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"content": "\u003cp>Partly proud, partly mortified, Principal José Macias of the Sixty-First Street Elementary School in Los Angeles said that yes, it was true – his school had reported the biggest increase in the rate of fully vaccinated kindergarten students in the state. The number of kindergartners who met all vaccination requirements this year jumped by 82 percentage points at the school, according to data released this week.\u003c/p>\n\u003cp>“I’m glad,” Macias said, “but it also tells me we were low.”\u003c/p>\n\u003cp>Parents at Sixty-First Street Elementary support vaccinations for their children, Macias said, but follow-up is sketchy. That’s how the school ended up in 2015-16 with just 12 percent of its kindergartners up-to-date for all vaccinations. The remaining kindergartners – 88 percent of them – were admitted “conditionally” in 2015-16, meaning they had some but not all of the 10 immunizations required by the state, and promised to complete the rest. In 2016-17, the up-to-date vaccination rate for kindergartners at Sixty-First Street Elementary climbed to nearly 95 percent.\u003c/p>\n\u003cp>While Macias’ school reported the most dramatic upturn, new data from the California Department of Public Health show for the first time how individual schools contributed to a statewide increase in kindergarten vaccination rates to 95.6 percent.\u003c/p>\n\u003cp>\u003cem>Search this new \u003ca href=\"https://edsource.org/2017/vaccination-rates-by-school-in-california/580981\" target=\"_blank\">vaccination database\u003c/a>, created by EdSource, a nonprofit news site that focuses on education policy in the state, to see vaccination rates at individual schools.\u003cbr>\n\u003c/em>\u003cbr>\nThe new vaccination law, Senate Bill 277, took effect at the start of this school year, eliminating the ability of a parent to obtain a “personal belief exemption” to opt out of vaccinating their children attending public and private schools. But the removal of the personal belief exemption doesn’t account for the overall rise in vaccination rates, according to a summary report from the California Department of Public Health. Instead, schools and parents started to take immunization far more seriously, health officials say.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>International publicity about the Disneyland measles outbreak of 2014-15 brought the risk of contracting measles, which had been declared eradicated in the United States in 2000, back as a public health threat. As Senate Bill 277, authored by Sen. Richard Pan, D-Sacramento, wound its way through the Capitol, news reports highlighted testimony from parents who vowed never to vaccinate their children and testimony from parents who had seen the ravages of polio. A 6-year-old Marin County boy with leukemia, Rhett Krawitt, became the public face of the debate.\u003c/p>\n\u003cp>And state finance auditors announced they would be looking more closely at schools with high rates of kindergartners who were not fully immunized – who were “conditionally” enrolled – to evaluate whether these students were properly enrolled and legitimately eligible for state per-pupil funding, according to the California Department of Public Health summary report. Students who are not fully vaccinated run the risk of not being allowed to attend school.\u003c/p>\n\u003cp>When the law passed in 2015, staff at many schools launched a full court press to get every eligible incoming kindergartner vaccinated. Collecting immunization paperwork from parents rose to the top of the to-do list. Kimberly Wright, principal of Los Angeles’ Cienega Elementary School, said she made immunizations a permanent agenda item for her meetings with office staff. At the front counter, conversations with parents about vaccinations shifted in tone from a low-key reminder – “well, when you can do it,” Wright said, to “this is really important.” Staff made reminder calls to parents, and Wright kept a list of those with incomplete immunizations on her desk. Increases in vaccination rates at Cienega Elementary rose from 15 percent in 2015-16 to nearly 88 percent up-to-date in 2016-17.\u003c/p>\n\u003cp>“The vocabulary of the personal belief exemption seemed to imply it was a personal choice with only personal implications, when actually the effect on a community could be profound,” said Matt Willis, public health officer for Marin County.