‘We will pay a very steep cost;’ Texas measles outbreak shows local vulnerability

Nine out of 10 unvaccinated people will get measles if exposed to it, she said.

“You don’t need to have close exposure. You don’t need to be around them for a certain period of time. It’s just that contagious,” Thomas said.

Since measles was eradicated in the U.S. in 2000, the only way Americans get the virus is if they travel outside of the U.S. and end up bringing the virus back with them, Thomas said. Those can be isolated cases unless the carrier is exposed to a pocket of unvaccinated individuals.

“That county in Texas that’s the center of their outbreak has a very low vaccination rate, and it’s actually, unfortunately, the same as the vaccination rate here in Montgomery County that we have for our kindergartners now,” Thomas said.

About 84.6% of kindergartners in Montgomery County were vaccinated with the measles, mumps, and rubella (MMR) vaccine for the 2024-2025 school year, according to Public Health.

Decreased herd immunity

As of March 13, there have been 301 measles cases reported by 15 jurisdictions, including Alaska, California, Florida, Georgia, Kentucky, Maryland, New Jersey, New Mexico, New York City, New York State, Pennsylvania, Rhode Island, Texas, Vermont and Washington, according to the CDC.

More than 50 people have been hospitalized and two have died. Those are the first measles deaths in the U.S. since 2015, according to the U.S. Centers for Disease Control and Prevention.

In the largest outbreak that started in Texas, 259 cases have been identified since late January, as of March 14.

Texas is seeing a rise in measles cases due to decreased herd immunity, said Dr. Elise Striebich, a primary care doctor practicing at the Kettering Health Englewood Health Center.

“Any time we have less vaccination rates, there’s less antibodies, which means there’s a higher risk of an outbreak,” Striebich said.

A vaccination rate of least 94% is needed to reach herd immunity in order to prevent the spread of highly contagious diseases, according to the Mayo Clinic.

Only about 9% of the elementary schools in the region met the threshold of 94% or more of their kindergarten students having all of their required vaccinations for the 2023-2024 school year, according to a past Dayton Daily News analysis of Ohio Department of Health data.

Measles has health risks

Measles isn’t just contagious, it’s also dangerous.

“This is a disease that was feared,” Dr. Bruce Vanderhoff, director of the Ohio Department of Health, said about the time prior to the introduction of the MMR vaccine when measles was active in Ohio.

Measles can lead to severe health problems, Vanderhoff said, like encephalitis, which is a swelling of the brain with mild to life-threatening symptoms.

A rare, but fatal degenerative disease of the central nervous system can take place a decade after the initial measles infection. It can lead to behavioral and intellectual deterioration, as well as seizures, according to the U.S. Centers for Disease Control.

“Vaccines save lives — that’s never been more obvious to me,” said Chris Cook, health commissioner at the Clark County Combined Health District. “The sobering reality is that the two people who died from measles in Texas and New Mexico didn’t have to.”

Credit: Bill Lackey

Credit: Bill Lackey

Vaccination rates below pre-COVID levels

Vaccination rates have continued to decline since COVID-19.

“The downward trend has continued,” Vanderhoff said in a press conference on Tuesday.

Statewide, vaccination rates have declined among kindergarten students, from 86.2% in the 2023-2024 school year, to 85.4% of kindergarten students being fully vaccinated in the 2024-2025 school year, according to the Ohio Department of Health.

“This decline is alarming,” Vanderhoff said.

Montgomery County has not bounced back to its pre-pandemic vaccination rate of 91.3%, according to Public Health.

“Our modeling studies from the CDC show that when that rate gets less than 85% in particular, if a case of measles comes into a school and the vaccination rate is that low, it’s more than likely going to lead to a measles outbreak in that school,” Thomas said.

Clark County is similarly facing low rates of utilization of the MMR vaccine, according to the Clark County Combined Health District.

About 86.4% of kindergartners in the 2023-2024 school year in Clark County were up-to-date on their required childhood immunizations, according to the health district.

Credit: NYT

Credit: NYT

Clark County had a pre-pandemic high of 95.6% of kindergarten students in the 2016-2017 school year who were up-to-date on their vaccinations, the health district said.

“If we continue on a path of decreasing immunization rates, as individuals and as a community we will pay a very steep cost,” Cook said.

Butler County had a slightly better rate at 87.3% of kindergarten students being fully up-to-date on all of their childhood immunizations for the 2023-24 school year, according to ODH data.

Butler County’s vaccination rate for MMR is higher, with 94.1% of kindergarten students vaccinated with both doses, according to the Butler County General Health District’s most recent data.

Vaccine safety

Children should get two doses of MMR vaccine, the CDC says, starting with the first dose at 12 to 15 months of age and the second dose at 4 through 6 years of age.

The lack of uptake of vaccinations is disheartening from a public health perspective, Cook said.

“Individual health choices become the profile of a community’s health. We want our community to be as healthy as possible, especially our children,” Cook said.

Childhood vaccines are safe and effective, and they keep children alive, Cook said.

“That’s not a matter of opinion. That’s not a political statement. It’s a fact,” Cook said.

Doctors and public health experts are encouraging parents who are hesitant about vaccines to consult with their child’s doctor or a trusted medical professional.

“I love it when patients come in with questions like that, because that’s what I’m here for, that’s what I’m trained for,” Striebich said.

The American Academy of Pediatrics’ website healthychildren.org also provides parents with helpful resources on multiple topics, as well as information on vaccinations.

How to get your child vaccinated

The U.S. Centers for Disease Control provides resources on its website about how families can access vaccines for their children at no cost to them at cdc.gov/vaccines/programs/vfc/. The Vaccines for Children program offers vaccines at no cost for eligible children through doctors enrolled in the program.

Routine childhood vaccinations are also available at many pharmacies. To find a pharmacy near you, visit vaccines.gov.

Your county health department may be able to provide childhood vaccinations through the Vaccines for Children program. Below are the contact phone numbers for each county health department in the Dayton region: