Measles in Marin

“Having the right to do something does not mean it is always the right thing to do.” Mary Jane Burke, Marin County Superintendent of Schools

By Ellen Shehadeh
Linda Petersen

Americans value their freedoms. The spectrum is wide- from abortion to guns. Recently in Marin County, freedom has focused on the parents’ right to opt out of formerly required MMR immunizations for diseases like measles, mumps rubella for their children who attend public and private schools and day care centers. It has come to the fore as a once rare disease, measles, has begun to spread across the state, incubated in of all places, the Magic Kingdom of Disneyland in Orange County.

Parents in Marin County are viewed as interested and informed about health and safety issues but many view the perceived risks of vaccines to be greater than the benefits derived from them. The once perceived threat of vaccines causing autism has been laid to rest with many research studies, but for some the fear persists

The concept of “herd immunity” has become a reality for certain diseases. When a large enough proportion of people refuse vaccinations, once contained diseases can begin to disperse among the population and can again become a widespread danger to health

Measles is not necessarily a benign disease. Although is most cases it involves fever rash and discomfort, for some it can lead to pneumonia, swelling of the brain and in rare cases death.

California is among 20 states that allow parents to refuse vaccination for their children based on personal beliefs. However, a new law which took effect last year mandates that parents who request an exemption must consult with their doctor first who signs off on a form saying they have been informed of the risks of opting out. Those who claim an exemption for religious reasons do not need a doctor’s signature.

Both the Marin County Department of Health and Human Services as well as the Marin County Superintendent of Schools have taken strong stands on the advisability of vaccination. In loud and clear language, Marin County Public Health Officer Matt Willis, MD, MPH issued a press release stating that “if your child is unvaccinated or cannot provide laboratory confirmation of immunity and there is a case in their school, they will be excluded from attending school for 21 days to protect themselves and to limit further spread of disease.” He further points out that it takes two weeks to develop immunity after receiving the measles vaccine

Willis does not hold to the belief that excluding unvaccinated children from school where there is no evidence of measles transmission is an effective strategy for limiting the spread of the disease.

 

Mary Jane Burke, Marin County Superintendent of Schools, made a particularly forceful statement in her press release. She believes that “while parents may have the statutory right of refusal, they do not have the ethical right to expose others to their children’s lack of protection. Having the right to do something,” she states, “does not mean it is always the right thing to do.” She also quotes a recent NY Times article that points out “before 1963 when vaccines became widespread millions of Americans were infected (with measles) annually, and 400-500 died each year.

She fully supports the recent Public Health pronouncement issued by Matt Willis.

As of January 27, 2015 there have been 68 confirmed cases of measles in California in the year 2015. Last week, according the Marin IJ, two unvaccinated children became the first reported measles cases in Marin. The same article reports that “6.45 percent of Marin’s kindergarteners are not fully vaccinated against communicable disease, with some schools showing rates of 50 percent of more.” According to the state Department of Public Health, Marin has long had the Bay Area’s highest rate of “personal belief exemptions.”

Staff of our local Coastal Health Alliance report that due to the outbreak they are experiencing “a surge of interest” in vaccinating. “Parents who were against vaccines are changing their minds and are having their children vaccinated.” Interestingly, these same parents are also being vaccinated themselves.

Those with compromised immune systems are not eligible to receive vaccinations. These same students, some who have been treated for cancer, are the most vulnerable of all. The Marin IJ did a moving story on a 6-year-old boy, Rhett Krawitt, who has fought leukemia for over 4 years and is in remission. His father is calling for the Superintendent to require all children to be vaccinated so that children like his son can benefit form herd immunity and attend school.

Even more locally Alex Porrata’s son Ezekiel Porrata Powell has just finished a year of cancer treatment. He would love to go to school but probably won’t be able to because of the risks posed by unvaccinated children. Ironically Porrata’s other child, Yolanda, contracted whooping cough at age 6 weeks and was hospitalized for 10 days. Whooping cough is another disease that was almost wiped out before the fear of vaccine allowed the disease to reemerge.