\u003c/p>\n\u003cp>Matt Willis, public health officer for Marin County, which had some of the highest rates of personal belief exemptions in the state, said that the debate about vaccinations shifted in Marin in part because of Rhett and his story. Chemotherapy had compromised Rhett’s immune system, making him unable to be vaccinated against certain diseases, and leaving him at risk for catching a disease from unvaccinated classmates. He stood on a wooden chair at a March 2015 meeting of the Marin County Board of Supervisors and urged supervisors to support Senate Bill 277 “so kids like me don’t get sick at school.”\u003c/p>\n\u003cp>“One key was reframing vaccinations entirely as a matter of community responsibility,” Willis said. “The vocabulary of the personal belief exemption seemed to imply it was a personal choice with only personal implications, when actually the effect on a community could be profound.”\u003c/p>\n\u003cp>In addition, Willis surveyed Marin parents in 2013 about their beliefs about vaccinations, and found that most were choosing to vaccinate their children against some but not all of the 10 diseases. “We weren’t necessarily dealing with a community that was frankly against vaccinations,” Willis said. “That offered hope.”\u003c/p>\n\u003cp>At Reed Elementary School, Rhett’s school, the percentage of kindergarten students who are up-to-date with vaccinations went from 92.5 percent in 2015-16 to 97 percent in 2016-17. “It was the education of the community,” said Nancy Lynch, superintendent of Reed Union School District in Marin County. “People stepped up.”\u003c/p>\n\u003cp>Vaccination rates remained low, unsurprisingly, at schools that offer independent study programs or oversee home-schooled students. Students in those programs are not required to be vaccinated, nor are students who receive special education services. Aside from those types of schools, Walnut Avenue Elementary School in Chino Valley Unified had one of the lowest rates of immunizations, with 33 percent of kindergarten students up-to-date on vaccinations in 2016-17. Sixty-seven percent were overdue for vaccinations, meaning they were late getting a scheduled vaccination. According to the California Department of Education, children overdue for one or more required immunizations are subject to exclusion from school until they meet the requirements. \u003c/p>\n\u003cp>Brenda Dunkle, a spokeswoman for Chino Valley Unified, said the district could not comment on vaccination rates because its director of health services is out of the office until early May.\u003c/p>\n\u003cp>In Orange County, Pamela Kahn, coordinator of health and wellness at the Orange County Department of Education, said that education about immunizations unfolded with every news cycle in 2015 as dozens of children and adults, most of whom were unvaccinated, contracted measles after visiting two Disney theme parks in Anaheim. \u003c/p>\n\u003cp>“No. 1 was the Disneyland measles outbreak,” she said. “This brought people’s attention to the fact that this does still happen.”\u003c/p>\n\u003cp>An exodus of students from schools to home schools to avoid vaccinations didn’t occur, Kahn said. “We knew there would be some,” she said, and there were.\u003c/p>\n\u003cp>Along with the statewide increase in the vaccination rate, the rate of medical exemptions also rose, from 0.2 percent to 0.5 percent. A medical exemption requires a letter from a doctor stating the health reasons why a child cannot be vaccinated against certain diseases; there is no official form.\u003c/p>\n\u003cp>“From a medical point of view, there are some letters that are kind of suspicious,” Kahn said. “For example, we get the same exemption letter, with the same language, for different kids, from the same doctor. It could be ‘a familial history of reactions to immunization.’ That could be a cousin, a third cousin. One person wrote that this child was exempt until a date that correlates to high school graduation. That’s odd.”\u003c/p>\n\u003cp>But the schools don’t question the exemption letters, she said. “We were advised that we are not the medical experts,” she said.\u003c/p>\n\u003cp>“I think people are still looking for avenues not to be vaccinated,” said Dr. Kenneth Cutler, public health officer for Nevada County, which also has had pockets of unvaccinated students. Kindergarten vaccination rates for the county reached 81 percent, up from 69 percent about five years ago, he said.\u003c/p>\n\u003cp>Some schools in the county reported high levels of medical exemptions and high levels of personal belief exemptions, which were carried over from last year when the students were in transitional kindergarten. The law states that those exemptions remained valid for kindergarten this year.