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Washington Measles Outbreak Has Some Questioning Ohio's Vaccine Opt-Out

Air Force Senior Airman Antoinette Fowler shows a 4-year-old how to give a vaccination during a teddy bear clinic at Eglin Air Force Base, Florida.
Ilka Cole
U.S. Air Force
Air Force Senior Airman Antoinette Fowler shows a 4-year-old how to give a vaccination during a teddy bear clinic at Eglin Air Force Base, Florida.

As public health officials in Washington state scramble to contain a measles outbreak in the Pacific Northwest, some of their counterparts in Ohio suggest it is time to change the state law that allows parents to easily opt out of vaccinations.

In Ashtabula County, health officials say the measles outbreak in the Northwest is just a plane ride away from landing in Ohio. There have been serious outbreaks in Ohio, as recently as 2014, when there were 383 cases in nine counties, said Chris Kettunen, Director of Nursing for the Ashtabula County Health Department.

“We had a big measles outbreak and we had more cases than any other state in the country, and that can be potentially dangerous. And some of these diseases have bad consequences, even resulting in death,” Kettunen said.

Ashtabula County is particularly vulnerable because the overall immunization rate for kids under two is 83 percent, she said.

State health officials recommend a rate of at least 90 percent to maintain herd immunity — where a sufficiently high proportion of individuals are immune to the disease, especially through vaccination. This helps protect those who can’t receive the vaccine because of allergies and other reasons.

Statewide the vaccination rate for kids by the time they reach kindergarten is about 92 percent, according to the Centers for Disease Control.

Ashtabula has a large Amish population and this contributes to the lower immunization rate, said Kettunen, as some Amish people choose to opt out. But there are many other people, not in the Amish community, who object to having their kids immunized, she said. 

“I’ve had a few parents actually say it to me. I had one parent who came in and said ‘Well I want my child to be immunized except for the one that causes autism.’ And then I have to explain to them there aren't any that have been proven to cause autism,” Kettunen said.

A flawed study, which associated the Measles, Mumps and Rubella (MMR) vaccine with autism, has been debunked by numerous other scientific studies.

It has been hard, though, to persuade some parents with data, Kettunen said.  She thinks it is time to make it harder for people to opt out of vaccines in Ohio.

“I would much rather have a person come to agree than be forced to agree but I think at this time it's just getting too frightening with all the outbreaks,” she said.

Measles is very infectious and according to the CDC, it can range from a mild illness to one that is potentially deadly, especially for small children.  

For every 1,000 children who get measles, one or two will die from it.

Stephanie Stock, president of Ohio Advocates for Medical Freedom, says the 0.2 percent death rate from measles is relatively low compared to other infectious diseases. The group represents parents who believe it is their right to weigh the consequences and decide if their child is vaccinated.

“If you look at the CDC pink book, it clearly states the biggest percentage complication with measles is diarrhea. I mean you’re looking at a relatively mild childhood illness that results in a rash and fever for about a week and then the child has lifelong immunity,” Stock said.

Some parents in her organization have children who have experienced complications after being inoculated. These parents are protecting their kids from potential harm, she said.

In Ohio, people can opt out of childhood immunizations for medical, religious or reasons of conscience, said Melissa Wervy Arnold, CEO of the Ohio Chapter of the American Academy of Pediatrics.

“Nothing is 100 percent safe. People do have allergies to them but the benefits of vaccination way outweigh the risks,” Arnold said.

Measles was considered eradicated in the U.S. by the year 2000 and Ohio had one of the best immunization rates in the country, she said.

Things changed, however, after a new exemption was added in 2005, allowing parents to fill out a simple form at their child’s school saying they want to opt out for reasons of conscience. 

“Ohio allows for what we call a philosophical exemption that happened back in 2005, when we saw our rates start to drop. That was kind of a movement at the time on a national basis, but from there we have not been able to hit those (vaccination) numbers again,” Arnold said.

Ohio is one of 17 states that allows the philosophical exemption. California has eliminated it and other states facing the measles emergency are moving in that direction, she said. 

“Ohio is a much more conservative state and I don’t see us going down that path anytime soon, but I certainly hear from public health advocates and physicians and parents all the time — why aren’t you going after that exemption?” 

Arnold’s group, which represents Ohio pediatricians, supported a bill in the previous session of the Ohio legislature that would require education sessions for parents before they could opt out of vaccines for their children.

It stalled in the legislature last year, but Arnold says they hope to find a new sponsor for the proposal later this year.