graduated from college a year or two earlier, without having to withdraw from a prestigious school. Vaccination would have made sense for me.

You may or may not be aware that the argument you are using about hygiene was previously used by George Bernard Shaw. He was primarily opposing vaccination for smallpox. He even disputed the effect of Pasteur's vaccine in the case of rabies. Smallpox is now part of history. Rabies cases are so rare that doctors missed an example in 2012 where the disease was transmitted along with a transplant. Most involved did not even know that acute rabies in humans may not become apparent for up to a year after infection.

There is a lot we still do not know about immune function, but there is no longer any question that quite a number of vaccines do work. Medicine has done a fairly good job of dealing with acute infectious diseases, but even perception of chronic infectious disease remains poor. The long-term effects on immune function of such common practices as prescribing broad-spectrum antibiotics for undetermined bacterial infections is still very unclear. I have seen cases in which the pathogen turned out to be a virus. What the immune system decides to do based on the bad advice it is getting to attack harmless bacteria is anyone's guess. I would not be surprised if it became thoroughly confused, and less effective. This loss of specific immune response is now turning up in many diseases still listed as of unknown etiology.

Vaccination is one way of manipulating immune response, antibiotics are another. We really need to learn what we are doing. In the meantime, I would go with advice on vaccination, if I have to roll the dice. It is not risk-free, but I can't think of anything that is. I think the greatest dangers are those which are not even on the radar as far as the medical profession is concerned.

What are the ways that antibiotics manipulate the immune system? This is pretty interesting to me, I never thought there was much to them other then a function as a high anti bacterial but with adverse effects of killing beneficial bacteria and throwing off flora balance, among other things.