\u003c/p>\n\u003cp>But Sharyn Turner, school health services coordinator at the office of the Nevada County Superintendent of Schools, said she did see signs of change in what has been a strong anti-vaccination culture at some schools. In those schools, she said, parents who opposed vaccinations shunned some pro-vaccination parents. But Turner’s vaccinated grandson now attends School of the Arts, which has a history of being popular with vaccine opponents, and she said the family has been welcomed. “You are no longer excluded because you vaccinate your child,” she said.\u003c/p>\n\u003cp>Others remain outliers in the vaccination landscape.\u003c/p>\n\u003cp>At the Mountain Oaks School in Calaveras County, where all students are in independent study or home-school programs, supplemented by on-site classes for those who are vaccinated, 39 percent of kindergartners were up-to-date on vaccinations. Fifty-seven percent did not have to be immunized because they are not receiving classroom instruction or they are receiving special education services. An additional 4.5 percent had a medical exemption.\u003c/p>\n\u003cp>Vaccinated students can attend group classes at school, including pottery and algebra, said Anne Colman, administrator of Mountain Oaks School.\u003c/p>\n\u003cp>“Despite that, the percentage of parents who don’t care that their kids can’t take classes at school is really high,” Colman said.\u003c/p>\n\u003cp>Unvaccinated students had to stay home from a recent outdoor adventure school trip, she said. “We’re trying very hard to err on the side of caution,” she said. “I do not want to be the administrator on the 11 o’clock news – ‘Plague outbreak after unvaccinated kids are let in.'”\u003c/p>\n\u003cp>“Our parents are nothing if they’re not rebels, and they have been for a gazillion years,” she said.\u003c/p>\n\u003cp>At Sixty-First Street Elementary, planning for next year’s kindergarten immunization checks are well underway. At school drop-off in the morning, Macias sticks his head into parents’ cars and tells them he wants their younger children as kindergartners next year, but they need to be vaccinated. School staff photocopy flyers with the locations of health care clinics, translate forms into Spanish, and offer, time and again, to help parents get the job done.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“The only thing we haven’t done is bring the doctor here,” Macias said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Partly proud, partly mortified, Principal José Macias of the Sixty-First Street Elementary School in Los Angeles said that yes, it was true – his school had reported the biggest increase in the rate of fully vaccinated kindergarten students in the state. The number of kindergartners who met all vaccination requirements this year jumped by 82 percentage points at the school, according to data released this week.\u003c/p>\n\u003cp>“I’m glad,” Macias said, “but it also tells me we were low.”\u003c/p>\n\u003cp>Parents at Sixty-First Street Elementary support vaccinations for their children, Macias said, but follow-up is sketchy. That’s how the school ended up in 2015-16 with just 12 percent of its kindergartners up-to-date for all vaccinations. The remaining kindergartners – 88 percent of them – were admitted “conditionally” in 2015-16, meaning they had some but not all of the 10 immunizations required by the state, and promised to complete the rest. In 2016-17, the up-to-date vaccination rate for kindergartners at Sixty-First Street Elementary climbed to nearly 95 percent.\u003c/p>\n\u003cp>While Macias’ school reported the most dramatic upturn, new data from the California Department of Public Health show for the first time how individual schools contributed to a statewide increase in kindergarten vaccination rates to 95.6 percent.\u003c/p>\n\u003cp>\u003cem>Search this new \u003ca href=\"https://edsource.org/2017/vaccination-rates-by-school-in-california/580981\" target=\"_blank\">vaccination database\u003c/a>, created by EdSource, a nonprofit news site that focuses on education policy in the state, to see vaccination rates at individual schools.\u003cbr>\n\u003c/em>\u003cbr>\nThe new vaccination law, Senate Bill 277, took effect at the start of this school year, eliminating the ability of a parent to obtain a “personal belief exemption” to opt out of vaccinating their children attending public and private schools. But the removal of the personal belief exemption doesn’t account for the overall rise in vaccination rates, according to a summary report from the California Department of Public Health. Instead, schools and parents started to take immunization far more seriously, health officials say.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>International publicity about the Disneyland measles outbreak of 2014-15 brought the risk of contracting measles, which had been declared eradicated in the United States in 2000, back as a public health threat. As Senate Bill 277, authored by Sen. Richard Pan, D-Sacramento, wound its way through the Capitol, news reports highlighted testimony from parents who vowed never to vaccinate their children and testimony from parents who had seen the ravages of polio. A 6-year-old Marin County boy with leukemia, Rhett Krawitt, became the public face of the debate.\u003c/p>\n\u003cp>And state finance auditors announced they would be looking more closely at schools with high rates of kindergartners who were not fully immunized – who were “conditionally” enrolled – to evaluate whether these students were properly enrolled and legitimately eligible for state per-pupil funding, according to the California Department of Public Health summary report. Students who are not fully vaccinated run the risk of not being allowed to attend school.\u003c/p>\n\u003cp>When the law passed in 2015, staff at many schools launched a full court press to get every eligible incoming kindergartner vaccinated. Collecting immunization paperwork from parents rose to the top of the to-do list. Kimberly Wright, principal of Los Angeles’ Cienega Elementary School, said she made immunizations a permanent agenda item for her meetings with office staff. At the front counter, conversations with parents about vaccinations shifted in tone from a low-key reminder – “well, when you can do it,” Wright said, to “this is really important.” Staff made reminder calls to parents, and Wright kept a list of those with incomplete immunizations on her desk. Increases in vaccination rates at Cienega Elementary rose from 15 percent in 2015-16 to nearly 88 percent up-to-date in 2016-17.\u003c/p>\n\u003cp>“The vocabulary of the personal belief exemption seemed to imply it was a personal choice with only personal implications, when actually the effect on a community could be profound,” said Matt Willis, public health officer for Marin County.\u003c/p>\n\u003cp>Matt Willis, public health officer for Marin County, which had some of the highest rates of personal belief exemptions in the state, said that the debate about vaccinations shifted in Marin in part because of Rhett and his story. Chemotherapy had compromised Rhett’s immune system, making him unable to be vaccinated against certain diseases, and leaving him at risk for catching a disease from unvaccinated classmates. He stood on a wooden chair at a March 2015 meeting of the Marin County Board of Supervisors and urged supervisors to support Senate Bill 277 “so kids like me don’t get sick at school.”\u003c/p>\n\u003cp>“One key was reframing vaccinations entirely as a matter of community responsibility,” Willis said. “The vocabulary of the personal belief exemption seemed to imply it was a personal choice with only personal implications, when actually the effect on a community could be profound.”\u003c/p>\n\u003cp>In addition, Willis surveyed Marin parents in 2013 about their beliefs about vaccinations, and found that most were choosing to vaccinate their children against some but not all of the 10 diseases. “We weren’t necessarily dealing with a community that was frankly against vaccinations,” Willis said. “That offered hope.”\u003c/p>\n\u003cp>At Reed Elementary School, Rhett’s school, the percentage of kindergarten students who are up-to-date with vaccinations went from 92.5 percent in 2015-16 to 97 percent in 2016-17. “It was the education of the community,” said Nancy Lynch, superintendent of Reed Union School District in Marin County. “People stepped up.”\u003c/p>\n\u003cp>Vaccination rates remained low, unsurprisingly, at schools that offer independent study programs or oversee home-schooled students. Students in those programs are not required to be vaccinated, nor are students who receive special education services. Aside from those types of schools, Walnut Avenue Elementary School in Chino Valley Unified had one of the lowest rates of immunizations, with 33 percent of kindergarten students up-to-date on vaccinations in 2016-17. Sixty-seven percent were overdue for vaccinations, meaning they were late getting a scheduled vaccination. According to the California Department of Education, children overdue for one or more required immunizations are subject to exclusion from school until they meet the requirements. \u003c/p>\n\u003cp>Brenda Dunkle, a spokeswoman for Chino Valley Unified, said the district could not comment on vaccination rates because its director of health services is out of the office until early May.\u003c/p>\n\u003cp>In Orange County, Pamela Kahn, coordinator of health and wellness at the Orange County Department of Education, said that education about immunizations unfolded with every news cycle in 2015 as dozens of children and adults, most of whom were unvaccinated, contracted measles after visiting two Disney theme parks in Anaheim. \u003c/p>\n\u003cp>“No. 1 was the Disneyland measles outbreak,” she said. “This brought people’s attention to the fact that this does still happen.”