It is the rare comeback story no one was rooting for: measles. The highly contagious disease was once deemed eliminated in the U.S. But plunging vaccination rates have left pockets of the country susceptible to outbreaks, and last year brought 2,144 confirmed cases — the most since 1992.
Vermont has largely been spared from this resurgence, reporting only four cases over the last two years. That’s still twice the number of cases compared to the previous decade. And while the state boasts high vaccination rates, outbreaks could occur in communities with more limited coverage.
Seven Days spoke to Laura Ann Nicolai, an epidemiologist at the state Department of Health, to learn more about Vermont’s vulnerability to measles.
A key metric in assessing Vermont’s protection is the vaccination rate among school-age children, Nicolai said. Children must be vaccinated before entering child care or kindergarten in Vermont, unless they receive an exemption.
Vermont allowed parents to send their children to schools unvaccinated if they claimed a “philosophical exemption” up until 2016. Now, parents can only opt their children out of mandatory school vaccinations on religious grounds, unless there is a medical reason, such as being immunocompromised.
Only about 3 percent of the 80,000 K-12 students in Vermont claim religious exemptions, along with about 2 percent of children in childcare. Add in the small number of children exempt for medical reasons and that leaves about 94 percent of children fully vaccinated as of last year, state data shows.
That’s higher than the national average, 92.5 percent, Nicolai said. “But rates a bit higher would be preferable.” That’s because experts say 95 percent is needed to reach herd immunity and prevent community transmission.
The statewide data only tell part of the story. Some schools and childcare facilities report much lower vaccination rates. At a few smaller independent schools, less than half of the student body is vaccinated. A full breakdown of school vaccination rates can be found on the health department’s website.
Vermont’s childhood vaccination rates have held relatively steady in recent years, though health officials worry that growing vaccine skepticism nationwide may eventually lead to dips in coverage.
Such concerns have only grown following last week’s news that the federal government has reduced the number of vaccines recommended for American children. While the measles vaccine remains on the slate, Nicolai worries that the shifting guidance is confusing for parents and could lead some to delay or forgo vaccinations.
She encourages parents to continue vaccinating their children for measles, starting with a first dose after 12 months.
For the general public, her advice is equally simple: Figure out whether you’re immune, and get vaccinated if you’re not. “Because we all are going to be at increased risk for encountering measles virus in the future,” she said.
People born before 1957 are generally considered immune because contagion was so widespread prior to the introduction of vaccines that they’re assumed to have been infected with measles, whether they knew it or not.
Adults born after 1957 can check their vaccination records, which can usually be obtained from health care providers or from state-run record systems. Anyone who has had two doses of the M.M.R. vaccines can assume they’re immune, with a few caveats. Those vaccinated between the years of 1963 and 1967 may have received a different, less effective vaccine, while those born in 1989 may have only received one dose.
Those who are unsure whether they’ve received the vaccine have two options, according to Nicolai: They can have their blood checked for immunity — or they can just get a fresh dose.
“There’s no harm in getting vaccinated, even if you are already immune,” Nicolai said.