7AN01TE0220 Part 1 Correction

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SÉQUENCE 2: TACKLING VIRAL OUTBREAKS:

VACCINATION AND VACCINE HESITANCY

CORRIGE

PART I: Old diseases, new threats: Measles, a dangerous illness

Activity 1 - Warming up
Before you begin, look up the English or French equivalent for these infectious diseases. A good
translation dictionary is www.wordreference.com
1.  measles = la rougeole
2.  flu = la grippe
3.  whooping cough / pertussis = la coqueluche
4.  smallpox = la variole
5.  polio = la polio
6.  rubella = la rubéole
7.  mumps = les oreillons
8.  AIDS = le SIDA

Activity 2 - Reading comprehension - Roald Dahl’s open letter

2.
a.  Establish FACTS: Who - Where? When? What?
– Who is concerned? The author, Roald Dahl writing about his late daughter Olivia for British parents.
– Where does this take place? What places are referenced? Britain + references to the USA ! to
compare and contrast vaccination attitudes.
– When do the events take place? 2 timeframes: “present” (1986) vs past: letter was written 24 years
after his daughter died in 1962.
– What happened to his daughter? His 7-year-old daughter Olivia caught the measles and died from a
complication.
– What was the health situation in Britain in 1962? At the time, measles was common and there was
no vaccine.
– What is happening at the time in 1986 Britain? A vaccine has been developed though nothing can
be done about the complications of measles. However, many parents are not using the vaccine to
protect their kids.

b.  Focus on REASONS, CAUSES and PURPOSE: Why? What for?


– Why this open letter? A number of British parents are refusing to vaccinate their children.
– What is he writing for? To persuade British parents that measles is dangerous, that children still
die and urge them to get their children vaccinated.

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c.  Focus on MEANS and METHODS:
How does Roald Dahl persuade them?
– By using his own example, by telling his own story of a grieving parent
– By appealing to their parental responsibility and reminding them of the dangers of their children
falling ill and even dying.
– By labelling their attitude negatively : obstinacy, ignorance, fear, a crime
– By highlighting the safety and the efficacy of vaccine relative to the discomfort of rare secondary
effects
– By comparing the UK to the USA where compulsory vaccination has curtailed the disease
– By appealing to the children themselves
– By appealing to emotions and Olivia’s legacy

3.  N
 ow, using all your notes, you can write out your presentation. Begin by presenting the document briefly
then follow the steps suggested by the question.
In the year 1986, the author, Roald Dahl is writing an open letter addressed to British parents, 24 years
after his late daughter Olivia died aged 7 in 1962.
She had caught the measles and died from a complication from encephalitis.
At that time, measles was common as there was no vaccine available and no treatment for the
complication.
In 1986, however the situation had changed. A vaccine had been developed and in places like the USA,
vaccination had been made mandatory and had almost eradicated the illness.
However, despite this advance, and despite the fact that nothing could still be done about the
complications of measles. a number of British parents were still refusing to vaccinate their children
for a number of reasons.
Dahl’s objective is to urge these parents do the right thing and get their children vaccinated in order to
protect them from this terrible disease.
He resorts to a number of arguments to do this.
First by using his own experience and telling of how his beloved daughter died, then by appealing to
their parental responsibility and reminding them of the dangers of their own children falling ill and
even dying.
He labels their attitude negatively, calling them obstinate, ignorant, fearful and even criminal.
He reminds them of the safety and the efficacy of the vaccine relative to the discomfort of rare side
effects and compares the UK to the USA where compulsory vaccination has checked the disease.
He even appeals to the children themselves saying they should ask their parents to do what is
necessary to protect them.
Finally, by dedicating two of his much loved stories to Olivia, he hopes that her name and death will
serve to protect other children.

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Activity 3 - Bac oral practice

3.  Voici une citation de Roald Dahl pouvant être reliée à l’axe Espace privé et espace public
Vous disposerez d’un temps de préparation de 10 minutes. Vous pouvez suivre ces instructions pour organiser
vos pensées et faire votre présentation.
– Identifier le thème ou le sujet de la citation ou l’image .
1

– La relier à l’axe d’étude en formulant une question ou une problématique en lien avec l’axe étudié
– Répondez à cette question en 2 ou 3 points en vous appuyant sur la citation et vos connaissances sur
le sujet.
– Enfin, concluez brièvement.