\u003c/p>\n\u003cp>An exodus of students from schools to home schools to avoid vaccinations didn’t occur, Kahn said. “We knew there would be some,” she said, and there were.\u003c/p>\n\u003cp>Along with the statewide increase in the vaccination rate, the rate of medical exemptions also rose, from 0.2 percent to 0.5 percent. A medical exemption requires a letter from a doctor stating the health reasons why a child cannot be vaccinated against certain diseases; there is no official form.\u003c/p>\n\u003cp>“From a medical point of view, there are some letters that are kind of suspicious,” Kahn said. “For example, we get the same exemption letter, with the same language, for different kids, from the same doctor. It could be ‘a familial history of reactions to immunization.’ That could be a cousin, a third cousin. One person wrote that this child was exempt until a date that correlates to high school graduation. That’s odd.”\u003c/p>\n\u003cp>But the schools don’t question the exemption letters, she said. “We were advised that we are not the medical experts,” she said.\u003c/p>\n\u003cp>“I think people are still looking for avenues not to be vaccinated,” said Dr. Kenneth Cutler, public health officer for Nevada County, which also has had pockets of unvaccinated students. Kindergarten vaccination rates for the county reached 81 percent, up from 69 percent about five years ago, he said.\u003c/p>\n\u003cp>Some schools in the county reported high levels of medical exemptions and high levels of personal belief exemptions, which were carried over from last year when the students were in transitional kindergarten. The law states that those exemptions remained valid for kindergarten this year.\u003c/p>\n\u003cp>But Sharyn Turner, school health services coordinator at the office of the Nevada County Superintendent of Schools, said she did see signs of change in what has been a strong anti-vaccination culture at some schools. In those schools, she said, parents who opposed vaccinations shunned some pro-vaccination parents. But Turner’s vaccinated grandson now attends School of the Arts, which has a history of being popular with vaccine opponents, and she said the family has been welcomed. “You are no longer excluded because you vaccinate your child,” she said.\u003c/p>\n\u003cp>Others remain outliers in the vaccination landscape.\u003c/p>\n\u003cp>At the Mountain Oaks School in Calaveras County, where all students are in independent study or home-school programs, supplemented by on-site classes for those who are vaccinated, 39 percent of kindergartners were up-to-date on vaccinations. Fifty-seven percent did not have to be immunized because they are not receiving classroom instruction or they are receiving special education services. An additional 4.5 percent had a medical exemption.\u003c/p>\n\u003cp>Vaccinated students can attend group classes at school, including pottery and algebra, said Anne Colman, administrator of Mountain Oaks School.\u003c/p>\n\u003cp>“Despite that, the percentage of parents who don’t care that their kids can’t take classes at school is really high,” Colman said.\u003c/p>\n\u003cp>Unvaccinated students had to stay home from a recent outdoor adventure school trip, she said. “We’re trying very hard to err on the side of caution,” she said. “I do not want to be the administrator on the 11 o’clock news – ‘Plague outbreak after unvaccinated kids are let in.'”\u003c/p>\n\u003cp>“Our parents are nothing if they’re not rebels, and they have been for a gazillion years,” she said.\u003c/p>\n\u003cp>At Sixty-First Street Elementary, planning for next year’s kindergarten immunization checks are well underway. At school drop-off in the morning, Macias sticks his head into parents’ cars and tells them he wants their younger children as kindergartners next year, but they need to be vaccinated. School staff photocopy flyers with the locations of health care clinics, translate forms into Spanish, and offer, time and again, to help parents get the job done.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "California's New Vaccine Law Expected to Send Disease Rates Plummeting",
"title": "California's New Vaccine Law Expected to Send Disease Rates Plummeting",
