Decreasing Vaccination Rates in Texas Could Lead to Measles Epidemic

When it comes to incredibly contagious viruses such as measles, vaccination becomes exceedingly crucial in order to ensure adequate protection and prevent widespread epidemics. However, anti-vaccine stances are increasing as more and more parents choose to opt-out of vaccination coverage, and exemption rates continue to grow in number. A recent “perspective” piece published in PLOS Medicine, takes a closer look at vaccine rates in Texas and predicts that as vaccination coverage continues to decrease, the occurrence of another measles epidemic not only becomes possible, but highly probable.

Prior to the development of the measles vaccine in the 1960’s, every two to three years these large, and sometimes lethal, epidemics would occur among children throughout the country. According to the article, 50,000 of the pre-vaccine population ended up being hospitalized along with 500 cases resulting in death each year, with measles at the root of it all. On a global scale, the toll of measles epidemics was even higher, with it being the leading cause of death in children around the world.

According to the Centers for Disease Control and Prevention (CDC), in 2000, an incredibly effective vaccination program allowed for the United States to deem measles “eliminated” from the country, which means that the disease had not been transmitted for a year or more throughout the country. However, people can still become infected with measles if they are unvaccinated and travel to a country with measles prevalence; this means that if someone becomes infected with measles brings it with them into the Unitedd States, and then comes into contact with an unvaccinated child, the child can very easily become infected.

Peter J. Hotez, MD, PhD, dean of the National School of Tropical Medicine at Baylor College of Medicine, Texas Children’s Hospital Endowed Chair in Tropical Pediatrics, and author of the perspective piece, took a closer look at the increasing vaccine exemption rates in schools within Texas and found that the rates have nearly doubled from 2010, with about 45,000 children exempt from school immunization. He points out that measles “is one of the most highly transmissible human infectious disease agents known…a single primary case in a susceptible population would generate on average 12-18 new cases.”

Dr. Hotez attributes the increased exemption rate with a movement that has been gaining popularity in Texas, referred to as the “anti-vaxxer movement,” with an organization called “Texans for Vaccine Choice,” possibly at the root of it all. Based in Austin, Texas, the organization identifies as a “political action committee,” that provides parents with vaccination exemption through their website, taking them “step-by-step through the exemption process.”

One of the biggest reasons that parents are choosing to opt-out of vaccinating their children is the fear that vaccination may be linked to psychological impairment. Dr. Hotez specifically mentions Andrew Wakefield, MB, BS, FRCS, FRCPath, a gastroenterologist and medical researcher who is well known for his writings on the link between autism and the measles-mumps-rubella (MMR) vaccine, which has since been debunked. Although there are a number of studies discrediting any link between vaccination and autism, the fear remains.

The CDC provides a list of “Top 4 Things Parents Need to Know about Measles,” on their official website. Number four reminds parents of the importance of vaccination: “You have the power to protect your child against measles with a safe and effective vaccine.”

Due to the increasing number of vaccination exemptions, Dr. Hotez writes, “We might soon see a return of measles outbreaks, possibly far larger than the one that affected a megachurch in Tarrant County, Texas in 2013. Given that measles peaks in late winter or early spring, I predict measles outbreaks in Texas could happen as early as the winter or spring of 2018.”

Dr. Hotez pointed out that due to the fact that the anti-vaxxer movement seems to be predominantly in Texas, the second largest state within the country, is particularly concerning. However, there is hope that a future outbreak may be quelled. Dr. Hotez surmises that if the state legislature takes action to eliminate nonmedical vaccine exemptions, like California did when faced with the same problem, an outbreak may be prevented.

Dr. Hotez concluded, “We now need to enact something similar for the children of Texas in order to prevent imminent deaths from measles and other vaccine-preventable childhood diseases.”