Public Health: Measles, Herd Immunity, Ethical Issues, Causation vs Correlation, and Internet Influence

This article discusses the epidemiology of measles, the concept of herd immunity, ethical issues surrounding immunization, the difference between causation and correlation, and the influence of the internet on public health policies.

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Question 1
According to Cobey, & Baskerville, (2016) measles is still one of the most
communicable diseases in the United States and in the whole world. Measles is caused by a
virus- Paramyxovirus – which is transmitted by air droplets released when an infected person
coughs, sneezes or breathes. The disease is very communicable since the virus is able to stay for
long hours outside the body of the host. Measles mainly affects children between the ages of one
to six years but it may also affect adults. In fact, the disease is more severe in adults that in
children. Some of the signs and symptoms of measles includes sneezing, coughing, fever,
diarrhea, vomiting and skin rash which mainly develops 2 – 4 days after infection.
The causation of measles and prevalence of measles in a specific population can be
explained using the epidemiologic triangle. This is because the disease transmission process
involves the three components of the epidemiologic triad. These components include the host,
who in this case is a healthy susceptible person, the environment which refers to the surrounding
such as air and surfaces where the virus may inhabit and finally the external agent who in this
case refers to measles virus. In respect to the model, interaction of all these components need to
interact for the disease to be carried on from one person to the other which is the same case for
measles.
In the model, there are factors that increase the ability of the agent to cause disease. This
ability is referred to as the pathogenicity and it may include the concentration of the virus in a
certain area. The host has a variety of factors that may increase the risk of infection. In the case
of measles, the risk of infection may be increased by factors such as lack of vaccination of the
disease, weakened body immunity, congestion, unhygienic behaviors, age and immune status.

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According to the model, environment may also provide factors that may also increase the
risk. The environment comprises of both the human and the natural surroundings. Some of the
environmental factors that increase the risk of contracting measles include overcrowding,
sanitation and the climatic conditions. The existence of other infected people in the environment
also increases the risk since statistics show that an infected person infects one out of every ten
people around him or her (Cacciatore, Nowak, & Evans, 2016).
Question 2
According to Sobo, (2016) herd immunity is a type of immunity that develops when over
a certain population when part of the population has been immunized against a certain disease
condition. The strength of the immunity is determined by the proportion of the herd that have
been vaccinated against a certain disease. Herd immunity works on the basis that if many people
are vaccinated against a certain condition, there will be very few people who will be left
susceptible for the same condition. It will then be difficult for the condition to spread since most
of the people will be immune to the condition.
The proportion of people to be immunized in order to protect the rest of the people
depends on the specific disease people are being immunized against. The fact behind herd
immunity is that when part of the population is vaccinated they are able to protect the other
vulnerable members who are not vaccinated by not exposing them to the disease. Herd immunity
falls if the number of people who are not vaccinated greatly increases. The herd immunity in this
case may break down and provide infection of more serious conditions. Cases where herd
immunity has broken down include measles and pertussis outbreaks in Britain and in the United
States respectively.

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The advantages of herd immunity can be explained using the overall advantage of
vaccination and immunization. For instance, prevention of a disease is always cheaper than
treating the disease. Vaccination also reduces risks of other infections since the immunity is not
weakened by the disease. Herd immunity is also advantageous for government and large
corporations as it is an economical way of ensuring that diseases do not spread.
Herd immunity according to Hoppin, (2016) also benefits specific people in the
community who cannot be immunized due to age, physiological condition or their reaction to the
vaccines. This may include very young children or very elderly people who have developed
resistance to some drugs or who are currently diagnosed with various chronic condition and can
therefore not be immunized because of the effects of polypharmacy. Finally herd immunity helps
to prevent diseases spreading to people who do not have access to the vaccines. This is a current
trend where many people in the society today lack access to vaccination due to social economic
factors, ignorance of parents and care givers and fear of side effects of vaccines.
Question 4
In the world today is having more infections of preventable diseases. This has been
influenced by the various legal and ethical frameworks and debates surrounding the
immunization of certain diseases in the United States. These ethical and legal frameworks have
influenced the behavior and reaction of some people towards medications and vaccines. News,
internet and other non-medical sources have also influenced people’s behavior and attitude
towards recommendations for vaccination which has thus influenced the government and other
policy makers in the formulation of policies regarding immunization and vaccination (Hoppin,
2016).

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One of the major ethical issues surrounding the recommendation for immunization in the
United States is the autonomy that a parent has in deciding the immunization of their children
explains Hendrix, et al (2016). Sometimes parents disapprove immunization causing harm to the
child. There is also a continued emphasis on herd immunity as a way of preventing the greater
community from infection. Vaccine communication and mandates are also relevant ethical issues
surrounding immunization in the United States.
The idea of benefiting the greater good has been seen to affect the freedom of an
individual where an individual who has no need for vaccination is immunized by herd immunity.
In herd immunity, some people have also forfeited vaccinations for reasons that are not
associated with medical conditions. This has been seen to threaten the society as a whole
especially with the case of highly communicable and contagious diseases. Choices made by
people not to take vaccination at the expense of others inhibit the freedoms of others by posing a
risk to the vaccinated others.
There has been a controversy surrounding the MMR vaccine as outlined well by
Mnookin (2012) where many parents believe that the vaccines has side effects that cause autism.
In other societies, vaccines have been criticized by religion as causing side effects that reduce the
fertility of children. The clergy has then advised people to abandon the vaccines as they may
cause extinction of the human race. This has caused great risk to herd immunity as a significant
part of the population have abandoned the vaccination.
Question 5
Causation refers to the relationship between cause and effect. It helps to explain causes of
a certain phenomenon. On the other hand correlation refers to the establishment of a connection