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"content": "\u003cp>Mississippi hasn’t had a case of measles since 1992. West Virginia last saw measles – a highly contagious virus that kills an estimated 314 people worldwide every day – in 2009. Now, with California’s new vaccination law rolling out shot by shot, the state joins Mississippi and West Virginia to become the third in the nation to adopt stringent vaccination school entrance requirements. And medical experts say disease rates are likely to fall in California as they have in those states.\u003c/p>\n\u003cp>“It’s a good club to be in,” said Rahul Gupta, state health officer in West Virginia, who was effusive in welcoming California – home to more than eight times the number of children under the age of 18 as Mississippi and West Virginia combined – as a public health leader in school vaccinations, a role that the two Southern states have played for decades. “What we are seeing in West Virginia is a significant decline in vaccine-preventable diseases,” he said. “We expect the same in California.”\u003c/p>\n\u003cp>“We haven’t had a measles case in a schoolchild in decades,” said Thomas Dobbs, state epidemiologist in Mississippi, which has the highest school vaccination rate in the nation for measles, mumps and rubella with 99.7 percent of students receiving the immunization.\u003c/p>\n\u003cp>More than a year after a measles outbreak at Disneyland and Disney California Adventure spread to 134 Californians, as well as to residents in six other states and two other countries, the new law removes the personal belief exemptions that allowed parents not to vaccinate their children in public or private schools or child care centers based on an opposition to vaccines. As in Mississippi and West Virginia, California now allows only children who have a medical reason to be excused from the mandate if they wish to attend public or private schools and child care centers. Child by child, the new vaccination requirements, which took effect July 1, are being applied to babies, toddlers and students entering public or private child care, kindergarten and 7th grade.\u003c/p>\n\u003cp>Passing the law, known by its legislative number as Senate Bill 277, was arduous at times, as vaccination opponents traveled to Sacramento legislative hearings to voice their belief in a retracted 1998 case study that suggested a link between vaccinations and autism – a case study that the British Medical Journal declared to be “an elaborate fraud.” Public health advocates now are having a moment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Policies need to be based on science, not unfounded conjecture,” Dobbs said. “I am very impressed with California.”\u003c/p>\n\u003cp>California has more than 9 million children under the age of 18, compared with 737,000 children in Mississippi and 382,000 children in West Virginia, according to 2015 figures, making the impact of improved vaccination rates all that more significant.\u003c/p>\n\u003cp>“Nobody – myself included – was very confident that we could accomplish this law,” said Mark Sawyer, a member of the American Academy of Pediatrics Committee on Infectious Diseases and a medical school professor at UC San Diego. “Now people can see that it can be done – the legislators weighed the risks. I think other states will follow.”\u003c/p>\n\u003cp>“The likelihood is very strong that the end result will be fewer cases of vaccine-preventable diseases in California,” said Arthur Reingold, professor of epidemiology at the UC Berkeley School of Public Health. Several studies have documented that the easier it is for parents to decline to immunize their children, the higher the opt-out rates are and the greater the risk of outbreaks of measles and pertussis, also known as whooping cough.\u003c/p>\n\u003cp>In the absence of a federal law requiring school children to be immunized, state governments set the standards. Every state allows children to be exempt from vaccinations if they have a medical reason, such as a compromised immune system or a severe allergy. But 47 states allow parents to choose not to vaccinate their children because of a personal or religious opposition to vaccination. A parent’s right not to vaccinate a child based on beliefs has been defeated several times in Supreme Court rulings that state there is a greater public good in widespread immunization.\u003c/p>\n\u003cp>West Virginia instituted its vaccination requirements in 1987, has been strengthening them ever since and has never had a religious or personal belief exemption. Mississippi set its vaccination requirements in 1972, never had a personal belief exemption and ended its religious exemption in 1979, when the state Supreme Court ruled against such exemptions.