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A measles outbreak is spreading in a county in Washington known for not choosing to vaccinate its children, and health officials have declared a public health emergency.
UNITED STATES TODAY & # 39; HUI

Measles outbreaks have infected nearly 130 people in several American communities this year, and the Phoenix metropolitan area is also at high risk of an epidemic, health experts said.

Several factors expose schoolchildren to risks, including state immunization policy, politics in Arizona's Legislative Assembly, a well-organized community of people opposed to vaccine regulation and a lack of consistent and easily accessible scientific information on vaccines for parents.

The Metropolitan Phoenix is ​​the only place in the United States that is most exposed to a major measles outbreak, said Dr. Bob England, director of the Maricopa County Public Health Department for 12 years between 2006 and 2018.

In an interview with Arizona Republic, England said that Maricopa County is particularly exposed because of its large population – 4.3 million inhabitants.

Declining vaccination rates in county public schools, especially in charter schools, mean that an epidemic could be both large and expensive, he said.

"We do not have the lowest vaccination rates or the highest exemption rates in the country. But we are so big that if you contract an epidemic here – say that a case of measles falls in one of those schools where the number of cases is very low (vaccination) and you immediately get several new cases of measles "said England.

"There are enough of us and our population is moving enough so that there is a very good chance, in my opinion, that you are getting enough cases from these initial cases to cope with a widespread and ongoing outbreak."

There's only one measles case left in the "right place at the right time" and a measles outbreak in Arizona – perhaps as serious as the one currently taking place in Washington State, confirmed Will Humble , member of the executive board of the Arizona Public Health Association. director.

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A measles outbreak in the Pacific Northwest has already made 38 people sick and forced some people to change their daily habits. One mother says she does not take her son out of public in 11 months until he is vaccinated against measles at the age of one year. (January 30)
AP

An increasing number of parents around the world, including Arizona, are choosing not to vaccinate their children. The World Health Organization recently said that "hesitation about the vaccine" was one of the top ten threats to global health for 2019.

Measles, a highly contagious virus, is deadly in every other case in 1000. Although it was eliminated from the United States at one point, it is now back in force.

Last year, 372 cases of measles in the United States were reported to the US Centers for Disease Control and Prevention in 17 outbreaks, including three in New York State, New York City, and New Jersey. Cases in these states occurred mainly among unvaccinated persons of Orthodox Jewish communities

Here's why Arizona is at risk for outbreaks of vaccine-preventable diseases.

Too many schools in Arizona fall short of collective immunity against measles

When few children in a class are vaccinated against measles, it means that "collective immunity" is lost and that the group is more susceptible to an epidemic. This is especially worrisome for children whose immune system is compromised and babies too young to be immune.

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"Vaccination affects the entire population.It is the nature of its operation.The immunity of the flock allows it to function.This is not really an individual health choice" , said England.

According to data from the 2017-2018 academic year, more than 5,000 kindergarten students in Arizona would be at risk of measles in the event of an epidemic, the health services department said. l & # 39; Arizona.

Vaccine-preventable diseases in Arizona more than quadrupled between 2008 and 2013, an average increase of 242 cases per year, according to a study conducted in 2018 by researchers at the University of Arizona in the United States. PLOS One review.

The researchers found that whooping cough, also known as whooping cough, had increased six-fold during this period.

Public health officials consider that the collective immunity against measles corresponds to a vaccination rate of 95% or more. For In nursery schools in Maricopa County, the overall rate of fully vaccinated kindergarten students against measles, mumps and rubella was 93.1% for the last academic year, according to data from the Ministry of Health. ;State.

But some schools have extremely low immunization coverage.

According to state data, only 49% of the 757 schools in Maricopa County who reported having had a kindergarten class of 20 or more students last year had a collective immunity against measles.

"You have pockets that pull that average down, where vaccination rates are terribly low," said England.

Arizona allows vaccine exemptions to non-medical "personal beliefs"

Arizona is one of 17 states that allow parents to provide their children with vaccines because of their personal or philosophical beliefs.

Exemptions from personal beliefs over the past decade have increased in two-thirds of states – including Arizona – that allow it, reveals a study conducted in June 2018 by researchers at Baylor University and published in PLOS Medicine.

Phoenix has been designated as one of the major cities where children are not vaccinated in June 2018. The study was published in the journal PLOS Medicine. (Photo11: Getty Images)

In 2015, the California Legislature removed all exemptions for non-medical vaccines as a result of a measles outbreak at Disneyland that affected seven residents of Arizona. The rate of schoolchildren vaccinated in California has since increased.

"I honestly think that our community would be safer if we removed exemptions from personal beliefs," said England. "But I seriously doubt that politically, it will work here (in Arizona) unless there is a really serious epidemic."

Arizona Legislature: Bills Could Improve Immunization Coverage

The Republican-controlled Arizona legislature during this session did not propose bills that could have improved immunization coverage.

An Arizona bill introduced by the state's representative, Alma Hernandez, Democrat of Tucson, would completely eliminate exemptions from personal beliefs. But Bill 2162 has not yet been referred to a committee and the deadline for doing so was Friday.

