Toddler with measles rash. Photo: Centers for Disease Control/Public Health Image Library

Can refusing to vaccinate children result in a public health emergency? Let’s consider a case study in the state of Washington, where there is a serious outbreak of measles, as well as upstate NY and NYC. We’ll also take a look at the controversy about parents’ refusing vaccinations for their children, and the “anti-vaxxer” movement.

Measles is an extremely contagious virus, spreading among people through the air. Most cases affect kids under the age of 10. While it was a common rite of passage for many children up to the 1950s, it killed hundreds every year in the U.S., and tens of thousands worldwide.

The symptoms include a spotted rash starting inside the mouth, spreading over the entire body, with fever as high as 104 degrees, cough, enflamed eyes, and runny nose. One in every four measles cases requires hospitalization. Once infected, there is no treatment available, though ibuprofen and acetaminophen help to reduce the fever, according to the U.S. Centers for Disease Control and Prevention.

Pneumonia, inner ear infections, inflammations of the brain and seizures are some of the other complications arising from measles. Permanent neurological damage, deafness and death can also occur.

Fortunately, owing to a vaccination rate of 85 percent worldwide, death from measles — and the occurrence of the disease at all — had all but disappeared except in some developing areas in Africa and Asia. The island nation of Madagascar has suffered 300 deaths, and counting, in a measles outbreak that has hit 20,000 people who have lost interest in widely available vaccinations. And now in other parts of the world, more parents choose to avoid vaccination for their children, leading to more outbreaks, and a significant climb in measles-related deaths.

The World Health Organization reports more than 110,000 kids, mostly under the age of 5 years, died from measles last year, but not in the U.S. A public health policy that had once earned parents’ support nationwide accounts for our children’s escape from this dangerous but at the same time entirely preventable virus.

Now a dangerous turnaround can be found in communities in the states of Washington and Oregon. A number of parents choose not to allow their children to be vaccinated for measles or anything else. Take Clark County, Washington, which is only about nine miles away from Portland, Oregon. This county has among the lowest vaccination rates in the state. As recently reported in the Oregonian, citing state records, 22 percent of public school students in Clark County did not complete vaccinations. Since the beginning of 2019, they have identified 56 confirmed cases of measles with other, suspected cases soon to be diagnosed, prompting the declaration of a health emergency.

Starting late last year, there were measles occurring in Brooklyn and in the Lower Hudson Valley upstate, with over 200 cases, making this New York’s largest measles outbreak in decades.

Vaccination for kids covers not only measles, but also polio, rubella, mumps, diphtheria and other diseases that once took a terrible toll in human life year after year. Yet increasing numbers of parents have embraced the “anti-vaxxer” movement, deeply rooted in a growing distrust of big pharmaceutical companies and government. But are parents spreading preventable disease in the form of vaccine refusal?

Back to the West Coast — in 2016, in the face of an anti-vaxxer challenge, the courts upheld California’s “Proof of Vaccination” law. Refusing to vaccinate on religious grounds was also outlawed. Medical reasons, such as bad reactions to shots or a pre-existing condition, are the only exception. New York has a similar law, but foolishly still allows avoiding vaccinations for religious reasons. Also in 2016, at the Tribeca Film Festival, actor Robert DeNiro, himself the parent of an autistic child, hosted an anti-vaccine documentary. In it, a doctor who has since been barred from the practice of medicine linked child vaccines to autism. He claimed vaccines are linked as well to asthma, diabetes and allergies, all with absolutely no substantive proof.

The anti-vaxxer movement is also rooted in a belief that forced vaccinations are wrong in a free country. Insisting it’s a personal decision, the anti-vaxxers are known to send their kids to private schools that are more accepting of low vaccination status, or none at all, for their students. Many advocates of holistic medicine and the health food industry now openly question vaccines. They point to the ongoing, horrific opioid epidemic, and how it might have been avoided if so many had not relied, to their peril, on the pharmacy companies, the medical profession and the protection of government regulation. But is this relevant?

With vaccines, there is hard data backing the scientific conclusion that a vaccination rate of 93 percent or better is needed to prevent measles outbreaks among the public. To that end, government pushes mandatory vaccination. A resulting paranoia tightens its grip as some parents refuse to get their children vaccinated owing to distrust in government.

The CDC warns of measles outbreaks as travelers return from such areas as Israel and the Ukraine, where large outbreaks recently occurred, and spreading the disease here. The CDC emphasizes that the once-eradicated measles virus is more likely to spread in areas with “pockets of unvaccinated people.”

With all of this considered, maybe the time has come for strengthening mandatory vaccinations with penalties for those who refuse. Parents’ stubborn failure to vaccinate their kids unreasonably endangers the “herd immunity” on which they could be said to selfishly rely, unconcerned with the risk to others who could not be vaccinated for medical reasons or simply being too young. Some have suggested that health insurance by law should not cover medical expenses for illnesses arising from deliberately unvaccinated children – a harsh solution. But even more harsh is the spread of the virus among those who could not be vaccinated for valid reasons.

For information on measles vaccinations, and the senselessness of avoiding them, call the NY Measles Hotline at (888) 364-4837. To choose the antivaxxer path is fraught with risk. It makes sense to weigh carefully a truly life-and-death decision before you make it.

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Greg Blass
Greg has spent his life in public service since he enlisted in the U.S. Navy as a teenager. He is a former Suffolk County Family Court judge, six-term Suffolk County legislator and commissioner of Social Services. Now retired, Greg is active in volunteer work and is a board member of several charities. He lives in Jamesport. Email Greg