Measles vaccinations almost wiped out the disease from the United States in 2000. Elimination meant measles no longer spread, because most people were vaccinated. However, in 2019, instead of celebrating public health successes, we are losing ground.
So far this year, the number of measles cases in the U.S. is the second highest since 2000. Today, there are outbreaks of measles in Washington state, New York, California, New Jersey and Michigan, and New York City just declared a public health emergency because the outbreak there had become so severe.
Such outbreaks are a blunt reminder of how vulnerable we are in Colorado. For the 2017-18 school year, Colorado’s kindergarten vaccination rate for measles, mumps and rubella (MMR) ranked second to last in the U.S., with a coverage rate of 89 percent. Because measles is so highly contagious, we need 95 percent coverage to keep it under control and prevent an outbreak.
Vaccines are one of the greatest successes of our time — reducing illness, medical costs and emotional heartbreak for countless families. Vaccines have completely eradicated smallpox and are close to doing so for polio; they have also reduced disability and suffering from more than 18 diseases preventable by vaccines.
Yet, vaccines are victims of their own success. Keep in mind that because vaccines work so well to protect people, most of us haven’t seen the devastating consequences of diseases such as measles and mumps. In 2017 in Colorado, more than 9,000 children were taken to the hospital because they were ill from a disease that could have been prevented by vaccination. Tri-County Health Department serves Adams, Arapahoe, and Douglas counties, and we are seeing measles, mumps and whooping cough re-emerge among unvaccinated people.
Decisions by parents not to vaccinate their children is a growing public health issue across the world. Such “vaccine hesitancy” is considered by the World Health Organization to be among the most important of all global health issues. It’s also an issue in our jurisdiction: Among 1,135 child care centers, kindergartens and schools, parents of nearly 8,000 students opted out of having their child receive a recommended vaccine by using a personal belief or religious exemption. In our three counties, vaccination rates for MMR in kindergarteners in some schools run as low as 43%, and MMR rates are lower than the state average in one out of four kindergartens.
Much of this hesitancy is based upon an increasing amount of misinformation about safe vaccines actually are. Such misunderstanding can lead to concern among some parents who are trying to do the best they can for their child’s health and thus are cautious about health decisions. That’s understandable. But the truth is that vaccines are safe. Some of the best minds in science continuously study vaccines to ensure they are safe and effective — for the community, and for their own children. Myths about vaccine risks — such as the unfortunate fraudulent report that vaccines can cause autism — have been regularly assessed and debunked.
Now, the process for a parent to claim a non-medical exemption so their child can enter school without meeting vaccination requirements is easier than vaccinating a child. House Bill 1312, currently under consideration by the Colorado legislature, asks parents considering a non-medical exemption to put in time and consideration — just as the overwhelming majority of parents who do vaccinate their children take the time to do. This is important because vaccination is not only a personal choice. Whether or not a parent vaccinates their own child has very real impacts on people around them in the larger community.
Diseases quickly become outbreaks when we don’t work together. Take away vaccination and disease will return. As a part of this community, we have a responsibility to each other. Please talk to your health-care provider and get the facts about vaccination.
John M. Douglas Jr., M.D., is executive director Tri-County Health Department, and Bernadette Albanese, M.D., is medical epidemiologist for Tri-County Health.
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