From the Journals

Measles outbreak sends vaccine demand soaring, even among the hesitant


The Vancouver Clinic, which operates medical offices and urgent care centers in the area, reported that shots administered jumped from 263 in January 2018 to 1,444 last month, a nearly 450% increase.

That’s a huge rise in a county in which vaccination rates lag – only 76.5% of kindergartners had all the required immunizations for the 2017-2018 school year. Health officials have long worried about the potential for an outbreak in the region.

Statewide in Washington, orders for measles vaccine jumped about 30% in January, compared with the same month last year, climbing from 12,140 doses to 15,780 doses, figures showed. The vaccines include MMR, which protects against measles, mumps and rubella, and MMR-V, which also protects against the varicella-zoster virus, which causes chickenpox. The vaccine takes effect within 72 hours, health officials said.

The orders represent only state-supplied vaccines requested through the federal Vaccines for Children program, which provides free immunizations to children who otherwise couldn’t afford them.

But it’s a snapshot of the scare an outbreak can cause, said Alan Melnick, MD, the health officer and public health director for Clark County overseeing the response.

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“I would rather it not take an outbreak for this to happen,” he said.

Since Jan. 1, 2019, 50 cases of measles have been confirmed in Clark County, with 11 more cases suspected, officials said. The Pacific Northwest outbreak includes one confirmed case in King County, where Seattle is located, and four in Multnomah County, which includes Portland, Ore.

On Feb. 6, officials sent letters to families of 5,000 children in Multnomah County telling them they’ll be excluded from school if they don’t have up-to-date immunizations or valid exemptions by Feb. 20.

Most of the infections have occurred in children, under age 18 years, who were unvaccinated. The outbreak includes 43 cases among those who were not immunized, 6 cases in which immunization has not been verified, and 1 case in which the person had received only a single dose of vaccine.

The Centers for Disease Control and Prevention recommends two doses of measles vaccine, one given at between 12 and 15 months of age and one between ages 4 and 6. Health officials say the shots are safe and effective, providing about 93% protection with one dose and 97% with two doses.

The Northwest cases are among three ongoing measles outbreaks in the United States that sickened 79 people in January, according to the CDC. Last year, 372 measles cases were confirmed nationwide, the most since an outbreak in 2014 sickened 667 people.

Washington and Oregon are among 17 states that allow nonmedical exemptions from vaccination requirements for school entry, according to the National Conference of State Legislatures.

Washington state Rep. Paul Harris (R-Vancouver) has introduced a measure that would remove personal belief exemptions for the MMR vaccine.

Research has confirmed that vaccines don’t cause autism, a common reason cited by parents who reject vaccinations. Others object to the timing and combinations of the vaccines and to being forced to inoculate their children.

Kaiser Health News is a nonprofit national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation that is not affiliated with Kaiser Permanente.

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