Measles outbreaks during the past year have rekindled the national and Northwest debate regarding vaccines in an area with historically higher-than-average numbers of people who don’t have their children immunized against diseases.
There have been some gains. The National Immunization Survey found that both Washington and Idaho meet the public health goal of having more than 90 percent of toddlers – children 19 to 35 months old – vaccinated against the measles and a host of other diseases.
But there’s work to be done to improve the rates for schoolchildren from kindergarten through high school.
The highly contagious measles virus’ recent surge began in Disneyland before Christmas. The Centers for Disease Control reported that 102 cases have been found in 14 states. The numbers follow a difficult 2014, when there were 644 reported cases, including 27 in Washington state in the first six months of last year. More recent data isn’t available.
The issue even worked its way briefly into presidential politics this week as New Jersey governor and possible GOP presidential candidate Chris Christie said vaccinations are a parent’s choice. Hillary Clinton weighed in by tweeting: “The science is clear: The earth is round, the sky is blue, and #vaccineswork. Let’s protect all our kids. #GrandmothersKnowBest.”
“Outbreaks create a lot of fear and a lot of focus,” said Dr. William Lockwood, Community Health Association of Spokane’s chief clinical officer. “I think immunizations are important. There’s a lot more benefits than risk.”
Vaccination rates in the Northwest have long lagged behind the national numbers. Outreach efforts and information campaigns made some gains but not enough to bring the number of people inoculated against disease in line with other parts of the country.
Immunization records are required for students attending schools, but parents can opt out for personal, religious or medical reasons.
The anti-vaccination movement cuts across the socioeconomic and political spectrum, even though health care providers embrace immunizations and conspiracy theories about safety have been debunked.
Idaho parents can fill out a form declaring they choose not to have their child vaccinated. Washington law changed in 2011, requiring a health care provider signature for an exemption.
“Not having a child vaccinated puts everyone at risk,” said Dorothy MacEachern, a Spokane Regional Health District epidemiologist.
Measles are contagious for four days before a rash develops and four days after. The virus is contagious in a room for two hours after an infected person leaves.
Washington officials have confirmed four measles cases.
Two are Grays Harbor teens who traveled to Disneyland, said Donn Moyer, Washington Department of Health spokesman said this week. Neither was vaccinated. The third is a King County infant who wasn’t vaccinated.
On Wednesday, officials confirmed that a man in his 50s who lives in Clallam County is in a Port Angeles hospital with measles.
So far, there are no confirmed cases in Idaho, though public health authorities are encouraging people to check their immunization records.
“It’s the most contagious vaccine-preventable disease,” said Mareva Kammeyer, Idaho Panhandle Health District’s immunizations coordinator. “Measles spreads rapidly because the virus is airborne but can also live on a surface for two hours. Generally, if one person has it, 90 percent of the people nearby who aren’t immune will also become infected.”
Places where people gather, such as schools, are of particular concern.
Thirteen percent of Coeur d’Alene School District’s kindergartners have not been immunized against measles, higher than the national average of 9 percent.
“These unvaccinated students could be at risk, as this measles outbreak continues to spread across the country,” Kammeyer said. “The CDC recommends all kids get two doses of MMR (measles, mumps and rubella) vaccine, the first at 12-15 months of age and the second at 4-6 years. The two doses are 99 percent effective.”
Spokane Public Schools has the second-highest number of students in the state who have opted out of vaccination requirements, according to the Washington Department of Health. The Bellevue School District had the most.
There are 2,077 students whose parents exempted them from vaccination requirements. That’s 4 percent of all students.
But the total number of unvaccinated children in Spokane schools – the state’s second-largest district – could be much higher. District officials are tracking down the immunization records of another 5,175 students who may not have the full regimen of recommended vaccines. That’s because some children were enrolled without parents providing their complete vaccination records.
The sum of these two groups of students is 24 percent of the children enrolled in Spokane Public Schools.
Laurie Moyer, Spokane Public Schools’ health services coordinator, said compliance numbers for vaccinations have improved during the past 10 years.
“We used to allow parents an exemption by convenience because they’d show up to register a child and not have medical records,” Moyer said. With the new law that took hold in 2011, parents must have a physician’s signature that indicates they have been informed about immunizations or their child’s medical records.
There’s a special section for certain religions, such as Scientology or Jehovah’s Witnesses, which requires parents to specify their church affiliation.
Washington also has an electronic medical records database that health care providers, including school nurses, can check to verify vaccinations.
As for the parents choosing not to vaccinate, Lockwood thinks parents are basing their decisions on irrational fear “with no science to back it. That harms them and it harms the public.”
Other than fear, the second most common reason children are not immunized is access to health care. In response, school districts and the Spokane Regional Health District have been going to schools to offer low-cost or free vaccinations.
“Since we’ve been doing these, we’ve vaccinated hundreds of kids,” Moyer said.
No confirmed cases of measles have been reported in Eastern Washington during recent years, but Moyer fears that could change.
“With all the cases in Arizona and the Super Bowl … I worry about the outbreak and the potential of what it could look like,” Moyer said. “We don’t know how many of our families traveled.”
A Washington State University study offers one reason for the high number of unvaccinated children: misinformation gleaned from the Internet.
WSU marketing researchers Ioannis Kareklas, Darrel Muehling and TJ Weber investigated how Web comments from individuals who have little or no expertise influence people about vaccines.
What they found “kind of blew us away,” Kareklas said. People gave anonymous sources as much credibility as authoritative sources. People take word-of-mouth communications – both electronic and in person – more seriously than they do advertisements.”
The Associated Press contributed to this report.
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