While a measles outbreak in Washington state fueled by low vaccination rates has forced officials there to declare a state of emergency, health officials in San Francisco say tightened state vaccination requirements have largely reduced the risk of such an outbreak here.
Since 2015, when California moved to eliminate ‘personal belief’ exemptions that allowed parents to avoid immunizing their children, San Francisco schools report the number of students with all required immunizations has increased 2.4 percent. The change has left the city at a safe and comfortable overall 94.9 percent vaccination rate.
In comparison, Washington state schools are only reporting 85 percent of students are fully vaccinated, according to state health officials.
“You can never say that something couldn’t happen anywhere, but San Francisco is less vulnerable to measles outbreak because our vaccination rate is higher,”said Dr. Julie Stoltey, director of Communicable Disease Prevention for the San Francisco Department of Public Health.
California removed the ‘personal belief’ exemption for student vaccination following a 2015 measles outbreak at Disneyland, and now requires all students enrolled in a classroom setting to be fully vaccinated.
Along with a sustained effort by city health officials to investigate any reports of vaccine-preventable diseases, even those considered ‘low-suspicion,’ San Francisco is looking more resilient than ever.
However, there is still some reason for concern. In the three years since that change, the number of students that remain unvaccinated due to a doctor issued ‘medical exemption’ has more than tripled, according to the California Department of Public Health.
Even though the number of unvaccinated medically exempt students has tripled, the actual population still remains a fraction of a percent in San Francisco, or 0.7 percent to be exact. The increase in the number of fully vaccinated students outpaced the growth in medical exemptions by 250 percent, according to CDPH data.
When vaccination rates are high the community is better protected from the spread of vaccine-preventable diseases, Stoltey said. This is particularly important because the vast majority of infants under the age of 12 months are too young to be vaccinated and are vulnerable to measles and rely on a vaccinated community or ‘herd immunity,’ she said.
Measles, which is highly contagious and viral, has yet to be dethroned as the most lethal vaccine-preventable disease. Before a vaccine became available, it is estimated to have caused 2.6 million deaths per year, according the World Health Organization (WHO). The most recent figures show that it is still responsible for over 110,000 deaths globally in 2017, predominantly affecting children under the age of 5.
Health officials are working to stem the explosive growth medical exemptions.
Last year the California Medical Board sanctioned Bob Sears, an Orange County physician popular among vaccine skeptics, for giving a child a medical exemption without any examination.
There are also reports of doctors advertising courses training parents to utilize loopholes in the law.
A website by Dr. Kelly Sutton reads “Get the tools and knowledge to you need to protect your rights as a parent to choose the healthcare for your children. Take advantage of this EXCLUSIVE program for $97.”
Stoltey said she wished that parents who have concerns and want to apply for a medical exemption would talk to their family doctor and trust the decades of science that support the safety and effectiveness of vaccines.
Despite the healthy vaccination rates, CDHP still cautions that “if introduced into California from either the current Washington state outbreak or from travel overseas, measles could easily spread in local contexts such as schools or social networks in California that include persons who have not been vaccinated.”