This new school year will be a test to see if new Washington legislation and public awareness efforts have gone far enough to protect against another outbreak of measles, a dangerous, highly contagious — and preventable — disease.
Last spring, Washington saw two measles outbreaks totaling 86 cases. Seventy-one of those were in Clark County, prompting lawmakers to eliminate personal and philosophical exemptions to measles, mumps and rubella (MMR) immunization requirements for K-12 schools, preschools and licensed child cares. The law, which took effect at the end of July, leaves religious and medical exemptions, as well as personal exemptions for other vaccinations, unchanged.
Ninety-seven percent of people who receive the MMR vaccine develop immunity. Those few who do still contract the diseases tend to experience milder symptoms. Widespread vaccination offers critical protection to those who cannot, themselves, be vaccinated.
The Clark County outbreak cost public health departments more than $1 million and wreaked havoc with the school year, as 800 exposed students were barred from classrooms for several weeks. A smaller Seattle-area outbreak led to similar precautions at Issaquah High School and North Creek High School in Bothell — a public health necessity and significant interruption to learning.
Last year's statistics lend important context: As of last November, just over 86 percent of kindergartners had completed state-mandated vaccination schedules, according to data released last week by the Washington State Department of Health. In the Puget Sound region, county compliance figures met or exceeded the state average, but did not top 89 percent.
Significantly, although only around 5% of the state's kindergarten students received exemptions to vaccination requirements, 7% of students were "out of compliance" — they either had not been vaccinated or had not provided adequate documentation to school officials. Here, too, the region closely mirrored the statewide average. In King and Pierce counties, the number of students out of compliance exceeded those who had received exemptions. In Snohomish, the difference was minimal.
There are many reasons for noncompliance, said Rep. Monica Stonier, D-Vancouver, member of the House Committee on Health Care & Wellness and an instructional coach in Evergreen Public Schools, which were Ground Zero in the Clark County outbreak. Often, it is not because parents overtly oppose vaccinations, but that they failed to follow through. Cost should not be a factor — a state program makes vaccines available to children for free.
A co-sponsor of the bill eliminating philosophical objections to MMR vaccines, Stonier said she is confident the state will see an increase in immunizations this school year, noting that immunization rates "skyrocketed" in Clark County last spring due to heightened awareness and accountability. Rep. Eileen Cody, D-Seattle, chair of the House Committee on Health Care & Wellness, said state lawmakers will be monitoring progress, although follow-up legislation is unlikely this session.
Compliance matters. Fewer than 5 percent of this year's measles cases in Washington have involved patients who had had two or more doses of the vaccine — as is required for kindergarten enrollment. Sixty six of the 86 cases involved unvaccinated people.
Nationwide, 1,234 cases of measles have been confirmed in 31 states so far this year, far surpassing last year's total of 372 cases, according to the Centers for Disease Control and Prevention. This is not a trend to trifle with.
If this year's vaccination figures do not show significant improvement in compliance and rates of vaccination, state lawmakers should take further action to safeguard public health, particularly in Washington's schools.