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Measles

We haven’t had an outbreak in Texas. Yet.

Measles has replaced Ebola as the infectious disease threat of the moment, but the only recent case in Texas occurred in Fort Worth in mid-January and was unrelated to the current outbreak that originated in Disneyland.

The Houston health department has tested two suspected cases and both came back negative, but local officials still express concern about the possible risk to infant children who can’t yet be immunized.

“Parents should be alarmed about this outbreak if they have children under 12 months,” said Kathy Barton, spokeswoman for the Houston health and human services department. “Infants travel to other areas, and the measles virus can be imported to any area at any time, including this one.”

Barton said parents of children who have been immunized should feel confident the vaccine will protect their child.

Children are eligible for the first dose of the combination MMR (measles, mumps, and rubella) vaccine at 12 months through 15 months of age. The second dose, recommended at 4 to 6 years of age, is required of Texas schoolchildren, though conscientious objectors can opt out by signing an affidavit. Those numbers in Texas are small (38,197 people, or 0.75%, in 2013-2014) but growing.

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The national rate of people opting out of vaccination remains under 1 percent, but the number can vary according to community. In Texas, where the percentages have grown significantly in the last decade, the 2013-2014 rate exceeds 3 percent in five counties — Jeff Davis (3.1), Blanco (3.6), Robertson (4.1), Gaines (4.3) and Lampasas (5.2). Harris County’s rate is 0.57, up from 0.19 in 2007. The state’s county-by-county numbers are here.

Tiffany recently underwent a round of booster shots in anticipation of some business travel. I’ve been thinking of doing the same thing for myself. I don’t feel like herd immunity is good enough to rely on any more.

Cherise Rohr-Allegrini reminds us that however enjoyable it is to publicly shame anti-vaxxers, it doesn’t do much to actually get them to vaccinate their kids. Research has shown that no persuasion strategy for overcoming anti-vaxx sentiment is likely to succeed. As such, I personally agree with Jamelle Bouie that where persuasion fails, coercion is the way to go. There’s a reason Mississippi – Mississippi, for crying out loud! – has the best vaccination rate in the country: They don’t allow exemptions. Vaccinate your kids or they don’t get to go to school. In Texas, that would likely mean more home-schooling, so the next level of this strategy is to require vaccinations for participation in any kind of interscholastic activity, from sports to debate to music to whatever else. If it involves other school-age kids, you have to have your shots. Finally, I’d take aim at the one thing that will make all those highly-privileged anti-vaxxers from California squirm, and that’s to put pressure on colleges and universities to require vaccinations as a condition of entry, just as kindergartens used to do before anyone heard of “conscientious objections”. This can be accomplished by the Legislature for public schools. For private schools, it’ll likely take a campaign from alumni organizations. If their kids can’t get into Harvard without having had their shots, they’ll get their shots. Lisa Falkenberg and Harold Pollack have more.

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