By George A. Conway

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S ince Edward Jenner’s development of the first effective vaccine in 1796, to prevent smallpox, medicine and public health have been able to greatly diminish many deadly infectious diseases through the widespread immunization of children.

One example was diphtheria, which caused tremendous mortality among American children. After the introduction of an effective vaccine, the death rate dropped over 99 percent in the U.S. Likewise, my schoolmate, who was permanently disabled in the 1950s, was in the last American generation to suffer the ravages of polio.

In order to keep these diseases from resurfacing, enough children need to be immunized to have effective “herd” protection within the school population. In the case of a highly contagious childhood illness like measles, the effective level is between 96 percent and 99 percent immunized. When immunization rates fall below the necessary level for “herd immunity,” it becomes very easy for an infectious disease to spread. When we have high community immunization rates, we are not only protecting our children from serious diseases, we are protecting those in our community who are medically fragile or too young to receive vaccines.

Unfortunately, due to the rise of misinformation and the fact that many American parents haven’t seen the devastating effects of these diseases, there has been an increase year after year of parents refusing vaccination for their children. Vaccination exemptions of children starting kindergarten in Oregon for nonmedical reasons has continued upward (with one slight correction occurring in 2014-15, due to the passage of SB 895 in 2014, which requires that parents receive vaccine education in order to claim a nonmedical exemption for their child).

While lack of vaccination and the resulting risk for vaccine-preventable diseases is generally concentrated in lower-income populations worldwide, the pattern of nonmedical exemptions in the U.S., particularly on the West Coast, is the opposite, often concentrating in schools serving higher income communities. This pattern of immunization exemption rates is apparent in Deschutes County, which is in the highest category in Oregon.

This makes our children vulnerable to serious vaccine-preventable illnesses such as measles, which is what happened in Clark County, Washington, last month.

Clark County has 70 reported cases of measles, which is creating a significant community impact. The outbreak has spread to neighboring Multnomah County and caused a measles exposure locally that required Deschutes County Public Health to contact numerous families of exposed children and encourage the unimmunized to be immunized. Mercifully, no local cases have occurred in our county as a result, but the cost of this response has exceeded $20,000.

Measles is a deadly disease worldwide, claiming the lives of 110,000 children in 2017, primarily in developing nations with inadequate vaccination programs.

Before the introduction of measles vaccine in the U.S., measles sickened a half-million children and killed 500 Americans each year. Since the introduction of measles vaccine in the U.S., cases and deaths have dropped over 95 percent, but outbreaks continue to occur among inadequately vaccinated populations.

After measles rapidly spread at Disneyland during an outbreak in 2014 sickening hundreds of children, California removed its nonmedical exemption option for childhood vaccination requirements for school attendance.

It is time, in my opinion as a health professional and as the Deschutes County Health Department director, for Oregon to do the same, as an essential measure to keep our children safe and well.

— George A. Conway is the director of the Deschutes County Health Services Department.