Every day nearly 400 people die of measles worldwide, mostly small children, according to the World Health Organization (WHO). In 2013, says the WHO, measles killed 145,700 people.
Measles can cause blindness, deafness, encephalitis and pneumonia. Happily, transmission of this highly contagious, airborne virus is preventable. In the United States, measles actually was declared eradicated in 2000.
Yet today we have measles outbreaks in 17 states, including five in Washington. With a total of 142 cases nationwide, we’re on track to surpass last year’s 644 cases nationally.
And this happened how? Hello?
Checkmating deadly viruses that cohabit the planet with us depends utterly on vaccinating nearly everyone. This reduces the availability of human hosts enough to result in “herd immunity.” For measles, achieving herd immunity in a given population requires a 92 to 94 percent vaccination rate, according to the federal Centers for Disease Control and Prevention (CDC).
Yet some people seem to believe they’re exempt from the civic duty that falls on us all to safeguard public health. That’s true even here in the Methow Valley, where people look out for one another.
Methow Valley Elementary School’s vaccination rate for measles was 92 percent and that of Liberty Bell Jr./ Sr. High School and the Independent Learning Center was 89 percent as of Feb. 12, 2015, according to school nurse Laura Brumfield.
She says 29 students in the kindergarten/elementary school and 38 in grades 7-12 and at the Independent Learning Center aren’t vaccinated. They can be banned from school during outbreaks.
This means the Methow Valley School District as a whole — with a 90.5 percent vaccination rate — falls short of meeting the CDC’s standard for herd immunity for measles, though the kindergarten/elementary school alone may have squeaked across the measles herd immunity safety line.
“I think balancing on the line of barely attaining the threshold of herd immunity is not the place I want our community to be in,” says Brumfield. She has no information on vaccination rates among home-schoolers, also part of the potentially at-risk community.
The high number of unvaccinated students here is particularly worrisome, adds Brumfield, because valley residents tend to be frequent travelers.
The rate of parental requests to have their children excused from state-mandated vaccinations in our school district “is relatively high” compared with other places, says Superintendent Tom Venable. In 2013-14, when the district had 634 students enrolled, 114 of them were granted exemptions from at least one vaccination, according to the state health department.
Washington state grants vaccination exemptions for medical, religious or philosophical reasons. Until five years ago, parents simply filled out a form to get the exemptions. Predictably, vaccination rates dropped.
Now parents must consult with a doctor, who has to sign the exemption form, and vaccination rates have improved. Even so, doctors appear to have signed off on so many exemptions that it’s questionable if herd immunity exists for measles in the Methow Valley School District. Little wonder that some state lawmakers are reconsidering allowing exemptions.
Ironically, surveys show that aside from those claiming religious objections, “educated” parents young enough to never have seen measles are the most cavalier about preventing it.
A confession by Gal Adam Spinrad in the Feb. 6 edition of the Washington Post headlined “I used to be a vaccine skeptic. Now I’m a believer,” reveals the thinking of some anti-vaccine parents. Spinrad says she believed her infant daughter’s immune system should have the chance to build up on its own “without being bombarded with viruses and chemicals.” She put her faith in a healthy diet, vitamins and hand washing.
“She’s safe even without her shots because everyone around her is vaccinated,” Spinrad recalls saying. “Friends said the same thing to me about their unvaccinated children. We had that luxury — we could count on herd immunity to protect our children.”
These parents assumed they could depend on other parents to provide a vaccine-free ride to safety for their kids, in other words. Anyone looking for herd immunity to provide that free ride from measles in the Methow Valley School District should look again.
Spinrad’s second daughter was born with a congenital defect. As her vulnerable infant struggled for life, Spinrad had a herd immunity epiphany. “I can’t say exactly why the idea of protecting others hadn’t hit me before — I have always considered myself a sensitive and empathetic person,” she wrote.
To get non-medical exemptions, parents should face a high burden, such as having to write a detailed, notarized letter annually, before being allowed to remove their children from the immunized herd, Dr. Saad B. Omer, an epidemiologist at Emory University, rightly argues.
He partly blames “intemperate comments by politicians” for fostering the dead-end dogma that vaccines are an unwarranted intrusion on personal liberties. He adds the ominous news that 31 bills were introduced in various states between 2009-13 to make exemptions easier.
Some parents have succumbed to junk science peddled by charlatans, notably the thoroughly discredited, fraudulent claim by Andrew Wakefield, whose license was revoked for falsely claiming a link between vaccines and autism.
“The science is unimpeachable,” says Dr. Arthur L. Caplan, director of the Division of Medical Ethics at New York University: “Vaccines do not cause autism.” Doctors who ignore science and proselyte against immunization are engaged in medical misconduct, he argues, and their licenses should be revoked.
Works for me.
Solveig Torvik lives in Winthrop.