Declining immunization rates a concern for Garfield County health officials
Garfield County hasn’t had a confirmed case of measles in the past decade, and only six cases of mumps since 2009, but public health officials are concerned about declining immunization rates.
“Declining vaccination rates are a concern, and could cause a vaccine preventable disease outbreak,” said Garfield County Public Health Director Yvonne Long.
Measles cases in the U.S. are currently at the highest rate since the disease was declared eradicated in this country in 2000, the Centers for Disease Control and Prevention announced last week.
Federal officials point to the declining immunization rate as a reason for the return of measles, which can lead to pneumonia and, in the worst cases, death.
When immunization rates drop even to 95 percent, health officials say, the chances of an outbreak become high due to the loss of “herd immunity.”
“With measles in particular, any time you fall below a vaccination rate of 95 percent, you will fail to achieve herd immunity. Herd immunity is particularly important to protect our most vulnerable populations, who cannot be immunized,” Long said.
The measles vaccine is combined with immunizations for mumps and rubella.
The last confirmed U.S. death from measles was in 2015, according to the CDC.
The risk factor
Garfield County’s total immunization rate for measles is around 90 percent; 5 percent lower than health officials say is necessary to avoid an outbreak.
Measles has a mortality rate of 1 or 2 out of 1,000 cases in children, according to CDC data. Other complications, such as brain swelling, are more rare. But one in every 20 children with measles also contracts pneumonia.
“In individuals who have no vaccination history or who are under-immunized, there is a 90 percent or greater chance of contracting the measles. As many as one out of every 20 children with measles gets pneumonia,” according to the Centers for Disease Control. Pneumonia is the most common cause of death from measles in young children.
While there have been no measles cases in Garfield County for some time, Danielle Dudley, immunization coordinator for Garfield County Public Health, said schools with lower rates of vaccination are at higher risk of an outbreak.
Dudley points to recent cases of pertussis, commonly known as whooping cough, which is immunized through the DTaP vaccine usually administered on children beginning at 2 months of age.
“Over the past decade, Garfield County has had 65 cases, including 49 children who were ages 18 years and younger. In 2013, there were 25 cases in six months alone locally,” Dudley said.
Whooping cough is highly contagious, but “it can be inferred that an outbreak of measles would be even worse and more widespread, indicating we need a coverage rate of 95 percent,” Dudley said.
Some school health nurses in certain districts have placed a heavy emphasis on reducing the number of kids who are deficient in required vaccines. Children are excluded from school until proof can be provided, Long said.
Such efforts can help schools maintain herd immunity thresholds, and have significantly reduced the chances of an outbreak, Long said.
Still, immunization rates are in decline in many places in the country and Colorado.
The best available data come from schools, which in Colorado are required to report immunization rates to the Colorado Department of Health and Environment (CDPHE) each year. CDPHE releases the data each spring.
Of the regional schools that report the immunization rates of students to the state, Waldorf School on the Roaring Fork had the lowest immunization rate for the 2017-18 school year.
Waldorf has similar policies regarding immunization as Roaring Fork School District Re-1 and Garfield Re-2 — students must show proof of vaccination, or their parents must sign an exemption waiver for personal, religious or medical reasons.
Waldorf follows all applicable laws regarding immunizations, and also “advises our parents to consider their social and civic responsibility as members of the greater community when making decisions regarding immunization,” Larry Smith, business administrator for Waldorf, said in an email.
Other area schools with lower-than-desired immunization rates or high opt-out rates included Crystal River Elementary School in Carbondale, Glenwood Springs Montessori and Ross Montessori in Carbondale.
Health officials stress the importance of immunizations as a simple and effective way to prevent diseases, but the rise of vaccine skeptics continues to grow.
Critics point to a number of vaccines that have had adverse side effects during testing, and question the accepted wisdom that vaccines are always a benefit.
“I think the general public is not allowed to see, objectively, all the evidence and research (on immunizations),” said Kent Albrecht, a Silt-based chiropractor.
“I think people should have freedom of choice, and not be mandated by the government out of fear to do something that may not be in their best interest,” he said.
Those skeptical of vaccines, Albrecht said, are too often shouted down even when they raise legitimate questions.
“Freedom of choice should be based on all the evidence, not just some of the evidence,” he said.
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