Things to Know About New Measles Case, Outbreaks and Vaccination Policies

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With the state’s first confirmed measles case this year and hundreds of cases in other states, vaccination rates and public health policies are back in the spotlight.

Here are answers to some common questions about the measles outbreak, the first confirmed Oklahoma case and the state’s vaccination policies.

What’s the latest on measles in Oklahoma?

The Oklahoma State Department of Health said Wednesday it confirmed a case of measles in Okmulgee County, the first confirmed case since May 2018. The department said measles was identified in a patient who returned to Oklahoma after traveling to domestic and international destinations. The department declined to say whether the patient was an adult or child or had been immunized. Nationally, the majority of people who have gotten measles were unvaccinated, the Centers for Disease Control and Prevention said.

State health officials are looking to contact anyone who visited the Saint Francis Glenpool emergency room on the morning of May 11 to see if they might have come into contact with the highly contagious virus.

Haven’t there been a lot of measles cases this year across the nation?

Yes. Nationwide, the CDC said 839 measles cases in 23 states had been confirmed by May 10. It’s the largest number of cases since 1994 and since the CDC declared measles eliminated in 2000. Ten places have recorded outbreaks, which the CDC defines as three or more confirmed cases in a particular area. Those outbreaks have been traced to people who have traveled to countries such as Israel, Ukraine and the Philippines, which have had large measles outbreaks.

Why is measles so contagious?

Measles can live for up to two hours on a surface or in the air after an infected person has left the area. That makes it one of the most contagious viruses out there. “Measles is so contagious that if one person has it, up to 90 percent of the people close to that person who are not immune will also become infected,” the CDC said.

How many Oklahoma kindergartners are up to date on the combined measles, mumps and rubella (MMR) vaccination?  

Oklahoma requires all kindergartners to be vaccinated for about a dozen diseases, including measles. Parents can apply for exemptions on medical, religious or personal grounds. The latest survey, for the 2017-18 school year, showed 92.6 percent of kindergartners at public and private schools had taken the required doses of the MMR vaccination. That was the lowest rate among the six types of vaccinations.

Overall, 91 percent of kindergarteners in Oklahoma public schools had up-to-date vaccination records. The rate among private schools was 84 percent for the 2017-18 school year. The survey covered 91 percent of public-school kindergartners and 54 percent of private-school kindergartners.

How many kindergartners have exemptions for vaccinations?

Oklahoma’s exemption rate is a small fraction but has been steadily climbing over the past several years. The exemption rate for all kindergarteners was 2.2 percent in 2017-18; that equals the national median rate. That’s up from 1.9 percent in 2016-17, according to the CDC. In 2009-10, the Oklahoma kindergartner exemption rate was 1.1 percent.

Like other states, medical exemptions for school vaccinations are the smallest share of exemptions in Oklahoma. The CDC estimates 91 kindergartners in the state had medical exemptions in the 2017-18 school year. That compared to 333 whose parents cited a religious exemption and an estimated 657 kindergartners whose parents sought a personal exemption.

How do parents obtain an exemption?

They download an online Certificate of Exemption form, fill it out and submit it to a school or child care or Head Start facility, which keeps a copy and submits the original to the health department’s immunization service for review. For religious exemptions, a parent must state their reason and have a clergy member sign the form. For a medical exemption, they must state the reason and provide a physician’s signature. For a personal exemption, the parent must provide a reason, but nothing else is required.

Why have childhood vaccinations become such a controversial issue?

Public health officials continue to push back against misinformation spread on social media about vaccinations and their safety. In addition, a small but vocal number of people who believe some vaccinations are harmful continue to push for expanded parental choice for vaccinations or their recommended schedule.

Has there been any legislation proposed this year to change Oklahoma’s vaccination policies?

Yes. Several bills were introduced this session dealing with vaccination policies and educational efforts. Most of the bills died in committee, but a few made it to either the House or Senate floor before being dropped. One of the few surviving bills, House Bill 2339, would require parental consent before any vaccinations are given at school from a mobile vaccination unit. After it was amended in the Senate, it is awaiting final consideration in the House.

Senate Bill 535, the Parental Rights Vaccination Act, died in a Senate committee earlier in the session. The bill, by Sen. Joseph Silk, R-Broken Bow, and Rep. Tom Gann, R-Inola, would have required “informed consent” of the benefits and risks of vaccinations as well as information about the National Vaccine Injury Compensation Program.

Senate Bill 925, by Sen. Greg McCortney, R-Ada, and Rep. Chad Caldwell, R-Enid, passed the Senate 32-12 but did not receive a committee hearing in the House. It would have required school districts to report the number and type of vaccination exemptions among students in the district.