This quote by Roald Dahl about vaccination and the need to vaccinate is particularly interesting in a
more general context of opposition to vaccination which has recently led to a resurgence of diseases like
measles that had disappeared in a number of developed countries like the UK or the USA.
It could very well illustrate the line of study Private space / public space. Indeed, one may ask whether
vaccination is a matter of individual choice or a matter of public safety?
While most people today agree with the idea that vaccination, through herd immunity, is a matter of public
health and well-being, a small number of people insist that it is a matter of personal choice. The choice
here, ironically, being not to vaccinate one’s own children, while vaccination has reduced deaths and
illness dramatically.
The first quote seems to be addressed directly to the children of these vaccine hesitant parents, and
encourages them to take a stand against their parents’ wishes and get vaccinated. According to Dahl, it
is a matter of life or death, which it is, reminding us that he lost his own daughter Olivia to measles when
she was only seven years old.
This also brings to mind the story of Ethen Lindenberger, an American high school student who in 2019
went against his anti-vaxx mother’s wishes, got himself vaccinated and became a vaccine advocate,
testifying before a number of important institutions like the US Senate or the EU Commission, even going
beyond what Roald Dahl was advocating.
This tension between the two angles, of whether vaccination is a personal or a social choice is apparent
in the USA, where a number of states have vaccination laws obliging parents to have their children
vaccinated but also exemption laws, permitting parents to opt out or be exempted for a number of
non-medical reasons such as religious or personal beliefs.

1  dans cet exercice vous avez présenté le document proposé et indiqué en quoi il illustre l’axe. Le jour de l’évaluation vous aurez
un choix à faire entre deux supports et vous devrez indiquer à l’examinateur pourquoi le support que vous aurez choisi illustre à
votre sens le mieux l’axe.

CNED  TERMINALE  ANGLAIS  3


Activity 4 - Mapping the current trend

1.  Measles cases in the US, 1950-2020


a.  Choose the best title for each one of these infographics:
Chart 1: A victory of modern medicine: the eradication of measles
Chart 2: A troubling trend: measles on the rise.
b.  Look at the graphs and answer the questions. Use the words below to formulate your answers.
(1)  What can you say about the period 1950 to 2000?
(2)  How do you explain the difference between the early 1960’s and the late 1960’s? (Hint: you can find the
answer in the previous document you studied)
(3  And the period 2000 - 2019?
From 1950 to the beginning of the 1960s, there were hundreds of thousands of cases per year,
commonly over 400,000. An epidemic even peaked at nearly 800,000 after 1955.
However, as Roald Dahl and the CDC document remind us, a vaccine was designed and used in 1963
followed by a second vaccine in 1968. In a few years, cases fell steeply and around 1980 measles had
almost disappeared.
However, around 1990, a small spike led to the introduction of a second injection and in 2000, measles
was declared eradicated from the USA.
Unfortunately, a small but steady upward curve has begun rising again, with tens and hundreds of
cases, peaking in 2019 with almost 1,400 cases recorded.

2.  Can you read the numbers in the following text? Read the text aloud with particular attention to the
numbers. Refer to the grammar lesson before you start.
(Dates - US format)
 nr 1 - Measles cases are increasing. Provisional data from the WHO indicates that during the first 6
  E
months of the year there have been more measles cases reported worldwide than in any year since
2006 (two thousand and six).
From 1/1/2019 (January the first, twenty nineteen) to 7/31/2019 (July thirty-first, twenty nineteen) *,
182 (one hundred and eighty-two) countries reported 364,808 (three hundred and sixty-four thousand,
eight-hundred and eight) measles cases to the WHO. This surpasses the 129,239 (one hundred and
twenty-nine thousand, two hundred and thirty-nine) reported during the same time period in 2018
(twenty-eighteen).
WHO Regions with the biggest increases in cases include the African Region (900%: nine-hundred
percent), the Western Pacific Region (230% : two hundred and thirty percent) and the European Region
(150%: one hundred and fifty percent).
*Note the US format for the date where the month precedes the day. Hence 9/11 would be the
eleventh of September (2001).
(adapted from https://www.cdc.gov/globalhealth/measles/globalmeaslesoutbreaks.htm)

