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June 26, 2019

End the religious exemption already: Every child, except those medically unable, should get vaccinated for measles

June 13, 2019
A sign warns people of measles in the ultra-Orthodox Jewish community in Williamsburg. New York City has ordered all yeshivas in a heavily Orthodox Jewish section of Brooklyn to exclude from classes all students who aren’t vaccinated against measles or face fines or possible closure. The order comes amid a recent outbreak of over 285 measles cases in Brooklyn and Queens, most of which have been concentrated in the Orthodox Jewish communities. (Spencer Platt/Getty Images)

The Centers for Disease Control recently reported that the current measles outbreak — the worst in the United States in 25 years — has spread to 1,022 cases in 28 states since September. The overwhelming majority of these cases have occurred in New York State, where the outbreak is largely linked to parents who have chosen not to vaccinate their children. To date, more than 50 patients across the state, mostly children, have been hospitalized, with some landing in intensive care units.

We should not take this outbreak lightly or believe there is an easy medical fix. Measles, which is vaccine-preventable, is one of the most contagious viruses identified by science — 10 times more contagious than influenza — and once someone is infected, there is no treatment. It’s estimated that, if exposed to the virus, 90% of unvaccinated people will end up infected and, once infected, one in four people with measles will be hospitalized.

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Beyond the severe flu-like symptoms, measles can lead to other illnesses, particularly in children, including pneumonia and encephalitis (swelling of the brain). In some cases it can be fatal for infants, pregnant women, and persons with otherwise weak immune systems. There is an overwhelming body of evidence that vaccines, including the measles, mumps and rubella vaccine (MMR), are safe and effective, and every year, millions of children and adults are given the MMR vaccine safely.

Unfortunately, many parents have been led to believe otherwise by anti-vaccine campaigners who have spread misinformation about vaccines through social media, handbooks and hotlines.

The only way to stop the outbreak is to make sure more children are vaccinated against measles. New York State policymakers must pass critical legislation, introduced by State Sen. Brad Hoylman of Manhattan and Assemblyman Jeffrey Dinowitz of the Bronx, which would eliminate non-medical exemptions from childhood vaccination requirements, including requirements for MMR.

Vaccine exemptions should only be permitted when a health-care practitioner determines that the vaccine would be medically inappropriate for the patient. Overuse of non-medical exceptions is jeopardizing public health.

With widespread vaccination, once-common childhood diseases like measles, whopping cough, diptheria and others have become rare in this country. Before a measles vaccine was introduced in the U.S. in the 1960s, the CDC estimates there were 3 to 4 million cases a year. The disease became largely preventable through two shots administered during childhood and was declared eliminated in the U.S, in 2000 by the CDC. However, the severity of the current outbreak puts our country at risk of losing our measles elimination status.

In 2014, when a measles outbreak started at Disneyland in California, lawmakers in the state quickly introduced and passed legislation to prohibit religious and philosophical exemptions for vaccines. The outbreak was curbed and today schoolchildren in California must be vaccinated unless they have a medical excuse. Unfortunately, bills similar to California’s have languished in the New York legislature since January.

Our policymakers must pass this important legislation before the legislative session ends. It is an important step towards protecting all New Yorkers — including our vulnerable children — from this grave public health emergency.

Fried is dean of the Columbia University Mailman School of Public Health.

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