Resurgence of Measles, Pertussis Fueled by Vaccine Refusals

Baby getting a vaccine

Credit: Centers for Disease Control and Prevention

I was born in 1950 and was home-schooled until the 6th grade. Thus, I missed exposure to several childhood illnesses that affected most of my generation. I never gave it much thought until, as a medical resident in North Carolina in 1979, I came down with a potentially life-threatening febrile illness that required hospitalization. Only after four days of 105 degree fever did a rash appear, and the diagnosis was made: measles. That was the sickest I have ever been. It turned out that one of my daughter’s school friends had developed measles in a small outbreak of unvaccinated kids in Chapel Hill, and I had been exposed to her. I was born too early to have been vaccinated.

But for most people born in the United States after the 1960s, they have never had to experience the high fever and rash of the measles or the coughing fits of pertussis, commonly known as whooping cough. That’s because these extremely contagious and potentially life-threatening diseases have been controlled with the use of highly effective vaccines and strong vaccination programs. And yet, the number of Americans sickened with measles and pertussis each year has recently crept back up.

Now, an NIH-funded report confirms that many of the recent outbreaks of these vaccine-preventable diseases have been fueled by refusal by some parents to have their children vaccinated [1]. The findings, published recently in JAMA, come as an important reminder that successful eradication of infectious diseases depends not only on the availability of safe and effective vaccines, but also on effective communication about the vaccines and the diseases they prevent.

In the study, led by Saad Omer of Emory University, Atlanta, researchers searched the medical literature for all reports of measles outbreaks in the United States from January 2000 through November 2015. They did a similar search for pertussis outbreaks since 1977, when cases of this disease reached their lowest point in the U.S.

Omer and his colleagues identified 18 published reports of measles outbreaks, describing more than 1,400 cases in people who ranged in age from 2 weeks to 84 years old. Although vaccination information was lacking for about 29 percent of the people, 804 cases (56.8 percent) were confirmed to be unvaccinated. Only 199 cases (14 percent) involved individuals known to have received a measles-containing vaccine.

The researchers next drilled down to seven studies with the most-detailed vaccination summaries to look for those who were intentionally unvaccinated. They found 574 out of 970 individuals were unvaccinated, despite being old enough to receive the measles-mumps-rubella (MMR) vaccine. Of the 574 people, 405 had filed an exemption for religious or philosophical reasons.

Omer and his colleagues also identified 32 reported pertussis outbreaks, totaling more than 10,000 cases in people whose vaccination status was known. In the five largest statewide epidemics, the data show that a substantial number—at least 1 in 4—of those who became ill were unvaccinated.

Unlike the measles vaccine, the pertussis vaccine can lose some of its effectiveness over time. As a result, some pertussis outbreaks have arisen in places with high vaccination rates. Still, the evidence shows that people who are intentionally unvaccinated have played an important role in many of the recent pertussis outbreaks.

The researchers also noted that the contribution of vaccine refusal to outbreaks of both measles and pertussis often appears greatest early in an epidemic. This trend suggests that vaccine refusers provide “pockets of susceptibility” that can help to trigger an outbreak.

This is an especially important point. Parents have a responsibility not only to their own children, but to their communities—it’s only by achieving a very high level of population immunity that outbreaks can be prevented. Vaccination is particularly crucial for children with cancer and other diseases that cause immunosuppression. They cannot be vaccinated safely, but are at high risk of severe consequences if they are infected—and, thus, they depend on the community’s so-called “herd immunity” for protection against a potentially fatal illness.

While some parents continue to express concern about a possible link between vaccines and autism spectrum disorders, the original report claiming this connection has been debunked and retracted.  A large number of carefully designed follow up studies have been carried out, and the overwhelming weight of scientific evidence shows no evidence for such a link. That’s why it continues to be so important to get the word out to parents: Have your kids vaccinated. The Centers for Disease Control and Prevention (CDC) recommends that all children receive a first dose of the MMR vaccine by 12 to 15 months of age, and a second dose between 4 to 6 years old. [2]. For pertussis, CDC recommends that children receive four doses of the diphtheria, tetanus and pertussis vaccines (DTaP) in the first 1½ years of life and a final dose between 4 and 6 years old [3].


[1] Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States: A Review of Measles and Pertussis. Phadke VK, Bednarczyk RA, Salmon DA, Omer SB. JAMA. 2016 Mar 15;315(11):1149-1158.

[2] Measles (Rubeola), Centers for Disease Control and Prevention, July 1, 2015.

[3] Pertussis (Whooping Cough) Vaccination, Centers for Disease Control and Prevention, February 3, 2016.


Vaccines (National Institute of Allergy and Infectious Diseases/NIAID)

Community Immunity (

Measles (MedlinePlus Medical Encyclopedia)

Pertussis (Whooping Cough) (Centers for Disease Control and Prevention)

Saad Omer (Emory University, Atlanta, GA)

NIH Support: National Institute of Allergy and Infectious Diseases

30 thoughts on “Resurgence of Measles, Pertussis Fueled by Vaccine Refusals

  1. Dear Dr Collins,

    Since my link to an excellent overview site was edited out, here are links to a number of pubmed articles about the toxicity of aluminum and the aluminum adjuvants used in vaccines.