\u003c/p>\n\u003cp>But in the ensuing decades, the fraudulent paper on the possible link between vaccinations and autism by Andrew Wakefield, a British doctor who was stripped of his medical license by a government review board, has sowed fear in parents and wreaked havoc on vaccination rates in Europe and, to a lesser extent, in the U.S. Both Gupta and Dobbs noted that it is far easier never to have had exemptions to vaccination requirements, or to have removed them decades ago, than to remove them in 2015 as California did.\u003c/p>\n\u003cp>West Virginia legislators continue to strengthen vaccination laws and in 2015 extended vaccination requirements to preschoolers. Amid complaints from a few parents that medical exemptions were being granted or denied without consistency, legislators last year created the position of state immunization officer, who is in charge of ruling whether a medical exemption is warranted. Having the state immunization officer has reduced complaints to legislators, Gupta said, “and significantly reduced criticism” of the vaccination requirements.\u003c/p>\n\u003cp>In California and elsewhere, non-medical exemptions have created pockets of unvaccinated children that have facilitated the spread of potentially life-threatening diseases, particularly measles and pertussis, according to a 2016 research review published in the Journal of the American Medical Association in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The most at-risk groups for the diseases are infants who are too young to be vaccinated and individuals with compromised immune systems, Sawyer said. On July 15, a previously healthy 5-month-old San Diego infant died of pertussis, according to the San Diego County Health and Human Services Agency. On the same day, a 51-year-old San Diego man said to have underlying health issues died of complications from chicken pox, the health agency said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mississippi hasn’t had a case of measles since 1992. West Virginia last saw measles – a highly contagious virus that kills an estimated 314 people worldwide every day – in 2009. Now, with California’s new vaccination law rolling out shot by shot, the state joins Mississippi and West Virginia to become the third in the nation to adopt stringent vaccination school entrance requirements. And medical experts say disease rates are likely to fall in California as they have in those states.\u003c/p>\n\u003cp>“It’s a good club to be in,” said Rahul Gupta, state health officer in West Virginia, who was effusive in welcoming California – home to more than eight times the number of children under the age of 18 as Mississippi and West Virginia combined – as a public health leader in school vaccinations, a role that the two Southern states have played for decades. “What we are seeing in West Virginia is a significant decline in vaccine-preventable diseases,” he said. “We expect the same in California.”\u003c/p>\n\u003cp>“We haven’t had a measles case in a schoolchild in decades,” said Thomas Dobbs, state epidemiologist in Mississippi, which has the highest school vaccination rate in the nation for measles, mumps and rubella with 99.7 percent of students receiving the immunization.\u003c/p>\n\u003cp>More than a year after a measles outbreak at Disneyland and Disney California Adventure spread to 134 Californians, as well as to residents in six other states and two other countries, the new law removes the personal belief exemptions that allowed parents not to vaccinate their children in public or private schools or child care centers based on an opposition to vaccines. As in Mississippi and West Virginia, California now allows only children who have a medical reason to be excused from the mandate if they wish to attend public or private schools and child care centers. Child by child, the new vaccination requirements, which took effect July 1, are being applied to babies, toddlers and students entering public or private child care, kindergarten and 7th grade.\u003c/p>\n\u003cp>Passing the law, known by its legislative number as Senate Bill 277, was arduous at times, as vaccination opponents traveled to Sacramento legislative hearings to voice their belief in a retracted 1998 case study that suggested a link between vaccinations and autism – a case study that the British Medical Journal declared to be “an elaborate fraud.” Public health advocates now are having a moment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Policies need to be based on science, not unfounded conjecture,” Dobbs said. “I am very impressed with California.”\u003c/p>\n\u003cp>California has more than 9 million children under the age of 18, compared with 737,000 children in Mississippi and 382,000 children in West Virginia, according to 2015 figures, making the impact of improved vaccination rates all that more significant.