Measles outbreak revives debate
Focus on personal belief exemptions to childhood shots
VANCOUVER, Wash. — A measles outbreak near Portland, Ore., has revived a bitter debate over so-called philosophical exemptions to childhood vaccinations as public health officials across the Pacific Northwest scramble to limit the fallout.
At least 44 people in Washington and Oregon have fallen ill in recent weeks with the contagious virus, which was eradicated in the United States in 2000 as a result of immunization but arrives periodically with overseas travelers.
More than a half-dozen more cases are suspected, and people who were exposed traveled to Hawaii and Bend, Ore., raising the possibility of more diagnoses in the unvaccinated.
Washington Gov. Jay Inslee has declared a state of emergency.
“I would hope that this ends soon, but this could go on for weeks, if not months,” said Dr. Alan Melnick, public health director in Clark County, Wash., north of Portland.
Of the confirmed cases, 37 are people who were not immunized. Most of the confirmed cases have been children under 10.
“The measles vaccine isn't perfect, but one dose is 93 percent effective at preventing illness,” Melnick said. “The recommended two doses of the measles vaccine provide even greater protection — 97 percent.”
The outbreak has lawmakers in Washington state revisiting nonmedical exemptions that allow children to attend school without vaccinations if their parents or guardians express a personal objection. Oregon and Washington have some of the nation’s highest statewide vaccine exemption rates, driven in part by low vaccination levels in scattered communities and at some private and alternative schools.
Four percent of Washington secondary school students have nonmedical vaccine exemptions.
In Oregon, which has a similar law, 7.5 percent of kindergarteners in 2018 were missing shots for nonmedical reasons.
Washington and Oregon are among 17 states that allow some type of nonmedical exemption for vaccines for “personal, moral or other beliefs,” according to the National Conference of State Legislatures.
Numerous studies have shown vaccines do not cause autism — a common reason cited by those who don’t want their kids immunized.
Those opposed to certain vaccines also object to an outside authority mandating what they put in their children’s bodies, and some have concerns about the combination of the measles vaccine with the mumps and rubella immunizations, which is how it’s routinely given.
A measure introduced by Republican Rep. Paul Harris of Vancouver, Wash. — the epicenter of the current outbreak — would remove the personal exemption specifically for the combined measles, mumps and rubella vaccine, or MMR. It’s scheduled for a public hearing Feb. 8.
Oregon has the nation’s highest statewide vaccine exemption rates. Washington’s exemption rate is also high when compared with other states. Nationwide, the median exemption rate for at least one vaccine for children entering kindergarten in the 2017-18 year was just over 2 percent.
California is one of the few states that stripped away personal belief vaccine exemptions for children in public and private schools. The law passed in 2015 after a measles outbreak at Disneyland sickened 147 people and spread across the U.S. and into Canada. Vermont also abandoned its personal exemption in 2015.
There were 17 outbreaks and about 350 measles cases in the United States in 2018.
A Vancouver, Wash., clinic sign warns of a measles outbreak there and in Oregon. That’s revived a debate over personal belief exemptions to childhood vaccinations.