    Aluminum Adjuvant Linked to Gulf War Illness Induces Motor Neuron Death in Mice
    Petrik MS, Wong MC, Tabata RC, Garry RF, Shaw CA. Neuromolecular Med. 2007;9(1):83-100.

    Aluminum Neurotoxicity In Preterm Infants Receiving Intravenous-feeding Solutions
    Bishop NJ1, Morley R, Day JP, Lucas A. N England Journal of Medicine 1997 May 29;336(22):1557-61.

    Effects of Aluminum Ingestion on Spontaneous Motor Activity in Mice
    Golub, M S. Donald, J M. Gershwin, M E. Keen, C L. Neurotoxicology and teratology ; 11(3):231-5

    Lead Poisoning in an Adult: Lead Mobilization by Pregnancy?
    Riess, Matthias L. Halm, Josiah K. Journal of general internal medicine 2007; 22(8):1212-5

    Metabolism and Possible Health Effects of Aluminum
    Ganrot, P O. Environmental health perspectives 1986; 65():363-441

    Slow CCL2-dependent translocation of biopersistent particles from muscle to brain
    Khan Z, Combadière C, Authier FJ, Itier V, Lux F, Exley C, Mahrouf-Yorgov M, Decrouy X, Moretto P, Tillement O, Gherardi RK, Cadusseau J. BMC medicine 2013 Apr 4;11:99.

    Administration of aluminium to neonatal mice in vaccine-relevant amounts is associated with adverse long term neurological outcomes
    Shaw CA, Li Y, Tomljenovic L. Journal of inorganic biochemistry 2013 Nov;128:237-44.

    Aluminum hydroxide injections lead to motor deficits and motor neuron degeneration
    Shaw, Christopher A. Petrik, Michael S. Journal of inorganic biochemistry 2009; 103(11):1555-62

    Aluminum vaccine adjuvants: are they safe?
    Tomljenovic, L. Shaw, C A. Current medicinal chemistry 2011; 18(17):2630-7

    Delivery of nanoparticles to brain metastases of breast cancer using a cellular Trojan horse
    Choi, Mi-Ran. Bardhan, Rizia. Stanton-Maxey, Katie J. Badve, Sunil. Nakshatri, Harikrishna. Stantz, Keith M. Cao, Ning. Halas, Naomi J. Clare, Susan E. Cancer nanotechnology 2012; 3(1-6):47-54

    There is (still) too much aluminium in infant formulas
    Shelle-Ann M Burrell, Christopher Exley BMC Pediatrics 2010, 10:63

    Avoidance of aluminum toxicity in freshwater snails involves intracellular silicon-aluminum biointeraction
    White, Keith N. Ejim, Abraham I. Walton, Rachel C. Brown, Andrew P. Jugdaohsingh, Ravin. Powell, Jonathan J. McCrohan, Catherine R. Environmental science & technology 2008; 42(6):2189-94

    Delivery of nanoparticles to brain metastases of breast cancer using a cellular Trojan horse
    Choi, Mi-Ran. Bardhan, Rizia. Stanton-Maxey, Katie J. Badve, Sunil. Nakshatri, Harikrishna. Stantz, Keith M. Cao, Ning. Halas, Naomi J. Clare, Susan E. Cancer nanotechnology 2012; 3(1-6):47-54

    Macrophagic myofasciitis lesions assess long-term persistence of vaccine-derived aluminum hydroxide in muscle
    Gherardi, R K. Coquet, M. Cherin, P. Belec, L. Moretto, P. Dreyfus, P A. Pellissier, J F. Chariot, P. Authier, F J. Brain : a journal of neurology 2001; 124(Pt 9):1821-31

    Unequivocal identification of intracellular aluminium adjuvant in a monocytic THP-1 cell line
    Mold, Matthew. Eriksson, Håkan. Siesjö, Peter. Darabi, Anna. Shardlow, Emma. Exley, Christopher. Scientific reports 2014; 4():6287

    The interrelationship between silicon and aluminium in the biological effects of aluminium
    Birchall, J D. Ciba Foundation symposium 1992; 169():50-61; discussion 61-8

    Updated aluminum pharmacokinetics following infant exposures through diet and vaccination
    Mitkus, Robert J. King, David B. Hess, Maureen A. Forshee, Richard A. Walderhaug, Mark O. Vaccine 2011; 29(51):9538-43

    Aluminum toxicokinetics regarding infant diet and vaccination
    Keith, L S. Jones, D E. Chou, C H S J. Vaccine 2002; 20 Suppl 3():S13-7

    In vivo absorption of aluminium-containing vaccine adjuvants using 26Al
    Flarend, R E. Hem, S L. White, J L. Elmore, D. Suckow, M A. Rudy, A C. Dandashli, E A. Vaccine ; 15(12-13):1314-8

