Abel Zhang, 1, smiles after receiving the last of three inoculations, including a vaccine for measles, mumps, and rubella (MMR), as his mother Wenyi Zhang checks on him at the International Community Health Services in February in Seattle. (Elaine Thompson / Associated Press file photo)

Abel Zhang, 1, smiles after receiving the last of three inoculations, including a vaccine for measles, mumps, and rubella (MMR), as his mother Wenyi Zhang checks on him at the International Community Health Services in February in Seattle. (Elaine Thompson / Associated Press file photo)

Editorial: After vaccine mandate, talk with hesitant parents

They need the confidence that vaccines are safe, effective and best for their kids and community.

By The Herald Editorial Board

Some might find the illustration paternalistic — or is it maternalistic? — but ending parents’ ability to refuse the measles vaccine for their children for personal reasons, as the Legislature voted to do last month, is akin to a mom or dad yanking back to safety a child who darts out into the street.

The time for the talk about looking both ways and holding hands comes after the child is safe.

With lawmakers having voted to remove the threat that the exemption to the measles, mumps and rubella vaccine — MMR — has posed to public health, the responsibility now falls on physicians, health workers, public health officials, the media and — importantly — the friends and family of moms and dads to continue their message to persuade vaccination-hesitant parents of the safety and efficacy of all vaccines.

That state lawmakers had to take this step is a disappointment; reliance on facts, reason and the considered opinion of a family pediatrician would be preferable to a state mandate, but recent measles outbreaks in the United States and in southwest Washington state required that legislators act quickly.

Clark County Public Health has only this week declared its measles outbreak over. The outbreak, which began in early January, confirmed 71 cases of measles, 66 of which involved children between 1 and 18 years of age. Of the 71 cases, 61 involved those who had never been vaccinated.

Elsewhere in the U.S., the outbreak continues with more than 700 sickened by measles, the largest number of confirmed cases in a single year in the last 25 years and for a disease that had been declared “eliminated” in the U.S. in 2000. Of those, The Washington Post reports, more than 500 had not received the vaccine; and 66 have been hospitalized, including 24 with pneumonia. A third of those infected are children younger than 5.

Measles is a threat, contrary to the meme currently floating around social media that uses a 1969 “Brady Bunch” episode to downplay its seriousness. In the episode, eldest daughter Marcia proclaims: “If you have to get sick, sure can’t beat the measles.” Maureen McCormick, who played Marcia isn’t happy with the meme or its message. McCormick told NPR that she actually contracted measles as a child and became very sick; McCormick made sure her daughter received the vaccine.

For those who prefer facts to memes, according to the Centers for Disease Control and Prevention:

About 1 out of every 20 children with measles will get pneumonia;

About 1 out of every 1,000 with measles will develop encephalitis, a swelling of the brain that can cause convulsions, deafness and intellectual disability; and

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

The measles vaccine is very safe and effective. Two doses of MMR vaccine are about 97 percent effective at preventing measles; one dose is about 93 percent effective.

In the years before a measles vaccine was introduced in 1963, about a half-million annual cases were typical in the U.S., with 48,000 hospitalizations, 1,000 for encephalitis, and 400 to 500 deaths, according to the CDC.

Six years later, the year of the “Brady Bunch” episode, the number of measles cases in the U.S. dropped to 25,000 with 41 deaths.

One important reason to limit the exemptions for vaccines is to protect those, who for medical reasons, cannot receive the vaccine. Important to a vaccine’s effectiveness is the development of immunity within a community; the higher the vaccination rate, the better the chance that those who can’t safely be vaccinated will be protected.

The legislation ending the personal exemption to the MMR vaccine, which Gov. Jay Inslee is expected to sign, comes with two realities to keep in mind:

Some parents now will vaccinate their children because of the mandate, a stronger requirement that children attending public schools be vaccinated; unfortunately, not because they now have the confidence that this is what’s best for their kids and their community; and

The personal exemption remains for other childhood vaccinations recommended by the CDC.

The Legislature has done its job to yank us back to safety.

Now it’s up to those in the community to talk with parents who have questions and concerns and give them greater assurance of the safety and effectiveness of all vaccines.

Also in The Herald on the subject:

A dose of transparency can help science make case,” The Conversation, March 17;

Higher vaccination rates protect health, safety,” by Dr. Mark Beatty, Snohomish Health District health officer, Feb 17;

Editorial: End personal exemption for measles vaccine,” The Herald, Feb. 7.

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