Milwaukee vulnerable to measles outbreak with 11,000 unvaccinated children

Thousands of Milwaukee children are not fully immunized, exposing Wisconsin's largest city to the risk of a measles outbreak, as the virus is spreading in the country at a rate never seen for 25 years .

More than 11,000 students in public schools in Milwaukee have not all received the required vaccinations this school year, including against highly contagious rashes and devastating diseases such as polio, diphtheria and hepatitis B, according to state health records.

With nearly 15% of students attending public schools without the necessary vaccinations, there could be too few pupils vaccinated within the district boundaries to create what is called the "school". collective immunity, which prevents newborns, unvaccinated children, or unhealthy adults from contracting diseases that could disable or kill them.

"It's as if you had a gas can and you just waited for someone to give up a match," said James Conway, a physician specializing in pediatric infectious diseases and assistant director of science. of Health at the University of Wisconsin-Madison School of Medicine and Public Health.

The vaccine bill faces resistance

As health authorities in cities and schools prepare for a possible medical emergency, Republican leaders in the state legislature do not subscribe to legislation that would further prevent parents from sending their children to school. School without vaccines.

"I support the law, I do not think anyone should have, but the government should be able to demand that something be done to your child," said Robin Vos, Speaker of the House on Tuesday. -Rochester. "Now, would I support an education campaign because I think the vaccination is right? I would do it."

Democratic Gov. Tony Evers said he would sign the bill presented amidst the largest measles outbreak since 1994. But with the opposition of Vos and the word of the Senate majority leader, Scott Fitzgerald, on the verge of knowing if he will support the bill, the proposal could be dead.

"We are going to increase immunization rates in one of two ways: we are going to pass this bill … or we will have a measles outbreak," said the bill's author, Gordon Hintz, D-Oshkosh. "This is no longer cool once it becomes real."

"All you need, it's one person"

According to state registers, approximately 85% of students attending Milwaukee schools meet the state's minimum vaccination requirements, which means that they received 16 doses of vaccines during childhood to protect themselves against nine diseases. State officials have no way of knowing how many students do not qualify for their vaccines to be vaccinated, said the spokesperson for the Department of Health Services. , Jennifer Miller.

"For measles, it's so contagious that it's probably going to be close to 95% to really prevent outbreaks from going crazy," Conway said. "Knowing that 85% represents 60% in some neighborhoods and 90% in others, it's a bit terrifying for me."

If enough people in a community are vaccinated, a single case of illness can not spread to an epidemic. To protect against the spread of measles, this vaccination rate must be between 93% and 95% in a community.

"Immunization rates for schools and 2-year-olds are below this threshold for HDM," said Milwaukee Health Department spokeswoman Diamond Hanson.

Municipal health officials are working to increase this rate among children by offering vaccines at clinics and schools in the city, she said.

But Hanson also said the poor record keeping had probably reduced the district's vaccination rate, which means that vaccinated students may not have been reported to the state's immunization registry. She stated that it was "hard to say" how many more students could be vaccinated than the authorities reports.

"We have students from another state or country who have left Wisconsin and may not have up-to-date records, but may be aware of their vaccines," he said. MPS spokesman Andrew Nelson. "We communicate with parents and other school districts to ensure our records are accurately updated."

Not knowing exactly which students are vaccinated and which ones are not vaccinated could affect the city's response to an epidemic. Hanson said any case of measles should be immediately reported to department officials, who would start vaccinating those in need and quarantine all exposed people to prevent the spread of the disease.

"We use parent-teacher conferences, follow-up visits to health units, open houses and other activities in the district to communicate with parents about their child's immunization status and provide them with resources." said Nelson.

He added that the district was working closely with the city's health department and that in case of epidemic, the district would work closely with the city to identify students who do not have all the necessary vaccines and ask them to get vaccinated before they can go back to school. .

According to Miller, the risk of the epidemic depends on the distribution of 11,000 students who have not yet received a full panel of vaccines.

"There are schools with very few likely individuals, so their risk of epidemic is different from that of a school with a much higher percentage of susceptible individuals, even if the two are in the same district, "she said.

Miller said measles did not spread within the strict limits of a school district but rather in communities with low vaccination rates.

Mr. Conway added, however, that while people who are not completely vaccinated tend to cluster in neighborhoods, one student on a school bus is enough to spread the disease elsewhere. With an international airport in Milwaukee and reported cases in three states bordering Wisconsin, Mr. Conway said it was probably only a matter of time.

"All you need is someone to pick up and you have an epidemic," Conway said. "In a way, it's even more amazing that it has not happened in Wisconsin yet."

& # 39; The perfect storm & # 39;

About 86% of students attending Milwaukee schools live in low-income households – an environment that can create barriers for parents to vaccinate their children but may not have enough time during hours a clinic is open or underwriting insurance. pay for the vaccines.

Data from public schools in Milwaukee show that the vast majority of the 11,278 students who do not have all the required vaccines have not left them without choice.

"In Milwaukee, families in underserved areas have access problems over certain areas, as well as people who choose not to immunize," Conway said. "When you combine that with a densely populated city and where there is a lot of movement in and out of this city … it's the perfect storm."

Only 1,624 students in Milwaukee are not fully immunized because their parents or guardians have requested a waiver of state laws requiring vaccines for religious, medical or personal reasons.

Nelson said some families chose to give up some vaccines and that a "minimal" number of students out of 76,000 in the district were not receiving any vaccine. Miller said that parents who apply for a waiver may apply for one, but not all, of the waivers.

Conway said his goal is to find ways to make it more difficult to reject vaccines than to receive them, in part, by requiring legislators to remove from state legislation the ability for parents to hold vaccines on the basis of their personal beliefs.

Opposition to legislation, which would maintain exemptions for medical or religious reasons, comes from both conservative and liberal circles.

"In Dane County, some of the biggest opponents of immunization are here, so that does not really correspond to the (political) tradition," Hintz said of the highly liberal county.

Senator Fred Risser and Representative Chris Taylor represent areas of Madison with traditionally higher rates of parents choosing not to immunize their children. Risser co-sponsors Hintz and Taylor's legislation has not yet made a decision, according to lawmakers' staff.

The representative of the Republic, Jeremy Thiesfeldt, chairman of the Assembly Education Committee, said at a TV show "UpFront" of WISN that he supported the vaccines but did not want to tell parents how to take care of their children.

"There are few things more sacred than being able to control one's own health care and I think that's just one step too far," Thiesfeldt said.

He also claimed to suspect some families who choose not to vaccinate their children after studying the associated effects of "knowing more than doctors."

Parents can enroll their children in school without first obtaining the vaccines, citing their personal beliefs on a form collected by the state's Department of Health Services. Wisconsin is one of 17 states that allow parents to refuse vaccines for personal reasons.

But parents do not have to say what are these convictions and the state does not have an approval process in which the reasons of the parents may be deemed insufficient to guarantee that the parents will be sentenced. enrollment of unvaccinated children at school, according to Miller.

Patrick Marley of the Milwaukee Journal Sentinel contributed to this report.

Contact Molly Beck at (608) 258-2263 or [email protected].
Follow her on Twitter at @MollyBeck.

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