Another Arizona bill that would require schools to post vaccination coverage levels on their websites is also likely to disappear during this session.

House Bill 2352 "would simply provide transparency and critical health information to parents considering setting up an educational framework," said Bill's sponsor, Kelli Butler, D-Phoenix, The Republic of Arizona.

"It gives parents like me at least information that can affect where they send their child to school," said Kaye Lawson, a Phoenix parent whose 12-year-old son years spent nine years with a fragile immune system because of a cancer treatment.

"The average duration of treatment for children with cancer is two to three years, during which time the immune system of children is compromised," she said. "This bill would give parents more information and choice."

READ MORE: I am an adult worried about measles. What should I know?

In addition to requiring schools in Arizona to post vaccination rates on their websites, Butler's bill would require schools to indicate if a nurse is assigned to them. school and clinical degrees of people providing health services on campus.

Butler said The Republic Nancy Barto, R-Phoenix, declined to hold a hearing on the bill. Barto, the chair of the House's Human Services Committee, has not responded to phone calls and e-mails from the Republic this week.

Barto sponsored three other separate school vaccination bills to which the Arizona Public Health Association and other public health officials opposed, claiming that they would reduce immunization coverage and put in place endangering the herd's immunity.

The three bills were passed Thursday by the health committee following a hearing of several hours.

During the meeting, Barto challenged state data showing that vaccine exemptions had increased in Arizona. She said the rates "are static". She also allowed two vaccine critics to make a one hour presentation before hearing the testimonials on the bills.

Parents "hesitant about vaccines" get puzzling information

Any parent trying to do their own research on vaccination England sees contradictory information on the Internet and this creates confusion.

The National Vaccine Information Center is an organization that reviews vaccines, but its view is not immediately clear.

A 1998 study in The lancet have reported a link between autism and vaccines and, although the study has since been discredited, some vaccine critics continue to believe that there is a link.

Critics of vaccines who attended hearings before the Arizona Legislature this week argued that reports on herd immunity are a propaganda, that vaccines injure more people. Children do not realize it and doctors vaccinate children even if they are likely to have undesirable physical reactions.

Dr. Negin Blattman, a molecular virologist and deputy chief of infectious diseases in the US Department, said Dr. Negin Blattman, "oriented in a certain direction" and presented in a biased way that does not allow to consult all data and information. Veterans Affairs in Phoenix who attended one of the hearings.

"Vaccines prevent disease, we know it is true," Blattman said. "If you want to know if this is really true and about the complications of vaccines, ask our veterans who serve in countries where measles and polio outbreaks still exist and see how they are protected, their response to vaccines."

This week, the wife of the White House's Communications Officer tweeted about bringing back childhood diseases such as measles because they "keep you healthy and fight cancer," said the president. Washington Postreported.

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Darla Shine, the wife of the White House's director of communications, Bill Shine, tweeted about the benefits of measles and presented anti-vaccination claims. Justin Kircher from Veuer has more.
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"With more and more inaccurate content floating on social networks, it's very easy as a good responsible parent to create confusion," said England. "If you" secure vaccination "on Google, you will see many anti-immunization sites.

"It's not that so many parents are fiercely opposed to vaccination, but simply that many parents are confusing in front of all competing demands."

The previous academic year, Arizona had implemented a pilot program offering parents who were applying for a vaccine exemption for their children an online program based on science and the vaccines and diseases they prevent.

But after a reaction from parents, many of whom said they did not vaccinate their children, the state canceled the program. The Arizona Department of Health Services is employing to reinstate the educational program for the 2019-2020 academic year.

A well-organized community is wary of vaccine science

Vaccine-critical groups monitor vaccine bills in state legislatures, particularly in Arizona, and organize correspondence campaigns with legislators. Their arguments often focus on parental rights, individual rights and freedom.

More than 100 parents and individuals have sent emails to the governor's Regulatory Review Council last summer to oppose a Vaccine Science Training Course for parents who want to take advantage of the vaccine. 39, a vaccine exemption for their children.

Many of these writers sent the same letter, stating that they would be opposed to any further action to obtain an immunization exemption. A course created with material from public health organizations is "one-sided," said one author.

"At a time when science is less and less invoked or valued, and is considered a mere opinion, then it becomes really difficult to counter all this misinformation," said England. "To a certain extent, the more we try to (counter misinformation), the worse we do it."

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According to the Center for Disease Control, there have been more than 100 cases of measles since the beginning of 2019, of which more than half are concentrated in the state of Washington. But health officials say the epidemic is boosting vaccination and awareness (14 February)
AP

Leading public health organizations support vaccinations, citing scientific evidence that they are much safer than the life-threatening diseases they prevent.

Yet for some people, doubts persist.

"For basic anti-vaccines, it's not a scientific question, it's a belief," said England. "But, in reality, it's the only health choice we're all together in. And we have to either make the decision of a society to protect ourselves by using this tool, or not."

England said that choosing not to vaccinate your child would amount to not respecting the speed limit because you could drive as fast as you wanted, and this is not the case of others, but yours.

"We do not let people do that because it puts others at risk," he said.

Contact the reporter at [email protected] or follow her on Twitter: @pephanieinnes.

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