    Biopersistence and brain translocation of aluminum adjuvants of vaccines
    Gherardi, Romain Kroum. Eidi, Housam. Crépeaux, Guillemette. Authier, François Jerome. Cadusseau, Josette. Frontiers in neurology 2015; 6():4

    Effect of Routine Vaccination on Aluminum and Essential Element Levels in Preterm Infants
    Movsas, Tammy Z. Paneth, Nigel. Rumbeiha, Wilson. Zyskowski, Justin. Gewolb, Ira H. JAMA pediatrics 2013; 167(9):870-2

    Neurotoxic effect of enteral aluminium
    Bilkei-Gorzó, A. Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association 1993; 31(5):357-61

    Behavioral abnormalities in young female mice following administration of aluminum adjuvants and the human papillomavirus (HPV) vaccine Gardasil
    Rotem Inbar, Ronen Weiss, Lucija Tomljenovic, Maria-Teresa Arangoa, Yael Deri, Christopher A. Shawe, Joab Chapmana, Miri Blanka, Yehuda Shoenfelda
    (This paper was withdrawn after an unheard-of second review, to which the authors were given no opportunity to respond. One suspects pharmacuetical influence.)

  2. In recent years problems have been emerging with pertussis vaccination i.e. the apparently defective acellular pertussis vaccine may actually be causing new strains of the disease to develop[1], and spreading the disease via vaccinated individuals.[2]

    The response to the emerging problems with acellular pertussis vaccination has been to recommend ‘boosters’, e.g. in March 2012 A/Professor Ruiting Lan of the University of New South Wales said: “We need to look at changes to the vaccine itself or increase the number of boosters.”[3] (My emphasis.)

    My question is, how does increasing the number of ‘boosters’ of the current acellular pertussis vaccine protect against new strains?

    I forwarded this question to A/Professor Lan, (and also followed up with Professor Lyn Gilbert), in December 2012, see copy of email accessible via this link:

    Neither A/Professor Lan nor Professor Gilbert deigned to respond to my enquiry …

    Questionable repeated revaccination with the apparently defective acellular pertussis vaccine is being foisted upon the community, and parents are being compelled by law in countries such as the United States and Australia to have these multiple revaccinations. This pressure, coercion and manipulation to undergo the medical intervention of vaccination conflicts with the obligation for ‘valid consent’ before the medical intervention of vaccination.

    What is the point of imposing more and more so called ‘boosters’ with an apparently defective acellular pertussis vaccine which may be causing new strains of the disease to develop, and spreading the disease via vaccinated individuals?

    Certainly repeated revaccinations/’boosters’ must be a very lucrative profit centre for vaccine manufacturers.

    I suggest children are being grossly over-vaccinated with the diphtheria, tetanus and acellular pertussis vaccine products, and that their parents are not being properly informed about the uncertainties surrounding this vaccination.

    I question whether it is ethical to:

    (a) not properly inform citizens about the uncertainties surrounding acellular pertussis revaccination, and

    (b) for governments to implement vaccination laws which coerce parents to have their children repeatedly revaccinated with the questionable diphtheria, tetanus and acellular pertussis vaccine products.

    [1] See for example: Sharp rise in cases of new strain of whooping cough. UNSW Australia Newsroom, 21 March 2012; and Octavia, S. et al. Newly Emerging Clones of Bordetella pertussis Carrying prn2 and ptxP3 Alleles Implicated in Australian Pertussis Epidemic in 2008-2010. JID 2012:205 (15 April). Brief Report; and Stacey W Martin et al. Pertactin-Negative Bordetella pertussis Strains: Evidence for a Possible Selective Advantage. Clin Infect Dis. (2015) 60 (2): 223-227. First published online: October 9, 2014; and Safarchi A et al. Pertactin negative Bordetella pertussis demonstrates higher fitness under vaccine selection pressure in a mixed infection model. Vaccine. 2015 Oct 2. pii: S0264-410X(15)01340-7 (Epub ahead of print); and Anna M Acosta et al. Tdap Vaccine Effectiveness in Adolescents During the 2012 Washington State Pertussis Epidemic. Pediatrics April 2015; and Bart MJ et al. Global population structure and evolution of Bordetella pertussis and their relationship with vaccination. MBio. 2014 Apr 22;5(2); and Octavia S et al. Insight into evolution of Bordetella pertussis from comparative genomic analysis: evidence of vaccine-driven selection. Mol Biol Evol. 2011 Jan;28(1):707-15. Epub 2010 Sep 10; and Lam C et al. Selection of emergence of pertussis toxin promoter ptxP3 allele in the evolution of Bordetella pertussis. Infect Genet Evol. 2012 Mar;12(2):492-5. Epub 2012 Jan 24.
    [2] FDA study helps provide an understanding of rising rates of whooping cough and response to vaccination. FDA News Release, 27 November 2013; and Jason M Warfel et al. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model. PNAS, 22 October 2013
    [3] Sharp rise in cases of new strain of whooping cough. UNSW Australia Newsroom, 21 March 2012.

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