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Measles cases are up nationwide. This is what vaccination rates look like in local schools
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Dr. Kathering Herzog checks the heartbeat of Joel Elias Laguna, 1, center, with his father, Guadencio Elias, left, holding him at Longstreet Clinic on Thursday, May 30, 2019. Longstreet is launching a renewed educational initiative about the importance of vaccinations with measles outbreaks occurring across the country. - photo by Austin Steele

Gaudencio Elias responded to a question about why he wanted to have his 1-year-old son, Joel Elias Laguna, receive a host of vaccinations as if the answer was obvious.

“To prevent the measles,” he said, speaking through a Spanish-language translator, on a recent morning at The Longstreet Clinic in Gainesville.

The Longstreet Clinic in Gainesville has launched a renewed educational push for staff, their families and the Hall County-Northeast Georgia community about the importance of vaccination.

Elias said recent reports of measles outbreaks across the nation had him worried for the health and safety of Joel, who was also at the clinic to be immunized against mumps and rubella, as well as chickenpox and Hepatitis A.

Elias’ fears are well founded.

Measles in the United States has climbed to its highest level in 25 years, according to the Centers for Disease Control and Prevention.

From Jan. 1 to May 24, 940 individual cases of measles have been confirmed in 26 states, including Georgia.

This is the greatest number of cases reported in the U.S. since 1994, when 963 cases were reported. No area of the country has been spared.

Public health officials largely attribute the resurgence to the spread of misinformation that is turning parents against vaccines.

The number of cases is likely to go even higher. Measles is highly contagious and can spread through the air when someone coughs or sneezes. It can take 10 to 12 days for symptoms to develop.

The CDC recommends the vaccine for everyone over a year old, except for people who had the disease as children. Those who have already had measles are immune.

The vaccine, which became available in the 1960s, is considered safe and highly effective, and because of it, measles was declared all but eliminated in the U.S. in 2000. But it has made comebacks since then, including 667 cases in 2014.

Public health experts say some U.S. communities have low vaccination rates because of the spread of bad information — especially the now-debunked notion that the measles-mumps-rubella vaccine is linked to autism — through social media, pamphlets, hotlines and other means.

And measles’ return may be an early warning sign of resurgences in other vaccine-preventable diseases such as rubella, chickenpox and bacterial meningitis, Schaffner said.

Measles in most people causes fever, runny nose, cough and a rash all over the body. However, a tiny fraction of those infected can suffer complications such as pneumonia and a dangerous swelling of the brain.

According to the CDC, for every 1,000 children who get measles, one or two will die from it. No deaths have been recorded this year.

There have been three measles-related deaths reported in the U.S. since 2000, the last one in 2015. The worst year for measles in modern U.S. history was 1958, with more than 763,000 reported cases and 552 deaths.

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In an article that appears in The Longstreet Clinic’s June newsletter, Dr. Saima Hussain, a board-certified pediatrician at Longstreet Clinic Pediatrics in Braselton, warns about the popular misinformation spreading about vaccines and how it creates dangerous myths that have contributed to the recent outbreaks.

“Out of sight, out of mind,” she wrote. “It’s human nature not to think too much about the things we don’t see or that don’t involve our day-to-day lives. Many of us aren’t old enough to remember when illnesses like measles were causing serious medical complications or even death. It’s likely you’ve never even met someone who had the mumps as a child.”

Vaccinations have long been considered one of the preeminent modern medical breakthroughs, according to Hussain, and not just because they saves children’s lives.  

As Hussain explains, vaccines are an antigen, which kill or weaken viruses.

“The immune system then recognizes the antigen and creates antibodies against the disease,” she said. “The antibodies remain in your system, tricking your body into thinking you’ve already had a certain disease.”  

Moreover, immunizations are an essential part of preventive care and disease prevention.

“It builds ‘herd immunity’ by protecting other children too young for vaccinations or unable for medical reasons,” Hussain said. “And it keeps society immune – mostly.”

Herd immunity is critically important in crowded environments like schools, according to the CDC, and it eradicated smallpox, for example.

“However, myths and misinformation campaigns have caused more parents to delay or skip childhood vaccinations, which is why we have seen big spikes in cases of measles and mumps this year,” Hussain said.

The percentage of population vaccinated for herd immunity to be effective varies depending on the disease.

Vaccination rates needed for herd immunity

Measles: 92-94%

Pertussis: 92-94%

Diphtheria: 83-85%

Rubella: 83-85%

Mumps: 75-86%

Influenza: 30-75%

Source: Centers for Disease Control and Prevention

Local public school districts, including Gainesville City Schools and Hall County Schools, follow the guidance of the state Department of Public Health as it concerns mandatory vaccinations and what exemptions exist.

Exceptions include a medical exemption authorized by a medical doctor or a conflict with religious beliefs verified by a parent’s sworn affidavit.

The local public health department audits school districts, as well as private schools, to determine vaccination rates.

Dave Palmer, spokesman for the District 2 public health office based in Gainesville, said vaccination rates have been consistent over the past several years.

The number of religious and medical exemptions in Hall County is typically just 1% to 2%, or less, according to Palmer.

Moreover, Palmer said, incomplete certificates make up a large percentage of noncompliance. “However, per Georgia immunization rules, students have a certain time period to get caught up on vaccinations before not being allowed to attend classes,” he added.

Interestingly, though, is that vaccination rates in local public schools have actually decreased slightly between 2015 and 2018, while private schools, many religiously affiliated where exemptions are more common, have seen their vaccination rates increase significantly in the past three years.

Vaccination rates 

Local public school districts follow the guidance of the Georgia Department of Public Health, which includes basic requirements such as mandatory vaccinations for diphtheria, haemophilus influenzae type B, Hepatitis A, Hepatitis B, measles, meningitis, mumps, pertussis, pneumococcal, poliomyelitis, rubella, tetanus and chickenpox. The local public health department audits local schools to determine vaccination rates for students entering kindergarten and seventh grade.

2015

Kindergarten

Public: 96.44%

Private: 83.95%

Seventh Grade

Public: 98.27%

Private: 80.14%

2018

Kindergarten

Public: 95.30%

Private: 87.96%

Seventh Grade

Public: 96.38%

Private: 89.30%

Mamie Coker, the Hall County Schools’ health services coordinator, said it’s important for parents who may have concerns about vaccines, or who are looking for more information about their safety and efficacy, to speak with their primary care doctors.

That’s in lieu of taking to the Internet and social media, she added, where vaccine pseudoscience can be made to look or seem legitimate.

“Articles can seem very valid,” Coker said, “even though there’s no research-based data.

“Don’t get into the weeds,” Coker added, referring to what she calls “Dr. Google.”

Mimi Collins, CEO of The Longstreet Clinic, said it’s important for health care providers to proactively confront the latest outbreak and reemergence of measles and other viruses.

“The ability to access information is easier than ever, which can be a good thing, but it also means that inaccurate information is readily available, too. Unfortunately, misinformation has contributed to a decrease in vaccination rates.”

And this is why The Longstreet Clinic is working to confront the issue head on.

“With the recent news about the measles outbreaks across the country and the reemergence of diseases like mumps and whooping cough, we decided it was important to use our voice in a way that could have a positive impact on our patients, our staff and the community as a whole,” Collins said. “It’s also important to reiterate our commitment to evidence-based standards of care. Longstreet Clinic has a responsibility to be part of the dialogue with our community around this topic.”

The Associated Press contributed to this story.

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