Measles Outbreaks Increase as Vaccination Rates Decrease
World Health Organization calls vaccine hesitancy a top 10 threat to global health
A measles outbreak near Portland, Ore., has caused health officials in nearby Clark County, Wash., to declare a public health emergency, warning that infected people have visited airports, schools, churches, dentist offices and area retail outlets.
According to The Washington Post, the number of confirmed cases have been steadily rising from a handful last week to 23 cases on Tuesday, Jan. 22.
“The vast majority of those who had have fallen ill had not been immunized,” the Washington Post wrote.
While this news is alarming to health care officials, it does not come as a surprise. The World Health Organization (WHO) says the number of measles cases has grown 30 percent worldwide and that “vaccine hesitancy” is one of the top 10 threats to global health in 2019.
The WHO defines vaccine hesitancy as “the reluctance or refusal to vaccinate despite the availability of vaccines.”
The organization says vaccine hesitancy threatens to reverse progress made in tackling vaccine-preventable diseases that currently prevents 2-3 million deaths a year. But the WHO states a further 1.5 million could be avoided if global coverage of vaccines improved.
In New York, NBC News reports that an outbreak among Orthodox Jews has led to 177 cases. The Centers for Disease Control and Prevention states that 349 cases of measles were confirmed in 26 states in 2018, making last year the second-worst year for measles since 2000.
“Almost none of the cases had been vaccinated against measles,” NBC reports.
Measles is one of the most infectious viruses known to man and will infect 90 percent of unimmunized people who breathe it in. What frustrates health care providers is that the spread of this highly contagious disease can be contained.
And while the vaccine has been found to provide about 95 percent protection, a recent poll of Texas parents found 13 percent say they believe the risks of vaccines outweigh the benefits and 16 percent say they should be able to opt out of vaccinating their children.
Texas has one of the highest rates of unvaccinated children in the U.S., partly due to a 2003 state law allowing parents to opt out of getting their children immunized for medical reasons or conscientious and religious beliefs.
In an editorial in the Fort Worth Star-Telegram, Peter Hotez, M.D., director of the Texas Children’s Hospital Center for Vaccine Development, urged parents to provide immunization for their children, Dr. Hotez warned that “we are extremely vulnerable to a measles outbreak in Texas.”
Dr. Hotez identified Tarrant County and Fort Worth as national “hot spots” for a potential outbreak. A study co-authored by Dr. Hotez found that parents of at least 518 kindergartners in Tarrant County schools last year opted to not get preventive shots for their children.
“This news is frustrating to physicians and other health care providers because measles is a disease once thought to be all but gone from the planet. It’s not a coincidence that as we have seen more people hesitant to receive the vaccine, we have seen the number of measles cases increase nationwide,” said Justin Smith, M.D., a pediatrician at Cook Children’s. “The numbers are very concerning. In 2000, the United States declared that measles was eliminated from this country. Now, more and more kids aren’t getting immunized and diseases like measles have returned. Measles is very serious and can cause pneumonia. Children under the age of 5 have a higher risk of hospitalization.”
Keeping vaccination rates relatively high (somewhere around 90 percent) helps protect all children (vaccinated or not) from diseases, Dr. Smith said. In addition, when outbreaks occur, even children who are vaccinated become at risk for contracting disease due to the number of possible exposures.
"Populations who choose to not follow the recommended vaccine schedule are actually setting up the perfect conditions for the diseases they are unvaccinated for to erupt into an outbreak. It is really not a question of whether these outbreaks will occur but when," Jason Terk, M.D., a Cook Children's pediatrician.