(Dates in British English)


  Enr 2 - From 1/1/2019 (the first of January, two thousand and nineteen) to 7/31/2019 (the thirty first of
July, two thousand and nineteen)

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Activity 5 - Listening comprehension - In-Depth Look at the MMR Vaccine
Debate
Listening practice: Listen to the first half of the video In-Depth Look at the MMR Vaccine Debate – Part 1,
taking notes as you go along. You will be doing a debrief to check what you have understood.
Video 1 : In-Depth Look at the MMR Vaccine Debate

Lakeland PBS 2017


TRANSCRIPT
With 73 confirmed cases, the measles outbreak in Minnesota has now surpassed the total number of cases in
the United States in 2016.
Last year, seventy cases of measles were diagnosed nationwide. And at the heart of the current Minnesota
outbreak is an ongoing debate: should parents have their children vaccinated?
Clayton Castle traveled to Saint Paul to make an in-depth look at the vaccination debate.
Clayton: It’s a virus that has ravaged the state of Minnesota for the better part the last two months. With their
73 cases state-wide, the measles outbreak has been deemed the largest in Minnesota in the last 30 years,
The largest concentration of cases is in the Cedar Riverside neighborhood of Minneapolis, which is a
predominantly Somali-American population where there has been an ongoing debate for years about the
effectiveness of the Measles-Mumps and Rubella or MMR vaccine.
Many reports say that as many as 42% of Somali American children were unvaccinated prior to the beginning
of the recent measles outbreak.
I talked to Dr Stephen Vincent, Chief Medical Officer at the People’s Center located in the heart of Cedar
Riverside and asked him why so many Somali children were unvaccinated before the outbreak.
Well, the fear of autism that could be caused by the MMR vaccine is an unfounded fear, based on a study from
England 20 years ago in the 1990s, a doctor Wakefield, that was later found to be falsified.

3. Debrief
When listening, try to anticipate, establish the facts (who? where? when? what?), explain the reasons,
expose the consequences if any and state the conclusion(s) reached.
a.  What did you anticipate from the title? In-Depth Look at the MMR Vaccine Debate
“In-depth look”: means you can expect explanations about the different sides of a problem.
What problem? the MMR vaccine = Measles Mumps Rubella vaccine
“Debate”? About what? Is there a problem with this MMR vaccine?
Between who and who? At least 2 sides, 2 groups of people
(organise columns to put them in)

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b.  What keywords did you pick out? What can you deduce about the subject?
Outbreak x5 - Cases x5 - measles x5 - Minnesota x4 - Somali x4 + unvaccinated x2 - vaccine +
vaccinated + vaccination x4 - Debate x3 - children x3
From these keywords you can already begin to understand some basic information:
In Minnesota, there is a measles epidemic.
It is linked to a debate about vaccination.
Unvaccinated Somali children are concerned.
c. Now, you can focus on more detailed comprehension by asking yourself questions about the FACTS: What?
Who? Where? When?
What? A news report on the Lakeland PBS channel
A measles outbreak: 73 cases in Minnesota in 2017 (2016: 70 in the US)
Debate repeated 2x and on screen Vaccination debate: Yes or No? in the first part
Subject of debate = Should parents have their children vaccinated with the MMR vaccine?
Who?  How many people did you hear? What were their roles and relationships?

