Dear Dr. Roach: I have been following with great interest the recent measles outbreak. Back when I was a child, if little Johnny got the measles I remember every mom in the neighborhood would take their child to little Johnny’s house so their kids could contract the measles. This was the case for every childhood disease. The only thing I can remember being vaccinated for was smallpox, and we all had the scar to show for it. In fact, I never remember my mom getting crazy about me getting any kind of illness. If I had an earache, she would take me to the neighborhood doctor for a shot of penicillin. I just had my 69th birthday, and I cannot remember the last time I had even so much as a cold. I do get a flu shot every year just because I don’t want to take the chance of getting sick at my age. Do we baby boomers have stronger immune systems because of the natural immunity we got from having all those childhood diseases?

— C.H.

Dear C.H.: In the days before vaccines, it sometimes made sense to deliberately infect a child. Some diseases are much worse to get at an older age (such as chickenpox), so exposing children to a hopefully mild case at an age when they are most likely to have a benign outcome was rational.

This is not done now because even in the best situation, measles is still a dangerous virus and the vaccine very infrequently has serious complications. Even though most children did fine with measles disease, hospitalizations were not uncommon. One or two times in a thousand cases, measles was (and still is) fatal. There is also a late complication called subacute sclerosing panencephalitis, which is 100% fatal.

Measles disease weakens the immune system, at least for several years after infection. During this period of time, people (adults and children) are at higher risk for many types of infection, especially pneumonia, which is more likely to be fatal. However, eventually the body’s immune system will recover. People who have had measles are, almost always, protected from measles for lifetime.

The vaccine has a low risk of serious complications. A febrile seizure happens in about 1 person in 3,000; temporarily low platelets happen in about 1 person in 30,000. There is very strong evidence that childhood vaccines, including the MMR, do not increase risk of autism. People who have had two doses of vaccine are about 99% likely to be immune to measles.

Nobody gets smallpox vaccine anymore (except military, some lab workers and a few bioterrorism responders), because smallpox no longer exists in the wild. It is still possible to eradicate measles the same way.

Dear Dr. Roach: I’m not against medical marijuana when prescribed, but why do patients want or need to smoke it? What does the secondhand smoke do to children and adults around those who are smoking it?

— C.G.

Dear C.G.: Secondhand cannabis smoke has potential adverse effects. It can be irritating to the eyes and respiratory tract. The psychoactive component, THC, can be absorbed by someone in close proximity, especially if exposed over a prolonged period. This is also true for the vapor made by an e-cigarette device.

Cannabis smoke is irritating for the user as well. Many people who use medical cannabis use edibles containing extracts, THC and CBD. These have no risk to others, although they do carry a higher risk of acute intoxication for the user than smoked cannabis. In any event, cannabis users should take care not to expose people who do not want to be exposed, especially children.

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