1. Helming, Mary A.

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We've heard a great deal in recent months about the national measles outbreak in the United States. As of July 11, 2019, there were 1,123 cases, with outbreaks in 28 states (Centers for Disease Control and Prevention, 2019). Lower vaccination rates in America, along with global travel, have increased exposure for nonvaccinated individuals and contributed to the number of measles cases.

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Low vaccination rates significantly contribute to measles epidemics in developing countries. The American Red Cross (2019), with its Measles and Rubella Initiative, has provided vaccinations in countries such as Ethiopia and Kenya at the surprisingly low cost of $2 each. Even in developed countries, such as Israel, measles is occurring in epidemic proportions due to orthodox practice allowing vaccine refusal.


This issue of JCN contains a timely and important update on the measles outbreak crisis. Contributing Editor Karen Schmidt has written "Measles and Vaccination: A Resurrected Disease, A Conflicted Response" (pp. 214-221), offering vital information for nurses. Schmidt provides an overview of the measles vaccine, herd immunity, anti-vaccine support, and with sensitivity to vaccine hesitancy, offers suggestions to help nurses educate patients and the public.


Nurses frequently counsel patients on health promotion needs, advise parents on their children's vaccinations, and participate in vaccine administration. The most recent Gallup poll on ethics and honesty noted nurses-for the 17th year in a row-as the most trusted professionals in the U.S. (Brenan, 2018). In fact, "People look to their nurses for honest answers and ethical guidance to difficult medical situations...." (Stone, 2019, p. 1). Building on this trust, nurses can and should have a strong role in educating the public about the importance of vaccinations and addressing the concerns of the anti-vaccine community.


Many in the United States are unaware of the potential consequences of measles because the disease was rarely seen or discussed until the recent outbreak (Mastroianni, 2019). Some of the anti-vaccine or "anti-vax" movement came about due to a now-retracted study claiming a link between the measles vaccine and autism. A few prominent public personalities have taken anti-vax stances, which further leads the public astray. Mastroianni further differentiates between the "vaccine hesitant," a group that may more likely become vaccine-compliant upon good education, and the smaller minority of vocal "anti-vaxxers." It should be noted that national cohort studies repeatedly support no relationships between measles, mumps, rubella vaccination and autism (Hviid, Hansen, Frisch, & Melbye, 2019; Jain et al., 2015).


Some who are pro-life oppose vaccination because of the use of a vaccine cell strain from an aborted fetus developed in the 1960s (see sidebar in Schmidt article, What Is Vaccine Hesitancy p. 219). However, because only the cells from the one original fetus and one other were used, the process of using fetal cells to create vaccines has not continued.


Some Christian evangelicals have promoted vaccination as God's gift through modern medicine (Carter, 2019; Rudd, 2019). Carter notes Christians must look to the common good of humanity when considering vaccinations, in that the harm of children not getting the vaccine is potentially worse than harm from vaccines, because of the blessings of herd immunity. Jesus taught, "Love your neighbor as yourself" (Matthew 22:39, NIV), which reflects considering others when making the all-important vaccination decision.


American Red Cross. (2019). Measles and rubella initiative. Retrieved from[Context Link]


Brenan M. (2018, December 18). Nurses again outpace other professions for honesty, ethics. Gallup News. Retrieved from[Context Link]


Carter J. (2019). The FAQs: What Christians should know about vaccines. Retrieved from[Context Link]


Centers for Disease Control and Prevention. (2019). Measles cases in 2019. Retrieved from[Context Link]


Hviid A., Hansen J. V., Frisch M., Melbye M. (2019). Measles, mumps, rubella vaccination and autism: A nationwide cohort study. Annals of Internal Medicine, 170(8), 5413-5520. doi:10.7326/M18-2101 [Context Link]


Jain A., Marshall J., Buikema A., Bancroft T., Kelly J. P., Newschaffer C. J. (2015). Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. JAMA, 313(15), 1534-1540. doi:10.1001/jama.2015.3077 [Context Link]


Mastroianni B. (2019). Measles in America: What life was like before and after the measles vaccine. Retrieved from[Context Link]


Rudd G. (2019). Is vaccination complicit with abortion? Retrieved from[Context Link]


Stone A. (2019). Nurses ranked most trusted profession in 2019. Retrieved from[Context Link]