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Fact check: Do deaths from vaccination outnumber deaths caused by measles?

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February 11, 2016
By Autumn Lewien

Michigan state Representative Thomas Hooker (R) claimed that “some statistics indicated more children had died from immunizations than died from measles,” according to a Gongwer News article published in early December.[1] This statement came after Hooker introduced two bills into the Michigan House Committee on Health Policy.

In January 2015, the Michigan Department of Health and Human Services issued new rules regarding immunization opt-out procedures. The regulation requires parents who request a nonmedical exemption form to first attend a meeting with a local health department official to discuss the potential risks.[2] House Bill 5127, introduced by Rep. Hooker in December 2015, would reverse this policy. A second bill, HB 5126, would prevent local health departments from restricting non-immunized students from attending school as a “disease control measure” except in cases of an epidemic.[1][3]

Do deaths from vaccination outnumber deaths caused by measles? At first glance the numbers seem to support Representative Hooker's conclusion; since 2000, the U.S. has seen 12 recorded measles deaths and 104 deaths reported after the administration of the measles vaccine. However, in our examination of the data we find several confounding variables that suggest that there is more to the story.

Measles as a cause of death

Two weeks prior to publishing this article, we reached out to Representative Hooker’s office for clarification on what statistics he was referring to. We have not yet received a response, but if we hear back, we will update this article accordingly.

We limited the geographical scope of our examination to the United States. Measles, a highly infectious disease, remains one of the leading causes of death among children worldwide. According to the World Health Organization, approximately 114,900 people died of measles in 2014—the majority of which were children under five years old—but none of these deaths were in the United States.[4]

In the National Vital Statistic Reports (NVSR) produced by the U.S. Center for Disease Control and Prevention (CDC) between 2000 and 2013 (the last year with available data), measles is listed as a cause of death 11 times. Two of these cases were children under the age of four.[5] In 2015, the Washington State Department of Health recorded one measles death.[6] The victim was a 22-year-old woman.[7] However, of the 12 deaths reported, only two are considered verified by the CDC. Ian Branam, a spokesman from the CDC’s National Center for Immunization and Respiratory Diseases, clarified in an email:

“ Measles deaths are only counted and considered verified when there is evidence that an acute measles infection was responsible for the death. The last verifiable deaths in the United States from acute measles infection occurred in 2003 when there were two reported deaths.[8][9] ”

Immunization and deaths

What about the second part of Rep. Hooker’s claim regarding deaths caused by vaccination?

The Vaccine Adverse Event Reporting System (VAERS), a national database jointly run by the CDC and the Food and Drug Administration (FDA), provides information about possible side effects that occur after vaccination.[10] From January 2000 to December 2015, 104 deaths were reported to VAERS following the administration of one of the four measles vaccines. However, there are several variables that affect the interpretation of this data.

First, VAERS is a self-reporting system. This means that anyone—doctors, patients, family—can file a report, even if the event is not verified. As such, there is a high opportunity for reporting errors and information bias in the data. Second, VAERS does not establish a causal relationship between vaccination and the adverse event. A disclaimer on the VAERS website reads:

“ When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event.[11][9] ”

In other words, a reported event is not proof that the vaccine was the cause of death. Instead, a report is simply a claim that death occurred sometime after vaccination. Given these constraints on the data, we are unable to meaningfully compare the VAERS reported deaths to the number of deaths caused by measles recorded by the CDC.

Mortality rates pre- and post-immunization

Hooker’s claim does not address the correlation between immunization and the decline in measles cases and deaths.

