Dispatches from Mexico: Measles Edition

Graphic Courtesy of the County of San Diego

Graphic Courtesy of the County of San Diego

Feb. 6, 2015 (San Diego) There are times that you are presented raw data, with no explanation, that is troubling. Such was the World Bank data on measles vaccination rates. The data for Mexico was very troubling. According to the data the country went from 99 percent vaccination compliance to 83 percent from 2012 to 2013.

The number is troubling. Given that Mexico has a very successful vaccination program that literally is in your face every October. There had to be a reason for this drop. Thankfully it was not a major disaster, or my fear, the war on drugs. The reason was initially to be found in the raw data set from UNICEF for 2013 and 2014, and it was not just measles. It was every vaccine. It was in a footnote. Mexico changed how they reported vaccination rates in 2013, the year of the drop. They also have other means of making sure the 95 percent vaccination rate goal is met. This goal ensures herd immunity, why this is a priority.

According to a research team of epidemic disease specialists, there are issues with vaccination in Mexico, and some of it is as simple as having a document with you when you visit the doctor. Every child in Mexico, just like the United Staes, is issued a vaccination record at birth. The first vaccine, like in the United States, is Hepatitis B.

There are issues with under vaccination in isolated areas of the country, or in very poor states, such as Guerrero and Oaxaca, but there were a series of recommendations as well, such as making sure there are enough vaccines on hand.

The study is titled “Cobertura de vacunación en niños y adolescentes en México: esquema completo, incompleto y no vacunación” and can be found here.

In Mexico vaccination is considered a universal right. It is also independent of whether babies, children and teenagers have a right to be treated by the Social Security System, or any other state based medical system. Every year, in October, there is a national vaccination week, were teams go to schools and other places, and vaccinate those who need it. These teams not only vaccinate children, but there is a separate campaign to give adults both the flu and pneumonia shots.

So why the drop in compliance? Many parents do not have their vaccination forms. This is particularly the case with parents in poor or marginalized areas, and it does match poverty rates in the country. It also closely tracks with ability to read, and primary school or less. What was recommended by the experts, was that instead of tracking the actual vaccine, they track vaccination cards. They want to improve that tracking. Moreover, they want to encourage health care providers in educating their patients as to why these forms are important.

The country can do this since they have other ways to make sure goals are met. One of them is blood samples, which is where this recommendation came from. Children who did not have in their records a vaccine against measles, for example, had blood drawn before the vaccine was administered and they had a simple antibody test. These antibodies were present and there was no other way for them to have them.

Measles, German Measles and Polio are no longer considered endemic in Mexico. The last three cases of measles in Mexico, confirmed, were in 2011. (Until the Disney outbreak this January, more on this bellow) The definition for not being considered endemic is that there is no transmission from person to person for 12 months. This is an internationally accepted standard.

There is more, measles is considered an eradicated disease in the Americas. According to the Guardian, the penchant in Western nations not to vaccinate is bringing back diseases, and it threatening campaigns to eliminate these diseases.

Mexico had two cases imported from Disneyland as well. In other words, the denial of some is now threatening the health of others across borders.

Twitter: @nadinbrzezinski

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Categories: Dispatches from Mexico, Measles, public health

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