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The Measles Outbreak, Pennsylvania, and the Need for Vaccinations

The Measles Outbreak, Pennsylvania, and the Need for Vaccinations








On February 7th, the Times Herald headlined with "Case of measles suspected," about a teen-aged boy in Montgomery County, PA. Naturally, worrying kicked in. Had the virus traveled here all the way from California, where 103 cases had already been confirmed? Philly's news station KYW was all over the story, too, and seven-year-old Harry heard the report as he sat in the back seat of the family car on the way to basketball practice.

His question was immediate: "What's measles?" followed up with, "Can it make you die?"
After explaining a bit about the disease, he finally settled down when his mom ended with, "You don't have to worry about it; you've been vaccinated."

And that, of course, makes all the difference, not just for Harry, but the rest of us, too.
Writing for USA Today, Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, explained that back in 1990, four diseases, measles among them, were responsible for the deaths worldwide of almost 2 million children, five years and younger. Thanks to immunizations, however, by 2013, that number has been reduced by 70% to 600,000.

Hotez then goes on to posit that lots of children are still at risk in part because of the media's silence about these advances. This, he concludes, has allowed "fringe groups to disseminate false claims about vaccines and their alleged links to autism... despite a total absence of scientific credibility or even plausibility given what we know about the genetics of autism... "

The result: While back in 2000, the CDC was able to announce that measles had been eradicated in the U.S., that's no longer true. In fact, last year, 600 cases were diagnosed in the U.S., and now less than two months into 2015, 121 cases have already been confirmed, one of them in Cumberland County, PA.

And speaking of Pennsylvania, since 2008, just 35 cases have been reported. Hopefully, we can keep that number from growing. As for that Montgomery County teen suspected of contracting the disease? We're out of the woods for now, as tests have come back negative, but that doesn't necessarily alleviate concerns.

Explains the CDC: "Measles is a highly contagious virus that lives in the nose and throat mucus of an infected person. It can spread to others through coughing and sneezing. Also, measles virus can live for up to two hours on a surface or in an airspace where the infected person coughed or sneezed. If other people breathe the contaminated air or touch the infected surface, then touch their eyes, noses, or mouths, they can become infected. Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected."

Yikes, right? No wonder foregoing our children's immunizations is such risky business. Still, Pennsylvania allows parents to do just that for either medical or religious reasons; the law is less clear regarding philosophical or moral objections. The upshot is that, during the 2013-14 school year:
  • 2,351 public and 1,225 private school students went unvaccinated for philosophical reasons.
  • 2,119 public and 1,054 private school students went unvaccinated for religious reasons.
  • 1,444 public and 200 private school students went unvaccinated for medical reasons.
That translates to 2.2% of our 267,093 public school students and 6.5% of our 38,292 private schools students going to school unprotected and putting others at risk at the same time.
Meanwhile, to protect against measles, an MMR, short for measles, mumps and rubella, is required. All it takes is one shot between 12 and 18 months and a booster between four and six. Know, too, that, since its arrival in 1963, it has prevented some 36 million infections. In the '50s, reports NCBI, on average, more than 500,000 cases and nearly 500 deaths occurred every year.

Meanwhile, during the 2013-14 school year, 91.9% of Pennsylvania's public schoolers and 85.8% of our private schoolers got their MMR shots.

That's pretty good, but when was pretty good ever good enough, especially now that we no longer benefit from "herd immunity." In other words, vaccination levels are now below what's needed to prevent one or two cases from becoming a full-blown outbreak, aka epidemic.

The only logical conclusion: Make sure all family members who are old enough and/or healthy enough get not just the MMR but the full course of vaccines as required for school attendance in the Commonwealth:

"(1) Diphtheria. Four or more properly-spaced doses of diphtheria toxoid, which may be administered as a single antigen vaccine or in a combination form. The fourth dose shall be administered on or after the 4th birthday.

(2) Tetanus. Four or more properly-spaced doses of tetanus toxoid, which may be administered as a single antigen vaccine or in a combination form. The fourth dose shall be administered on or after the 4th birthday.

(3) Poliomyelitis. Three or more properly spaced doses of either oral polio vaccine or enhanced activated polio vaccine, which may be administered as a single antigen vaccine, or in a combination form. If a child received any doses of inactivated polio vaccine administered prior to 1988, a fourth dose of inactivated polio vaccine is required.

