Worried About Measles? Don’t Call Dr. Bob Sears

Dr. Bob Sears once wrote a non-evidence-based book about vaccines, urging parents to adopt “Dr. Bob’s Alternative Vaccine Schedule (TM?)” but at the least, to please purchase his book. Thousands of people, presumably terrified at the prospect of protecting their children against debilitating or fatal infectious disease on an evidence-based schedule, purchased the book and, one infers, followed its advice for “alternative” or “selective” schedules.

It’s a gambit that’s been called “cashing in on fear,” and it’s been hugely successful for “Dr. Bob.” Fear sells for Sears. Fear does not care about an evidence base.

When it comes to Dr. Bob, we’re talking about someone who’s willing to do a bit of, er, BOBbing (TM?) and weaving to keep the target that is his brand elusive to criticism. He also, it seems, would like to duck a few phone calls. So much so that he took to Facebook last week to enter a screed against the “^$#@*%*$# media” about the news reports on … yes … another measles outbreak, this one in his home territory of The OC, a.k.a., Orange County (natch). His grousy post, professionally entitled “Measles Epidemic … NOT!”, begins with this pediatrician’s bafflement about why, when there are “a few cases of measles, everyone panics?” Then, he goes on–and here, the reader must imagine wild, impatient gesticulation between keystrokes–

So, why do people panic? Here’s one reason: the ^$#@*%*$# media. News reports go out stating that there are outbreaks of measles, and everyone needs to be concerned. Everyone is quick to blame those who don’t vaccinate, AND those who don’t vaccinate start to panic. We’ve gotten dozens of calls to our office with people wanting to know if they should come in for the vaccine.

English: Histopathology of measles pneumonia. ...

Histopathology of measles pneumonia. Giant cell. Photo credit: Wikipedia

Oh, noes. You mean dozens of worried parents are calling a pediatrician’s office, concerned that perhaps in the midst of an outbreak of one of the most contagious viruses known to humans, one that in the US can hospitalize up to 20% of the people it hits and kill another three in 1000, are calling the doctor’s office about preventive care? Ye gods. What’s next? Calling a pizza restaurant to order pizza?

Possibly not recognizing the irony of his complaints, Dr. Bob continues with his “take on it.” This “take” does not include saying to said unvaccinating parents, according to the recommendations of his profession’s own governing body, “Yes. Get your rear-ends in here and get your children vaccinated.” Warning: Here there be a significant history of absence of evidence, or, as I like to say, absidence (TM?):

EVERY single year in the U.S. we have measles – between 50 and 150 cases. Last year there were two large outbreaks – 58 cases in New York and over 20 in Texas. Both those outbreaks died out. No one has died from measles in the U.S. in over 10 years. So, there is ALWAYS the potential for measles. ALWAYS. If you choose not to do the vaccine, then you just have to accept that fact, and not panic whenever you hear the “M” word. You’ve lived with this risk for years, so why panic just because there are 7 cases in the county you live in? This year there will be more than usual, the way it’s looking so far, but it’s not a reason to panic. Make your choice – do vaccine, or don’t do the vaccine.

Interesting absidence-based advice coming from a pediatrician, someone who’s sworn to do no harm, particularly, one assumes, for the population he trained to serve–the children. Reading the annoyed all caps, the claims that “no has died,” you might think that his words applied to a simple question about “Should little Johnny be allowed to chew gum?” instead of “Should we vaccinate our young children against this disease that could, yanno, see them hospitalized or dead?” And, of course, as always, no concern expressed for the people who, for real medical indications, cannot receive the vaccines, the people the rest of us who can will cocoon against disease by doing so ourselves.

Here’s the deal. Dr. Bob is a busy man. He has Facebook posts to write. He doesn’t want you to call about this problem or your concern unless you have a very specific experience, as follows:

If an actual direct exposure has occurred from a known case, then you might be at risk. This doesn’t mean a case in the county in which you live: it means that you’ve actually been in the same room with someone who has had measles. Or, at the most, maybe the same building. But transmission almost always requires close proximity (same room). There have been a handful of cases over the decades in which someone sitting across a stadium has caught it, but that is almost unheard of. You have to be in the same room, people. If THAT happens, call me. If not, then just relax and go about your life as usual.

Please. Go relax and go about your life as usual. No worries that once you’ve learned you’ve been in an actual room with an actual person who had the actual measles, or maybe the same actual building, or possibly an actual stadium (or county, perchance?)–once you’ve learned that, of course, you’ll probably already have the measles, but please, go about your life as usual and possibly infect some other folks who might be in actual rooms or building or stadia with you, too, before you find out.

After all, Dr. Bob says, he loves you, you cute little potential preventable-disease vector, you:

I love you all, and love caring for you all. But just chill out. Measles will never go away – it’s always going to be a very small risk. If you aren’t comfortable with that, get the vaccine. If you don’t want the vaccine, accept the risk.

This man loves you. He loves his work. Just don’t call him.

Here’s the thing. Measles had almost gone away in the US. It had almost disappeared. And then Andrew Wakefield exercised some callous disregard. And Jenny McCarthy spoke her Google-U-derived thoughts. And Dr. Bob published a book. In 1982, we were this close to eradicating “domestic” measles in the US. Vaccination uptake had brought the virus–and the complications, hospitalizations, and deaths–to an all-time low, almost to zero, and to domestic eradication in the USA. Elsewhere in the world, work remains.

And then the outbreaks started to grow, hitting 220 in 2011 and 189 in 2013 in the USA, up from domestic eradication in 2000. The virus is still out there, beyond our borders, and unvaccinated people travel beyond those imaginary lines that pathogens don’t seem to honor and bring them home. Clearly, the real barrier between the US and measles is our domestic vaccine program. The better barrier would be vaccines between measles and anyone, anywhere, in the world. Yet this year has already seen a total of 80 cases in ongoing outbreaks in the USA. The vast majority–80%–of those infected are unvaccinated. For people who’ve not had a booster, vaccination fails about 2-5% of the time. For those who have had both doses, which people born after 1985 whose parents followed the recommended, evidence-based schedule will have, the vaccine is effective more than 99% of the time.

Perhaps it’s easier to hear a message of “I love you. Don’t call me” and “I understand your fear. Here’s a pass on preventive care involving needles” than it is to set aside anxiety to embrace benefits that far outweigh risks. But an irony awaits those who resist vaccination. Staying on the eradication track would have done for the measles vaccine what it did for the smallpox vax: It would have ended the need for the vaccine in the first place. Now, the rejectionism and fear have reversed that course. But I do agree with Dr. Bob Sears on one thing: If measles breaks out in your actual community, don’t actually call him. Just get yourself and your children vaccinated if you haven’t already.

Article source: http://www.forbes.com/sites/emilywillingham/2014/03/23/worried-about-measles-dont-call-dr-bob-sears/

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