Two years after a Minnesota measles outbreak infected 79 people, Washington State Gov. Jay Inslee has declared a statewide public health emergency, with 43 cases of the potentially deadly and highly contagious disease confirmed there as of Friday.
Sadly, both outbreaks have several critical factors in common. Children most commonly became ill, and the epicenters in both states involved communities with low vaccination rates for routine childhood shots. That last data point especially ought to prompt a critical question at both states’ legislatures. What are political leaders and state health officials doing to promote vaccines when the metastasizing conspiracies spun by anti-vaccine forces are clearly putting children at risk?
To Minnesota lawmakers’ credit, the 2017 outbreak centered in the state’s Somali-American community did not go unnoticed at the Capitol. The disease’s spread across the state prompted an energetic push by public health-minded legislators such as Rep. Mike Freiberg, DFL-Golden Valley, to tighten the state’s personal-belief exemption for mandated vaccines for school-age children. This overly broad loophole allows misinformed parents to forgo routine childhood vaccinations.
California has taken a common-sense step to tighten exemptions, but Freiberg’s bill stalled. And while he plans to try again this session, a recent announcement from the World Health Organization (WHO) should prompt additional action beyond tightening the exemption.
The WHO recently posted 10 threats to global health in 2019. What it called “vaccine hesitancy” made the list, along with Ebola, antibiotic resistance and an influenza pandemic. Vaccines save 2 million to 3 million lives a year, the WHO stated, and 1.5 million more could be saved if vaccination rates improved. It noted that there has been a 30 percent increase in measles cases globally this year.
A public health campaign to counter vaccine disinformation is needed in Minnesota and elsewhere. Such an effort could involve a media campaign to educate parents and also encourage them to address questions to reputable medical providers. It could also include additional training for doctors to help walk parents through their concerns. A further deep-in-the-health-policy-weeds wish is that insurers better compensate doctors who spend time counseling parents on vaccine issues.
There is a model for what could be done in Minnesota, Washington and elsewhere. Early this decade, health department officials in Milwaukee launched a “Safe Sleep Campaign” to encourage parents to put babies in cribs, instead of in parental beds, to avoid accidental suffocation. The ads drove home the risks and garnered local and national headlines. Minnesota’s vaccine campaign need not be as provocative, but getting the message out prominently, as Milwaukee did, is important.
It is not clear how much a campaign would cost. But it’s worth noting that the Minnesota Department of Health spent over $900,000, and Hennepin County spent $400,000, responding to the 2017 measles outbreak. That doesn’t include medical care and hospitalization costs for those who became seriously ill.
Gov. Tim Walz’s upcoming budget should include a reasonable sum for a campaign spotlighting vaccines’ importance. This public health issue merits the same urgency as combating the opioid crisis and strengthening elder-care reforms, which are already gubernatorial priorities.
State lawmakers should also hold a hearing on vaccination rates. According to the respected Minnesota Childhood Immunization Coalition, 119 schools in Minnesota had rates of nonmedical exemptions for the measles, mumps, rubella (MMR) vaccine at “10 percent or higher. One school has 60 percent of kids with an MMR exemption.” That’s unacceptable.
While the state has admirable vaccine advocacy organizations, groups promoting vaccine doubts tend to be better connected politically and have surprising financial resources. A controversial “vaccine safety” group held a legislators-only event last year at the Minneapolis Club. This month, a prominent and often misinformed vaccine skeptic, Robert F. Kennedy Jr., will give a “legislative briefing” in Minnesota on children’s health. One of the event’s sponsors: a Minnesota nonprofit whose mission includes increased awareness of “side effects of vaccine choices.”
A recent tweet from the Minnesota Childhood Immunization Coalition asks a serious question: “Where will the next measles outbreak be?” A vaccine education campaign is needed — at a minimum — to ensure it’s not here.