(4) Measles (rubeola). Two properly-spaced doses of live attenuated measles vaccine, the first dose administered at 12 months of age or older, or a history of measles immunity proved by laboratory testing by a laboratory with the appropriate certification. Each dose of measles vaccine may be administered as a single antigen vaccine or in a combination form.

(5) German measles (rubella). One dose of live attenuated rubella vaccine, administered at 12 months of age or older or a history of rubella immunity proved by laboratory testing by a laboratory with the appropriate certification. Rubella vaccine may be administered as a single antigen vaccine or in a combination form.

(6) Mumps. Two properly-spaced doses of live attenuated mumps vaccine, administered at 12 months of age or older or a physician diagnosis of mumps disease indicated by a written record signed by the physician or the physician's designee. Mumps vaccine may be administered as a single antigen vaccine or in a combination form.

(7) Hepatitis B. Three properly-spaced doses of hepatitis B vaccine, unless a child receives a vaccine as approved by the Food and Drug Administration for a two-dose regimen, or a history of hepatitis B immunity proved by laboratory testing. Hepatitis B vaccine may be administered as single antigen vaccine or in a combination form.

(8) Chickenpox (varicella). One of the following:

(I) Varicella vaccine. Two properly-spaced doses of varicella vaccine, the first dose administered at 12 months of age or older. Varicella vaccine may be administered as a single antigen vaccine or in a combination form.
(ii) Evidence of immunity. Evidence of immunity may be shown by one of the following:
(A) Laboratory evidence of immunity or laboratory confirmation of disease.
(B) A written statement of a history of chickenpox disease from a parent, guardian or physician.
(c) Required for entry into 7th grade. In addition to the immunizations listed in subsection (b), the following immunizations are required at any public, private, parochial or nonpublic school in this Commonwealth, including vocational schools, intermediate unit, special education and home education programs, and cyber and charter schools as a condition of entry for students entering the 7th grade; or, in an ungraded class, for students in the school year that the student is 12 years of age:
(1) Tetanus and diphtheria toxoid and acellular pertussis vaccine (TdaP). One dose if at least 5 years have elapsed since the last dose of a vaccine containing tetanus and diphtheria as required in subsection (b). TdaP may be administered as a single antigen vaccine or in a combination form.
(2) Meningococcal Conjugate Vaccine (MCV). One dose of Meningococcal Conjugate Vaccine. MCV may be administered as a single antigen vaccine or in a combination form.
(d) Child care group setting. Attendance at a child care group setting located in a public, private or vocational school, or in an intermediate unit is conditional upon the child's satisfaction of the immunization requirements in § 27.77 (relating to immunization requirements for children in child care group settings).
(e) Prekindergarten programs, Early Intervention programs' early childhood special education classrooms and private academic preschools. Attendance at a prekindergarten program operated by a school district, an early intervention program operated by a contractor or subcontractor including intermediate units, school districts and private vendors, or at private academic preschools is conditional upon the child's satisfaction of the immunization requirements in § 27.77.

(f) Grace period. A vaccine dose administered within the 4-day period prior to the minimum age for the vaccination or prior to the end of the minimum interval between doses shall be considered to be a valid dose of the vaccine for purposes of this chapter. A dose administered greater than 4 days prior to minimum age or interval for a dose is invalid for purposes of this regulation and shall be repeated."

And be sure to keep accurate records, including the day, month, and year of every vaccination, storing them in a safe place, as they're often needed by medical personnel, colleges, employers, and for international travel, too.

For more information on immunizations: 1-877-724-3258

Carol is a learning specialist who worked with middle school children and their parents at the Methacton School District in Pennsylvania for more than 25 years and now supervises student teachers at Gwynedd-Mercy University and Ursinus College. Along with the booklet, 149 Parenting School-Wise Tips: Intermediate Grades & Up, and numerous articles in such publications as Teaching Pre-K-8 and Curious Parents, she has authored three successful learning guidebooks: Getting School-Wise: A Student Guidebook, Other-Wise and School-Wise: A Parent Guidebook, and ESL Activities for Every Month of the School Year. Carol also writes for examiner.com; find her articles at http://tinyurl.com/1416px. For more information, go to http://www.schoolwisebooks.com or contact Carol at carol@schoolwisebooks.com.
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