Measles Epidemic Continues and Grows in Washington State, New Cases in Houston Texas

February 6, 2019 Rene F. Najera

The situation in Washington State is getting worse with respect to the measles outbreak that started there last December. Public health authorities are reporting that over 50 children have now been confirmed as measles cases, with the vast majority of them being unvaccinated. (The rest have either received one vaccination, don’t have a vaccine record, or were too young to be vaccinated.) This is happening as there are now reports of a nascent measles outbreak in Houston, Texas.

You should not be surprised about either location seeing measles. Only last week did the Houston Chronicle's editorial board publish an editorial critical of the low vaccination rates in and around the city:

"A measles outbreak health advisory issued last year by the Texas Department of State Health Services is a reminder that this state is walking down a dangerous path by issuing too many waivers to parents who don’t want their children to get immunization shots required to attend school.

Texas is one of 18 states that allows waivers of school vaccine requirements based on parents’ conscience or personal beliefs. Last year nearly 57,000 students claimed a non-medical exemption from taking otherwise mandatory shots to attend school. Houston, Austin, Fort Worth and Plano all rank among the top 15 metropolitan areas in the nation for vaccine exemptions.

Many of these waivers were granted at the request of parents who still believe the debunked theory that childhood immunization may cause autism or other disorders. Despite scientific evidence that the theory is just plain wrong, Texans for Vaccine Choice has successfully lobbied the Texas Legislature to kill any bill that would make it more difficult to get a vaccine waiver."

Just as predictable has been the response from anti-vaccine groups in Washington State and Texas. Some of them blame the MMR vaccine itself as causing measles. This is patently false. There is zero evidence of the MMR vaccine causing an outbreak of measles. Very rarely, it has caused measles-like symptoms in patients receiving the vaccine because those patients were severely immunocompromised. But for that to happen there had to be a convergence of two things: a very sick and immunocompromised patient and a healthcare provider that failed to detect it and administered the vaccine.

Other anti-vaccine groups and their members continue to hold on to the idea that the MMR vaccine causes autism. This is a very old and tired bit of misinformation that continues to make the rounds. The paper that was published in The Lancet alleging this link has been found to be a complete fraud. And, no, other research has not confirmed the fraud's findings. If anything, many resources were wasted trying to prove the fraud to be that, a fraud.

And then there are the anti-vaccine groups who claim that "forcing" vaccination is an assault to Liberty and religious freedom. First, no one is being forced to do anything. There are no SWAT teams breaking down doors, holding people down and vaccinating them against their will. There are laws and regulations to compel people to vaccinate themselves and their children, but these have been ruled constitutional time and again, and they are no different than traffic laws that compel us to drive at the speed limit, drive sober, and stay at the scene of an accident if we are involved in one. Just like we make a social contract to obey traffic laws if we are to use the roads and our vehicles, we need to make a social contract to protect each other from vaccine-preventable diseases if we are to use schools and public spaces.

Second, there is nothing saying that parents cannot opt out of vaccinating their children. They can do so, if they choose to, and no one will hold them to account... Which is kind of the problem, isn't it? If a parent knows the risks of not vaccinating, and their child becomes ill, what kind of consequences should they face? Other than social shunning, there isn't much in the law about punitive measures for parents who knowingly leave their children unexposed.

As these outbreaks of vaccine-preventable diseases like measles continue to become more commonplace, we as a society are going to have to make some tough choices. Do we allow children of misinformed parents to continue to be susceptible to a potentially deadly and debilitating disease? Do we protect anti-vaccine lies and misinformation like we protect other opinions under the umbrella of freedom of expression? Public health authorities are going to have to decide if and how to go after physicians who sell vaccine exemptions. Finally, education regulators need to decide how they're going to deal with the very high rates of exemptions that seem to concentrate around private schools (at least in and around King County, Washington, site of the latest large measles outbreak.)

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