You can make a chart to organise the information about the people involved or concerned:

Journalists Interviewees or people mentioned

Journalist (anchor) Pro-vaccine anti-vaccine


Clayton Castle (Minnesota) Dr Steve Vincent, CMO, Leo Cashman (Minnesota Health
Minneapolis Coalition = anti vacs group)
Kris Ehresmann Director of Somali-American community
Minnesota Department of Health 42% not vaccinated
Dr Wakefield : falsified study on
MMR autism

Where?  Minnesota, Minneapolis: St Paul + Minneapolis (Cedar Riverside)


When? 2017 (with references to the previous year 2016) and the 1990s = 20 years ago > England

d. REASONS: Ask yourself “Why?” questions to find the reasons behind the facts, one piece of information
can lead to a new question:
– Why did this epidemic break out?
Because the Somali-American community are less vaccinated (only 42%)
– Why are the Somali-Americans not vaccinated?
– Why is there a “debate” about vaccination?
Because Somali-Americans fear the MMR vaccine will cause autism.
– Why do they fear the MMR vaccine will cause autism?
Because of an English study in the 1990s by Dr Wakefield.
– What is the conclusion reached?
The fear is unfounded.
The claim was based on a falsified study

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5.  Report in French
Ce bulletin télévisé rapporte qu’une nouvelle épidémie de rougeole dans l’état du Minnesota a fait
davantage de cas (73) que l’an passé dans tout le pays (70 cas).
Cela s’explique par des interrogations autour de la question de savoir si les parents doivent faire vacciner
leurs enfants.
L’envoyé spécial Clayton Castle s’est rendu à St Paul rendre compte de ces interrogations.
Avec 73 cas depuis 2 mois, c’est la plus importante épidémie au Minnesota en 30 ans.
La majorité des cas se trouvent dans le quartier de Cedar Riverside de Minneapolis où vit une population
américaine d’origine somalienne qui depuis des années doute de l’efficacité du vaccin MMR (oreillons,
rougeole, rubéole).
Il est rapporté que seuls 42% des enfants de cette communauté étaient vaccinés avant le début de
l’épidémie.
Le journaliste a interviewé le Dr Stephen Vincent, responsable régional de la santé, pour avoir une
explication.
Il indique que cela est dû la crainte que ce vaccin provoque l’autisme, que cette crainte sans fondement
trouve sa source dans une étude anglaise des années 1990, dont on a découvert qu’elle était falsifiée.

6.  Bac practice


Now, practice what you have learnt. Listen to the second part of the video In-Depth Look At The MMR
Vaccine Debate – Part 2, take down notes and write your report in French.

Video 2

Lakeland PBS 2017

TRANSCRIPT
Leo Cashman of the Minnesota National Health Coalition an anti vaccination advocacy group states that the
MMR vaccine still causes autism.
There have been findings of the vaccine type of measles virus in the intestines of children with autism. And this
is what has been found in Minnesota in the Somali community.
The Somali community has noticed it and has observed it and talked about it and gotten more information
about it ….
Now, after hearing the complaint that it causes autism, I came here to downtown St. Paul and visited with Kris
Ehresmann with the Minnesota Department of Health and asked her if there’s any merit to that claim.
Kris Ehresmann: There have been a number of studies, so multiple studies, by different researchers using
different methodologies and performed in different places that have all refuted a link between vaccines and
autism, and so, that to me, is what’s really important is what did the science show?

CNED  TERMINALE  ANGLAIS  7


And for the mother of two, the vaccination debate is personal and hits home for her like it does for many
parents across Minnesota.
The reason I can say with confidence that I believe in vaccines, it is the two most important people in my life
are my children, and they are fully vaccinated and if I had any concerns about the value of vaccines, I wouldn’t
have vaccinated my own children.

