Summit County health officials: Measles outbreak highlights importance of vaccinations
Special to the Daily
With measles cases continuing to rise in the United States this year, it’s important to take a moment to understand the facts about this disease, the current outbreaks and the vaccine that prevents it. The total number of people reported to have measles between Jan. 1 and Feb. 27 has now climbed to 170 in 17 states and the District of Columbia. This represents four different outbreaks, the largest of which began at California’s Disneyland Resort in early January, according to the Centers for Disease Control and Prevention. The rates of infection are on track to surpass the 644 total cases in the United States in 2014 — an all-time high since measles was all but declared eliminated in our country in 2000. The majority of the people who have contracted the measles were unvaccinated, highlighting the importance of immunizations against vaccine-preventable diseases.
Measles is a highly contagious virus that spreads through respiratory droplets. It can live up to two hours in the air or on a surface where an infected person has coughed or sneezed. It is so contagious that 90 percent of the people close to the person infected who are not immune will also become infected. Most outbreaks occur when someone who is not vaccinated comes from a place where the disease is prevalent and then brings it back to the community. Measles is common today in many parts of the world, including Europe, Africa, Asia and the Pacific.
Initial symptoms of measles are similar to those of the common cold, including cough, runny nose and fever. The symptoms escalate, and within five days, a rash appears. An individual with measles is contagious from four days before to four days after the appearance of the rash. Though measles can be severe in all age groups, those under age 5 are most susceptible to complications. One in 20 children get pneumonia, one in 1,000 get encephalitis (swelling of the brain) and the disease is fatal in one to two cases in 1,000.
Though measles is highly contagious, it is also highly preventable through vaccinations. Typically, children receive one dose of the measles, mumps and rubella (MMR) vaccine at 12-15 months and a second at 4-6 years of age. The vaccine is very effective. According to the Colorado Department of Public Health and Environment, one dose of the measles vaccine is 93 percent effective in preventing infection if exposed, and the second increases the effectiveness to 97 percent. Delaying vaccination can leave children vulnerable to measles when it is most dangerous to their development.
Because no vaccine is 100 percent effective, communities rely on what is called “herd immunity” — immunization across large proportions of the population — to prevent the spread of communicable diseases. This herd immunity protects those who cannot be vaccinated, such as infants and those with immune deficiencies. The protection factor for measles decreases when less than 95 percent of the population is vaccinated. The CDC reports that less than 82 percent of kindergartners in Colorado are fully vaccinated for measles — the lowest rate in the country. This makes our state vulnerable to a measles outbreak.
Low socioeconomic status, lack of access to health care and cost all are obstacles to vaccinations. But under the Affordable Care Act, these barriers are reduced, as insurance plans must cover the cost of all recommended immunizations, including measles. For individuals who continue to be underinsured or uninsured, the MMR vaccine is offered for low to no cost through various community programs.
Another reason for low vaccination rates is the increasing number of nonmedical exemptions. Colorado is one of only 20 states that allow for personal-belief exemptions. The decision not to vaccinate is not an irrational one. Rather, it is often based on incomplete or inaccurate information. Much of the current fear of vaccines began after a fraudulent 1998 study that claimed a connection between the MMR vaccine and autism. This study was later retracted, and the lead author of the paper, Andrew Wakefield, has since lost his medical license for falsifying his data. There have been dozens of studies since, and a report from the Institute of Medicine, that have found no link between autism and any vaccines, including MMR.
So how does Summit County fair? Just over 95 percent of our kindergartners are vaccinated for MMR. This means we are meeting the CDC’s goal for 95 percent of kindergartners to begin schooling with MMR vaccinations. It is important to know that under Colorado House Bill 14-1288, effective July 1, 2014, schools and child care facilities are required to disclose immunization and exemption rates upon request. Parents can now use this information to inform their choice of a school program that is safe, enriching and healthy for their child.
The decision not to vaccinate can have repercussions across the broader community — not just in schools, but also in grocery stores, buses and other public places. It is also important to know that individuals who are either not immunized or underimmunized may be quarantined for up to three weeks if they are exposed to an infected individual. Parents should understand that the measles vaccine is the best way to protect a child from the measles if an outbreak were to occur. Summit County Public Health recommends that all children who have not previously been vaccinated get vaccinated as soon as possible.
Adults who do not have immunity need at least one dose of measles vaccine. Adults in settings that are considered higher risk for possible transmission should make sure they have had two doses of measles vaccine separated by 28 days. This includes students at post-secondary schools, health care personnel and international travelers. For those unable to verify whether they are immune to measles, either by documentation of immunity or vaccine records, we advise getting the MMR vaccine. There is no harm in getting another dose of the MMR vaccine even if you may already be immune.
To receive the vaccine, contact your primary care provider. For most people, the vaccine will be free. If you do not have a primary care provider, there are many locations in the community, including the Summit County Public Health Department, where you can be immunized at low cost. Summit School District’s School-Based Health Centers can also provide vaccinations.
For more information on measles or vaccinations, contact Summit County Public Health at (970) 668-9161, or visit the CDC at http://www.cdc.gov/measles.
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