Feb. 20 is School Exclusion Day, or the final day parents have to show their children are up to date on all their immunizations. According to the Oregon Health Authority, under state law, all children in public and private schools, preschools, Head Start and certified child care facilities must have their records complete or show an acceptable exemption.
- A medical professional gives a vaccination.
"This year's School Exclusion Day reminder has taken on added urgency as the Pacific Northwest confronts the worst preventable measles outbreak in more than two decades," Stacy de Assis Matthews, school law coordinator for the OHA Public Health Division, said in a press release. "Immunizations are the most effective way to stop the spread of measles and other communicable diseases that put children and others at risk."
On Jan. 30, Deschutes County Health Services said a person who visited Bend had a confirmed case of measles. DCHS officials suspect that the possible exposure is connected to a measles outbreak that began in Clark County, Wash., earlier this month—which also led to a case appearing in Multnomah County, Ore., and in Hawaii. The measles outbreak in Washington included 52 cases of measles and caused Gov. Jay Inslee (D) to declare a state of emergency Jan. 25.
As voiced in a story in the Washington Post, the Pacific Northwest is home to some of the nation's most vocal and organized anti-vaccination activists. In Oregon, Oregonians for Medical Freedom is part of Physicians for Informed Consent's network, whose vision—according to its website—is "to live in a society free of mandatory vaccination laws and to live in a society knowledgeable about infectious disease, the immune system, and informed consent."
The Post story said the Northwest has some of the lowest child immunization rates in the country, with as many as 10.5 percent of kindergartners statewide in Idaho unvaccinated for measles. Washington, Oregon and Idaho are some of the 17 states in the U.S. allowing medical exemptions, religious exemptions and "philosophical" exemptions—meaning virtually anyone can exempt out of the requirements—according to the Post story.
On the OHA's informational section on immunizations about exemptions and immunity, it says physicians can sign medical exemptions for children with "valid contraindications." People may also choose not to vaccinate for personal, religious or philosophical reasons. They're required to watch a video and submit a certificate of completion, or talk to a healthcare provider and have them sign a Vaccine Education Certificate.
Measles once sent tens of thousands of Americans to hospitals each year and killed an estimated 400 to 500 people—many of them young children, according to the Post story. The disease was declared eliminated from the U.S. in 2000, according to the Centers for Disease Control and Prevention, yet last year 349 cases were confirmed across 26 states and the District of Columbia.
Federal guidelines recommend children get the first vaccine dose at 12 to 15 months of age and the second when they are 4 to 6 years old. This combination is 97 to 99 percent effective in preventing the disease, according to the CDC.
This Feb. 21 marks the 21st anniversary of an article published in The Lancet, a prestigious medical journal from the United Kingdom, that many consider the birth of the anti-vaccination movement. The article—which linked the MMR (mumps, Measles, Rubella) vaccine to autism—was written by Andrew Wakefield, a British doctor who was eventually de-licensed by medical authorities for his deceit and "callous disregard" for children in his care, according to an article in TIME magazine. The article wasn't retracted until 2010, despite concerns raised by experts at the time of publication in 1998 and the 2004 expose on Wakefield's sloppy science and retraction by the co-authors, the TIME story said.
According to the OHA, Oregon law requires the following shots for school and childcare attendance. Kindergarten or grades 1 to 6: five Diptheria/Tetanus/Pertussis (DTaP), four Polio, one Varicella (chickenpox), two MMR, three Hepatitis B and two Hepatitis A.
Bend-La Pine Schools's Health & Immunizations information says that students may return to school after parents bring in proof of up-to-date immunization records, if they receive an exclusion notice. There are many resources for immunizations in Deschutes County, including Deschutes County Health Department and the Bend-La Pine Schools websites. Also, Ensworth Elementary and Bend Senior High School both offer school-based health centers where kids can be vaccinated.
Alandra Johnson, communications specialist for Bend-La Pine Schools, said the district hasn't received any complaints or concerns in the wake of the recent measles case, and won't have any current information about the number of vaccinated students until after the exclusion day.
Meanwhile, Rep. Mitch Greenlick (D-Portland) is preparing a bill that would eliminate non-medical exemptions for unvaccinated school children. The bill is still being finalized and could face stiff opposition. A similar proposal in 2015 was abandoned after pressure from opponents.
"People have the right to make bad decisions about the health care of their children," Greenlick said in an Oregonlive story. "But that does not give them the right to send unprotected children into their school."