Measles killed an estimated 2.6 million people worldwide each year before vaccination was widespread, according to the World Health Organization. In 2014, with approximately 85 percent of children worldwide vaccinated with the first dose, an estimated 114,900 people died from measles.[4] The trend is similar for the United States. In the decade prior the measles vaccine becoming available in 1963, the disease caused an estimated 440 deaths annually.[12] In 1965, two years after the introduction of the vaccine, 267 measles deaths were reported. The number dropped to 20 in 1975, and in 1985, with approximately 97 percent of the U.S. population vaccinated, only four measles deaths were reported.[13][14][15]

A decade and a half after the CDC declared the measles virus effectively eliminated in the United States, measles seems to be making a comeback.[16] In 2014, the CDC recorded 667 instances of measles, the highest number since 1994 when 958 cases were reported.[17][18] This resurgence, according to the CDC, is linked to stagnating vaccination rates. Since 2000, annual national childhood immunization rates have remained between 90 and 93 percent; however, these rates vary significantly across states and localities.[19][20] At the center of this matter is the concept of community (or "herd") immunity, a protective effect that interrupts the transmission of the disease to vulnerable people. However, the success of this effect is dependent upon high immunization rates through infection or vaccination.[21] In other words, when vaccination rates drop, the opportunity for outbreak increases.

Conclusion

State Representative Thomas Hooker was cited as saying that “some statistics indicated more children had died from immunizations than died from measles.” Outwardly, the numbers substantiate Hooker's claim. According to the CDC there have been only two verifiable deaths from acute measles infection since 2000. During this same time period, there have been 104 reported cases of death after vaccination for measles. However, the numbers do not tell the whole story. Due to the self-reporting nature of the VAERS reporting system, no cause-and-effect relationship can be established between the measles vaccine and the subsequent reported deaths. Additionally, Hooker's claim does not account for the decline in measles deaths associated with vaccination rates.

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Sources and Notes

  1. ↑ 1.0 1.1 Gongwer News, "Bills Ending DHHS Vaccination Rule Will See Hearing," December 11, 2015
  2. ↑ Department of Community Health, "MDHHS Communicable and Related Diseases Administrative Rules," accessed January 26, 2016 (page 11)
  3. ↑ Michigan House Republicans, "Rep. Hooker submits vaccination rights legislation for parents, local health boards," December 16, 2015
  4. ↑ 4.0 4.1 World Health Organization, "Measles," November 2016
  5. ↑ Center for Disease Control and Prevention, "National Vital Statistics Reports," accessed January 25, 2016
  6. ↑ Washington State Department of Health, "Measles led to death of Clallam Co. woman; first in US in a dozen years," July 2, 2015
  7. ↑ The New Yorker, "A Death from Measles," July 3, 2015
  8. ↑ Autumn Lewien, "Email communication with Ian Branam," January 27, 2016
  9. ↑ 9.0 9.1 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
  10. ↑ Center for Disease Control and Prevention, "Vaccine Adverse Event Reporting System (VAERS)," accessed January 26, 2016
  11. ↑ VAERS Vaccine Adverse Event Reporting System, "VAERS Data," accessed January 27, 2016
  12. ↑ JAMA, "Historical Comparisons of Morbidity and Mortality for Vaccine-Preventable Diseases in the United States," November 14, 2007 (pages 2155-2163)
  13. ↑ U.S. Department of Health, Education, and Welfare, "Vital Statistics of the United States 1965: Volume II Mortality Part A," 1967 (page 1-32)
  14. ↑ U.S. Department of Health, Education, and Welfare, "Vital Statistics of the United States 1975: Volume II Mortality Part A," 1979 (page 1-48)
  15. ↑ U.S. Department of Health, Education, and Welfare, "Vital Statistics of the United States 1985: Volume II Mortality Part A," 1988 (page 232)
  16. ↑ Center for Disease Control and Prevention, "Frequently Asked Questions about Measles in the United States," accessed February 3, 2016
  17. ↑ Center for Disease Control and Prevention, "Measles Cases and outbreaks," accessed February 5, 2015
  18. ↑ Center for Disease Control and Prevention, "Measles--United States, 1994," accessed February 5, 2015
  19. ↑ World Health Organization, "WHO vaccine-preventable diseases: monitoring system. 2015 global summary," accessed February 5, 2016
  20. ↑ Center for Disease Control and Prevention, "Vaccination Coverage Among Children in Kindergarten—United States, 2013–14 School Year," October 17, 2014
  21. ↑ Center for Disease Control and Prevention, "Vaccines and Immunizations: Glossary," accessed February 4, 2016

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