Dr Zappala - 2GB - Measles and herd immunity

STEVE PRICE:          I can't believe that people still don't get their children vaccinated, speaking about medical issues. There's been an outbreak- measles outbreak in Byron Bay. It's affecting babies and young children. It's reported that a local, unvaccinated child caught measles in New Zealand and returned to Byron Bay. Now, that's got the highest rate of unvaccinated children in the country.

Australian Medical Association Vice President, Dr Chris Zappala, is on the line. Doctor, thanks for your time.

CHRIS ZAPPALA:    Good afternoon, Steve.

STEVE PRICE:          How dangerous is measles?

CHRIS ZAPPALA:    Well, it's quite dangerous in a very small group of patients. It's a virus that has a high attack rate. So, by that I mean if you get exposed to it, then you've got a very high chance of becoming infected. And for a good proportion of those people, they'll have a respiratory-like illness, they'll feel terrible for a while - sore throat et cetera, lethargy, aches and pains - and then the rash will appear.

But in a small percentage of patients, they develop middle ear infections, they can get a pneumonia-type manifestation of the illness. They can develop gastrointestinal problems, and in severe cases, brain swelling, and even death. So, there is a very small mortality attached with measles, and we never need to forget that. And the vaccine which you alluded to can completely prevent this problem.

STEVE PRICE:          So, why would people- I mean, I know people have this moral outrage about vaccination, but this is just putting youngsters at risk. If there's an outbreak in your town, you'd be irresponsible, would you not, to not vaccinate?

CHRIS ZAPPALA:    I completely agree. And it's not just putting youngsters at risk; it's putting everyone at risk. So, there's a proportion of Australians, remember, who have only had one vaccination, who haven't had two. We started doing that routinely in the early '90s. And so those people might have waning levels of immunity and still be subject to infection.

And of course, if you've never had a vaccine then you're obviously at risk. And the difficulty and the danger is that someone brings the virus back in, for example from overseas, as in the case that you quoted, which is often the case in Australia, and then it spreads quickly to unvaccinated individuals in the country.

Whereas, if we had vaccination rates that were very high - we aim for above 95 per cent - then what happens there is that the virus can't get a foothold, it can't circulate in the community. So everyone gets protected when we're as good as that with our vaccination.

STEVE PRICE:          My understanding is that we passed a regulation in New South Wales that would prevent you sending your child to a childcare centre if they're not vaccinated. Clearly, that's not being properly monitored.

CHRIS ZAPPALA:    Well, it may not be. I can't comment on that. I mean, there's definitely been some improvements in vaccination rates in general across the country in recent years with some of the initiatives that have been put in place.

The biggest problem we have is combating the misinformation that's out there. I mean, some of the stories that go round quite widely on social media and on the internet are just plain wrong. For example, the thing that demonised the measles-mumps-rubella vaccine for years was the thought that it might be linked to autism. And you still hear that today. But that has been disproven and debunked so many times over with many rigorous trials that we just need to forget it. And so, when people still say these things, we need to say: no, no, no, no, that's not right. This is a very safe vaccine. The virus is worse. For goodness sake, let's just get this done and eradicate this illness because that's achievable.

STEVE PRICE:          I don't want to sound ancient, but I can remember in my childhood we all got measles, and you were told once you've had it once that was it, you didn't get it twice. And I think I went through from young age to teenage years having measles and German measles - I don't know what the difference is - I never got mumps, thank goodness, because that was very dangerous, but am I right to remember that - that we either didn't get vaccinated and- so we all got it?

CHRIS ZAPPALA:    Well, before- so vaccination for measles started in the mid '60s …

STEVE PRICE:          [Talks over] Yeah, right.

CHRIS ZAPPALA:    … but before that people did get measles. But we've got to remember that we didn't live as long when we were born in the, you know, '30s, '40s and '50s, and we're doing better now, and we're doing better now because of good public health initiatives like this. And there is that small mortality and, some would say even worse to contemplate, the chance that you'll be left with long-term impairment or brain damage as a result of the virus. And there is unfortunately that small risk, and that's there whenever anyone gets measles.

So the important message here is that we've got a very safe vaccine that can make all of this preventable and wipe it out from the country as a whole so that then, let's say someone inadvertently brings it into the country, it goes nowhere. It's stopped short because we're all so well vaccinated that it can't actually start circulating, and that's what we talk about - herd immunity. So we've got to get to over 95 per cent and we're all protecting each other, and that's when the measles vaccine will be fully effective and we'll have gotten rid of it in this country.

STEVE PRICE:          Excellent advice. Thanks for helping us today.

CHRIS ZAPPALA:    My pleasure.

STEVE PRICE:          Dr Chris Zappala there.

9 September 2019

CONTACT:        John Flannery             02 6270 5477 / 0419 494 761
                            Maria Hawthorne        02 6270 5478 / 0427 209 753

Follow the AMA Media on Twitter: http://twitter.com/ama_media
Follow the AMA President on Twitter: http://twitter.com/amapresident
Follow Australian Medicine on Twitter:  https://twitter.com/amaausmed
Like the AMA on Facebook https://www.facebook.com/AustralianMedicalAssociation