Here’s what you need to know about the vaccine debate and potential looming health crisis.
By Courtney Runn
Measles is making headlines again. The highly contagious disease infected 3 million to 4 million Americans each year at its peak but was officially eliminated in 2000, largely due to an aggressive vaccination campaign that prescribed a double dose of the measles vaccine. Nineteen years later, the disease is at the forefront of vaccine debates, and it’s increasingly difficult to sift through the heated social-media debates and click-bait headlines to find out whether a health crisis truly is threatening the country. From Americans concerned about government-mandated vaccines to parents convinced vaccines lead to more diseases to others fully supporting vaccines, everyone is picking sides.
MEASLES IN TEXAS
The Centers for Disease Control and Prevention defines a disease outbreak as three or more cases in one area, and according to that definition, seven states are currently experiencing an out- break of measles (Texas is not one of them). This year, as of late-May, 940 cases were reported in the country, a 152.7 percent increase from 2018, representing the highest number of reported cases in the past decade and the highest number, according to the CDC, since 1994.
A recent study by researchers at the University of Texas and Johns Hopkins University found Travis County is one of 25 of the most at-risk communities in the country for a measles outbreak. Harris County and Tarrant County are also among the top 25. The report cites non-medical vaccination exemptions and international travel as the two most common factors in the potential spread of “vaccine-preventable diseases.” While measles is returning at higher rates, the report iterates that many airborne diseases that were thought to be eliminated from the U.S. could also return with these factors at play.
Janet Pichette, the chief epidemiologist for the Austin Public Health department, confirms there has not been a case of measles in Austin this year. While she can’t predict an outbreak, she says the health department is concerned and actively preparing for one.
“I think it does have potential to become a health crisis just because it can rapidly spread within a community,” she says. “Because we are becoming more of an international hot spot and we have people flying in daily to [Austin-Bergstrom International Airport], it does present a challenge for us.”
The health department regularly monitors for more than 70 “different notifiable conditions,” which include vaccine-preventable diseases like whooping cough and mumps, which occur annually in Austin. The health department has a 24/7 hotline through which medical providers can immediately report cases so the department can initiate outbreak protocol.
In addition to checking on vaccine inventories, in order to prepare for a potential measles outbreak, Pichette says the department closely monitors measles cases throughout the country and world, and educates local health-care professionals about how to recognize and treat measles, as some doctors have not seen or treated measles in their careers.
To encourage vaccination efforts, APH operates two Austin clinics to provide vaccines to anyone, regardless of insurance, citizenship or residency. According to the CDC, the measles vaccine is 97 percent effective when both recommended doses are taken, meaning only 3 percent of vaccinated people may still get the disease.
“Washing your hands and staying home when you’re sick, in general, is always a good thing you can do to prevent spreading illness in your workplace or out in the community,” Pichette says, noting knowing the signs and symptoms of measles can be key in recognizing the long-dormant illness.
VACCINE EXEMPTIONS
From allergies to religious convictions, reasons vary for vaccine exemptions. While most states offer religion-based exemptions, Texas also offers residents an “exemption for reasons of conscience,” leading to its high rate of unvaccinated communities. In the capital city, Austin Waldorf School has the largest number of students with exemptions, with 45 percent of its student body filing for a “conscientious exemption” in the 2018-2019 school year. Austin Discovery School comes in second, with 35 percent.
In a media statement, representatives of Austin Waldorf School said while almost half the student body filed for exemptions, many of those students have some or all vaccines but are on a delayed vaccination schedule. While alternative vaccination schedules are not promoted by national health organizations, many doctors do offer and support flexible schedules.
PERSONAL FREEDOM VERSUS PUBLIC SAFETY
Beyond debating the safety of vaccines, the issue of parental rights versus public safety emerges in the national conversation about vaccines. Rebecca Hardy, director of state policy at Texans for Vaccine Choice, says she first joined the political vaccine fight when one of her Dallas representatives introduced a bill that would remove vaccine exemptions in schools. With a child in school with a vaccine exemption, she was determined to not let the bill pass. She created a Facebook group with other moms with the same stance, and the group quickly grew from 20 to thousands, and during the 2015 legislative session, she says they successfully fought against multiple vaccine bills.
“My greatest fear is to wake up in a state that no longer values parental rights,” she says. “When we start elevating the rights of one group, you are removing the rights of another, and that is not the definition of a free society.”
While Hardy personally doubts the safety and reliability of vaccines, she is clear to say her organization supports vaccine access. Her primary concern is forced vaccinations or exclusion of children from schools or other public places based on vaccine exemptions.
“We do not advocate to dismantle the vaccine program in this state,” she says. “We do firmly believe informed consent is lacking when it comes to vaccines and we do encourage informed consent.”
Many parents worry their children will be excluded based on personal beliefs. Beyond exclusion, families may also face backlash from communities because of their decision to not vaccinate. Several parents declined to comment for this story based on that fear.
While the vaccine debate rages on, the likelihood of more outbreaks in the U.S. is high. To make an informed decision and continue this conversation within your own community, see our tips for starting the convo.
HOW TO START THE CONVO
Know the facts. Hot topics thrive on hearsay. Do your research as you engage with your community on this issue. Janet Pichette suggests visiting austintexas.gov/resident/ public-health or cdc.gov.
Talk to your doctor. Many doctors offer vaccine delays if you’re concerned about the effects or aren’t sure about the pacing of the traditional vaccine schedule.
Call your representatives. Regardless of your position, talk to your local political reps to make your voice and concerns heard.
Know the symptoms. According to the World Health Organization, measles symptoms include a runny nose, cough, red and watery eyes, white spots inside the cheeks and a body-wide rash.