Health officials in Washington state are trying to contain a measles outbreak that grew this week to more than 50 confirmed cases. Gov. Jay Inslee, a Democrat, declared a state of emergency in late January, as an average of one new case daily was reported since the first patient tied to the outbreak sought medical care on Dec. 31.
The Washington State Department of Health reported 51 confirmed cases of the extraordinarily contagious airborne virus through Wednesday. Clark County in southern Washington near Portland, Ore., is the epicenter of the outbreak with 50 of the cases. Oregon has reported one confirmed case connected to the Washington outbreak. The vast majority of those infected are children under the age of 10.
Early symptoms of the measles include a fever, runny nose, and cough, followed by a blotchy rash that starts around the head and moves down the body. Though most people recover, serious complications include pneumonia and brain infection that can lead to blindness, deafness, brain damage, or death. In the decade before the measles vaccine was first introduced in 1963, between 400 and 500 people in the United States died of the disease every year, and nearly all children got measles by the time they were 15, according to the Centers for Disease Control and Prevention.
The United States declared the disease eradicated in 2000, but periodic outbreaks occurred as travelers infected in countries where measles was still common brought the virus back home. Last year, there were 17 measles outbreaks (defined as three or more cases) and more than 350 virus infections, the CDC reported.
Health officials in Washington state report that most of the measles cases in the current outbreak occurred in people who did not receive the vaccine against the virus. The CDC recommends children get two doses of the measles vaccine as part of routine childhood immunizations. One dose, usually given between 12 and 15 months, is 93 percent effective at preventing the illness. The second dose, usually given between the ages of 4 and 6, provides protection for 97 percent of people.
Exposing an unvaccinated population to the measles virus is like “taking a lighted match and throwing it in a bucket of gasoline,” said Alan Melnick, public health director for Clark County. “If you have a large unvaccinated population and you add measles to the mix, one measles case will infect 90 percent of contacts, and the early symptoms are not distinguishable from other respiratory illnesses—and you’re contagious at that point.” The virus can remain actively airborne in a contained space for up to two hours after its introduction.
Washington is one of 17 states that allows parents to send their children to school without vaccinations if they express a philosophical or personal objection to immunizations. The median rate of kindergartners in public and private schools who received the vaccine againt measles, mumps, and rubella (MMR) in the United States was 94.3 percent for the 2017-2018 school year, according to the CDC. In Washington state, the rate was 90 percent, and in Clark County, 84.3 percent of kindergartners had the MMR vaccine, according to the Washington State Department of Health. About 8 percent of Washington kindergartners’ parents requested exemptions to the vaccine requirements, with 6.3 percent for personal or philosophical reasons.
Most other states allow parents to exempt their children from immunizations for medical or religious reasons. Just three states—California, Mississippi, and West Virginia—allow exemptions only for medical reasons.
Parents who have concerns about vaccinations often cite the possible side effects they can cause. Others have concerns about the origins of the rubella vaccine, which, along with five other common vaccines, was manufactured using human tissue cultures originally derived from an aborted baby. WORLD editor in chief Marvin Olasky examined those concerns in detail in his 2015 report “Applying a Christian worldview to the vaccination issue.”
Michelle Cretella, a pediatrician and the executive director of the American College of Pediatricians (ACP), a morally conservative alternative to the American Academy of Pediatrics, told me her organization stands behind vaccines in terms of effectiveness and safety, following the CDC guidelines and recommendations. (The only area where they differ is not supporting school mandates of the human papillomavirus, or HPV, vaccine. HPV is a sexually transmitted disease.) “Vaccines are a victim of their own success,” she said. “The general population doesn’t really see measles anymore. You forget that children used to die from measles.”
But Cretella acknowledged the tension between vaccine mandates and parental autonomy, stating that the ACP “recognizes parents as the primary educators and nurturers of their children” and advises pediatricians to work with parents who are vaccine-hesitant.
Washington state Rep. Paul Harris, a Republican, introduced a bipartisan measure on Jan. 25 that would remove the philosophical exemption for the MMR vaccine. Previous attempts to revoke the personal exemption provisions in Washington and Oregon have failed. A hearing is scheduled for Friday.
“People are feeling extremely oppressed and feeling like they can’t make an educated decision,” said Barbara Loe Fisher, co-founder and president of Informed Choice Washington, a group that opposes the bill. She said the measure proposed by Harris would “bring a hammer down and threaten people instead of allowing them to make informed decisions.”
In 2015, California revoked its personal belief exemption for children in both public and private schools after a measles outbreak at Disneyland infected 147 people. The state gives parents who don’t want to vaccinate their children the option of enrolling them in an independent study program at a local public school.