Measles out­break re­vives de­bate

Fo­cus on per­sonal be­lief ex­emp­tions to child­hood shots

South Florida Sun-Sentinel (Sunday) - - Nation & World - By Gil­lian Flac­cus

VAN­COU­VER, Wash. — A measles out­break near Port­land, Ore., has re­vived a bit­ter de­bate over so­called 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 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.

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.

GIL­LIAN FLAC­CUS/AP

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