Vaccines play a critical role in keeping residents safe and healthy from diseases that spread easily and were once common in this county and throughout the globe. For example, before pertussis vaccines became widely available in the 1940s, about 200,000 children got sick with it each year in the United States and about 9,000 died as a result of the infection. Currently about 10,000 to 40,000 cases and up to 20 deaths are reported each year. Another vaccine preventable disease, polio, was once considered one of the most feared diseases in the United States. In the early 1950s, before polio vaccines were available, polio outbreaks caused more than 15,000 cases of paralysis each year in the United States, not including the deaths it also caused. Due to vaccination, the United States is now polio-free, but it only takes one unvaccinated traveler returning home to begin transmission among other unvaccinated persons. One key strategy in maintaining this decrease in vaccine preventable disease is to continue using vaccines. This directly protects the person being vaccinated and those who are unable to get vaccinated for medical reasons. Vaccines are so effective at preventing disease that once-common diseases are now rarely seen. Perhaps as a result, the number of people receiving vaccinations is declining. Washington is one of 17 states that gives parents the ability to opt out of school vaccination requirement for personal or philosophical reasons. The majority of states only allow medical and religious exemptions to school vaccine rules, and those states have less disease and fewer outbreaks than states that allow exemption for personal reasons.
As an example, in Snohomish County, two babies acquired the vaccine preventable disease Haemophilus-influenza type b (Hib). Both required mechanical ventilation in an intensive care unit and will likely have permanent severe hearing loss and possibly other serious complications.
As another example, Washington has experienced three large measles outbreaks in the past 10 years, and one woman died in one of those outbreaks. In 2018, the Health District responded to a measles outbreak amongst mostly unvaccinated persons. And currently, Clark County is responding to the largest measles outbreak in many years with 70 confirmed cases, 61 of those cases in unimmunized persons. Cost estimates for the public health response to date is $1.2M for the Washington State Department of Health alone. This estimate does not include loss of school days or business impacts.
Based on surveillance from the Washington State Department of Health, 5.5% - 7.3% of Snohomish County students in kindergarten through 12th grade have an immunization exemption. In taking a closer look, 9.8% of Snohomish County kindergartners were without complete measles, mumps and rubella (MMR) vaccines during the 2017-2018 school year. Reasons for not being vaccinated are personal exemption (4.6%); noncompliance with school requirements (4.5%); and the remaining 0.8% being either medical, religious, or religious membership exemptions.
Things we know about vaccines and the MMR vaccine:
-
The Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) both agree on the safety of vaccines. There are several systems that monitor vaccine safety, and any issues are promptly reported to health officials like me.
-
The Snohomish Health District’s childhood vaccine program works to ensure local providers maintain proper compliance protocols and safe storage and handling are followed.
-
There is no treatment for measles, which is dangerous disease that can lead to death or lifelong health complications. The vaccine, on the other hand, is very effective. Two doses of MMR vaccine are about 97% effective at preventing measles; one dose is about 93% effective.
-
Measles is one of the most contagious diseases, and a public health response effort is swift. If a student or staff member in a school is confirmed with measles, we would move to exclude all other students and staff members within that school until the risk of exposure is over. In some cases, this can be for more than three weeks.
-
Free vaccines, including Hib and MMR, are available through the childhood vaccine program.
By removing personal exemptions—and providing funding for public health outreach and partnerships with schools to decrease those noncompliance rates—we are better able to protect the 0.8% who cannot get vaccinated because of medical or religious reasons.