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Measles outbreak shows threat of vaccine holdouts

Post by Cheryl Tucker on May 30, 2011 at 3:37 pm |
May 27, 2011 5:40 pm

This editorial will appear in Tuesday’s print edition.

In 2005, health officials welcomed news that there had been only 37 cases of measles in the United States the previous year – the smallest number in the 90 years that such records had been kept.

Fast forward six years. Already in 2011, 118 cases have been reported in 23 states, including Washington – the highest number this early in the year since 1996. Although no one has died, 40 percent of those infected needed hospitalization. Among the complications of measles are pneumonia and encephalitis.

So why the surge in cases now?

The Centers for Disease Control noted that of the 45 U.S. residents  from 1 to 19 years old who got measles, 39 had not been vaccinated, including 24 whose parents had claimed a religious or personal exemption. Of the 42 U.S. residents over the age of 20 who got measles, 35 were unvaccinated, including six who declined because of “philosophical objections.” In 33 cases, Americans contracted the disease abroad; 30 were unvaccinated and one had received only one of two recommended doses.

Unvaccinated Americans who travel abroad face a particular risk. France is currently having a measles epidemic, with nearly 10,000 cases and six deaths in the first four months of this year.

Health experts worry that the growing vaccination “opt-out” movement could lead to more and bigger outbreaks of diseases once thought all but eliminated. Some parents refuse to have their children immunized for religious or philosophical reasons or because they buy into the now-disproved claim that links vaccinations to autism.

Washington has one of the highest school-immunization opt-out rates in the nation – 6 percent – compared to the national average of 2 percent. Fortunately, state lawmakers passed legislation this session that should help lower that rate by requiring parents who want an exemption to show proof that a health provider has given them information on immunizations.

The new requirement probably won’t have much effect on parents who have decided that they would rather let their children risk a host of dread diseases rather than the very small risk associated with vaccinations.
But many parents opt out simply because they don’t want to take the time to have their children vaccinated. If they have to see a health professional anyway in order to get an exemption, there’s a good chance they’ll go ahead and agree to the vaccination.

Some people – including babies younger than 12 months and people with compromised immunity conditions – cannot be vaccinated against measles. Their health depends on not coming into contact with someone who has been infected. The measles virus, which is highly contagious and spreads through the air, can linger in droplets for up to two hours. Up to 90 percent of unvaccinated people exposed to the disease will get sick.

Public health depends on the “herd immunity” created when those who are able to be vaccinated are. Before the measles vaccine became available in 1963,  half a million Americans were infected each year, and about 450 died. Although there’s no chance matters would reach that point today, there just isn’t good reason for any kind of spike in measles cases.

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