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of two or more variables. A correlation may take form of an interdependence, interconnection or
relation between two abstract things. In the world today, people often confuse the two and treat
the two in a similar manner (Nardi, 2018).
The main difference in causation and correlation is that in causation, one phenomena
directly affects another causing a change in the other phenomena hence the word causation. In
correlation however, the relation between two abstract things or variables does not necessarily
mean that one will definitely effect the other. Correlation only describes a casual relationship
between variables or abstract things.
In theoretical perspectives, correlation gives a likelihood of two things being related but
leading to different effects. A good example is alcoholism and smoking whereby alcoholics may
smoke often but it doesn’t mean that alcoholism causes smoking on the other hand, a good
example of causation would be alcoholism and liver cirrhosis whereby excessive consumption of
alcohol leads to infection of the liver which may result into liver cirrhosis.
A good example of correlation and causation and how it influences public health in the
panic virus book is where people believe that vaccines cause autism. Andrew Wakefield
proposed that the MMR vaccine causes autism. He was however unable to provide the
relationship between the two despite the fact that vaccines have been believed to cause various
developmental disorders. Wakefield was able to exploit an existing correlation between vaccines
and developmental disorders but he was unable to explain a causal relationship between the
MMR vaccine and autism (Davidson, 2017).
While members of the general public have tried to avoid vaccines in order to avoid the
risks of autism, they have suffered other deadly infections some of which retards the memory

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such as measles. It is therefore necessary for people to understand the relationship and the
difference between correlation and causation.
Another example that is relevant in today’s field of public health is the correlation
between pizza and the germ theory disease. People often made this relationship by explaining
that the price of a slice of pizza increases and decreases in the same respect as that of a subway
ride. This however arises from speculation only shows a casual relationship as there is also no
linkage between the two.
The germ theory of disease also relates bad odors and disease. While bad odor and
disease are known to be unpleasant. The relationship between the two is also casual as diseases
are caused by germs and not the bad odors. Just as germs causes bad odors and disease, inflation
causes increase in the price of a pizza and that of a subway ride. However neither the sub way
ride and the pizza nor the bad odor and disease are related.
Question 7
With increased globalization, dissemination of ideas facts and gossip has been realized
very fast. The internet has been one tool that has been highly used to advance various
technologies. The internet has also been significant in sharing knowledge and basically meeting
the demands of human interaction. This human interaction through the internet has had a
resounding impact in various areas of human life as human beings try to sharpen, caution or
warn each other. In the same respect, the area of public health has also been influenced by the
information shared over the internet (Larson, Paterson & Erondu, 2012).
The influence the internet has had in public health and public health policies can be
interpreted as both a blessing and a curse. For instance, it has profited human kind greatly since

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information of risk factors of disease, treatment options and methods and also preventive actions
have been disseminated. In some cases, diagnosis and treatment has taken place online where
people may interact with qualified health expert and share signs and symptoms. Psychotherapy
has also been advanced through online sharing of ideas and seeking of help from available
counselors and psychologists.
The use of the internet can also be interpreted as a curse. A good example stems from
Seth Mnookin’s panic virus book. Mnookin (2012) describes a world where the internet allows
an idea or a proposition to be highly withheld until it becomes difficult to distinguish facts from
human opinion. The dissemination of information works as a blessing and a curse since facts and
fiction as spread alike creating a controversy. Mnookin (2012) also explains how a doubt in the
population may take several years to distinguish despite unlimited efforts from experts to support
the truth. Mnookin (2012) argues how the media also plays a big role in making the public
believe both sides of the story by treating an assumption with equal magnitude as the truth itself.
He explains how people will tend to believe a myth even when they have relevant credible
information in a certain field
The use of internet has profited government and other corporations in disseminating
public health information since the internet is fast and reaches many people all over the world. In
the contemporary world, the views of respected people such as the aged and key celebrities in the
population are upheld and appreciated more than the views of specialists explains Caulfield, &
Fahy, (2016). This has influenced the internet in sharing various important information as the
information is prone to distortion which affects the credibility of the information that is shared.

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REFERENCES
Cacciatore, M. A., Nowak, G., & Evans, N. J. (2016). Exploring the impact of the US measles
outbreak on parental awareness of and support for vaccination. Health Affairs, 35(2),
334-340.
Caulfield, T., & Fahy, D. (2016). Science, Celebrities, and Public Engagement. Issues in Science
and Technology, 32(4), 24.
Cobey, S., & Baskerville, E. B. (2016). Limits to causal inference with state-space reconstruction
for infectious disease. PloS one, 11(12), e0169050.
Davidson, M. (2017). Vaccination as a cause of autism—myths and controversies. Dialogues in
clinical neuroscience, 19(4), 403.
Hendrix, K. S., Sturm, L. A., Zimet, G. D., & Meslin, E. M. (2016). Ethics and childhood
vaccination policy in the United States. American journal of public health, 106(2), 273-
278.
Hoppin, S. (2016). Applying the Narrative Paradigm to the Vaccine Debates. American
Communication Journal, 18(2).
Larson, H., Paterson, P. B., & Erondu, N. (2012). The Globalization of Risk and Risk
Perception. Drug safety, 35(11), 1053-1059.
Mnookin, S. (2012). The panic virus: The true story behind the vaccine-autism controversy.
Simon and Schuster.
Nardi, P. M. (2018). Doing survey research: A guide to quantitative methods. Routledge.

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Sobo, E. J. (2016). What is herd immunity, and how does it relate to pediatric vaccination
uptake? US parent perspectives. Social Science & Medicine, 165, 187-195.