COMPTE RENDU
Leo Cashman de la Coalition nationale pour la santé du Minnesota, une association anti-vaccins, dit que
le vaccin ROR (Rougeole Oreillons Rubéole) provoque l’autisme.
Il explique que l’on a retrouvé dans les intestins des somaliens du Minnesota des traces du virus vaccinal.
Il dit que la communauté Somalie l’a remarqué et en a parlé et s’est renseigné…
L’envoyé spécial s’est rendu dans le centre de St Paul interviewer Kris Ehresmann du département de la
santé du Minnesota vérifier si cette allégation était crédible.
Elle indique que des études nombreuses, conduites par des chercheurs dans différents pays avec des
méthodologies différentes, ont toutes réfuté ce lien et que c’est ce que prouve la science qui compte.
Le journaliste indique que pour cette mère de deux enfants, cette interrogation est importante à titre
personnel, comme pour beaucoup de parents du Minnesota.
Kris Ehresmann conclut avec fermeté en disant qu’elle fait confiance à la vaccination et que la preuve en
est qu’elle fait vacciner ses deux enfants qu’elle aime par-dessus tout.
Cette conclusion mais aussi la tonalité générale du reportage montre que le “débat” en question n’en
est par réellement un. D’un côté, nous avons des citoyens d’une communauté inquiets, qui se basent sur
des allégations non vérifiées, de l’autre des autorités en charge de la santé publique, des docteurs et des
scientifiques qui font confiance à la science.

Activity 6 – a 5-minute oral report on the topic of “Measles, a dangerous disease.”


Using what you have learnt in the documents you studied in this first part, prepare a 5-minute oral report
on the topic of “Measles, a dangerous disease.”
Use this checklist to structure your oral presentation.

Focus on your presentation:


□  What documents studied can you use to answer this question?
You can use 7 documents:
1: t he Disease R0 and Herd Immunity Threshhold comparative chart on p21 of the Herd Immunity page of the
Discovery section,
2: the WHO joint News Release
3: Roald Dahl’s open letter
4, 5, 6: the CDC statistics and charts and article
7: The Minnesota measles outbreak
□  Have you formulated a question, a problem?
□  Have you detailed your plan? Have you written it down?
□  Do you have a catchy introduction, a rhetorical question? An anecdote?
□  Have you made a list of the new vocabulary you will be using in your answer?

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Focus on phonology:
□  Remember, you should not write out your presentation and read it, but speak from a plan.
□  Have you checked the pronunciation and accentuation of new words or difficult words?
□  Have you practiced saying it with a timer or a stopwatch?

INTRODUCTION: In 1986, the famous author Roald Dahl wrote an open letter to the British public.
The title of the letter was Measles, a dangerous disease.
QUESTION: Why did he decide to write this letter? Was he not exaggerating? Why is measles
a dangerous disease?
A COMMON DISEASE: Up to the 1960’s, data from the CDC shows that measles was extremely
common in countries like the US with a record of 800,000 cases around the year
1955 and 400, 000 on average. Roald Dahl confirms that the same could be said
of the UK with 100,000 cases a year.
A CONTAGIOUS ONE: One can wonder why measles contaminated so many people. The reason is
simple: measles is the most infectious disease on earth with an R0 between 12
and 18, meaning, one person, often a child, can contaminate upto 18 others!
This also means, that for a population to be protected by herd immunity 83 to 94
% of the population needs to have immunity either from a vaccine or by falling ill
and recovering.
A DEADLY DISEASE: However, recovering from measles is not automatic. Roald Dahl’s daughter had
caught measles and seemed to be recovering. However, she suddenly suffered a
complication and died at the age of seven. Measles is dangerous because it kills.
In 2019, WHO, in a press release, published the frightening information that
140,000 people, mostly children, had died from the illness.
part from this most serious outcome, Roald Dahl reminds parents that
A
measles can have serious side effects and mentions the figure of 10,000 for the
total number of cases.
A CURE? Faced with such a serious disease, only vaccination is a means to protect the
young. The CDC charts show without a doubt how the introduction of a vaccine
in 1963 and in 1968 brought the number of cases down dramatically, even to the
point of eradication. Roald Dahl based his letter on the availability and safety of
these vaccines to convince his readers to protect their children.
CONCLUSION: However, it seems today, people have forgotten not only how serious this disease
is but also how necessary it is to protect the vulnerable. The CDC charts reveal
a resurgence of cases, even in developed countries like the US and the Lakeland
PBS report ascribes a recent outbreak in Minnesota to vaccine hesitant
communities and anti-vax propaganda.
Unfortunately, it seems the days of this dangerous disease are not over.

CNED  TERMINALE  ANGLAIS  9

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