\u003c/p>\n\u003cp>“Nobody – myself included – was very confident that we could accomplish this law,” said Mark Sawyer, a member of the American Academy of Pediatrics Committee on Infectious Diseases and a medical school professor at UC San Diego. “Now people can see that it can be done – the legislators weighed the risks. I think other states will follow.”\u003c/p>\n\u003cp>“The likelihood is very strong that the end result will be fewer cases of vaccine-preventable diseases in California,” said Arthur Reingold, professor of epidemiology at the UC Berkeley School of Public Health. Several studies have documented that the easier it is for parents to decline to immunize their children, the higher the opt-out rates are and the greater the risk of outbreaks of measles and pertussis, also known as whooping cough.\u003c/p>\n\u003cp>In the absence of a federal law requiring school children to be immunized, state governments set the standards. Every state allows children to be exempt from vaccinations if they have a medical reason, such as a compromised immune system or a severe allergy. But 47 states allow parents to choose not to vaccinate their children because of a personal or religious opposition to vaccination. A parent’s right not to vaccinate a child based on beliefs has been defeated several times in Supreme Court rulings that state there is a greater public good in widespread immunization.\u003c/p>\n\u003cp>West Virginia instituted its vaccination requirements in 1987, has been strengthening them ever since and has never had a religious or personal belief exemption. Mississippi set its vaccination requirements in 1972, never had a personal belief exemption and ended its religious exemption in 1979, when the state Supreme Court ruled against such exemptions.\u003c/p>\n\u003cp>But in the ensuing decades, the fraudulent paper on the possible link between vaccinations and autism by Andrew Wakefield, a British doctor who was stripped of his medical license by a government review board, has sowed fear in parents and wreaked havoc on vaccination rates in Europe and, to a lesser extent, in the U.S. Both Gupta and Dobbs noted that it is far easier never to have had exemptions to vaccination requirements, or to have removed them decades ago, than to remove them in 2015 as California did.\u003c/p>\n\u003cp>West Virginia legislators continue to strengthen vaccination laws and in 2015 extended vaccination requirements to preschoolers. Amid complaints from a few parents that medical exemptions were being granted or denied without consistency, legislators last year created the position of state immunization officer, who is in charge of ruling whether a medical exemption is warranted. Having the state immunization officer has reduced complaints to legislators, Gupta said, “and significantly reduced criticism” of the vaccination requirements.\u003c/p>\n\u003cp>In California and elsewhere, non-medical exemptions have created pockets of unvaccinated children that have facilitated the spread of potentially life-threatening diseases, particularly measles and pertussis, according to a 2016 research review published in the Journal of the American Medical Association in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The most at-risk groups for the diseases are infants who are too young to be vaccinated and individuals with compromised immune systems, Sawyer said. On July 15, a previously healthy 5-month-old San Diego infant died of pertussis, according to the San Diego County Health and Human Services Agency. On the same day, a 51-year-old San Diego man said to have underlying health issues died of complications from chicken pox, the health agency said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Health Officials Confirm a UC Berkeley Student Has Measles",
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"content": "\u003cp>Berkeley health officials are \u003ca href=\"http://www.ci.berkeley.ca.us/City_Manager/Press_Releases/2015/2015-08-31_Measles_Case_in_Berkeley.aspx\" target=\"_blank\">alerting the public\u003c/a> that a UC Berkeley student has a confirmed case of measles. The student rode public transportation in the Berkeley area and was on campus before being diagnosed and placed in isolation on Saturday.\u003c/p>\n\u003cp>The student has not been identified. Officials say the student was likely contagious as early as last Monday, Aug. 24. Measles is contagious before a person shows any symptoms, and both city and state health officials are working with the university to identify people who have been living or working in close contact with the student.\u003c/p>\n\u003cp>Measles is one of the most contagious pathogens known and can linger up to two hours after the infected person has left. The measles vaccine is considered more than 99 percent effective.\u003c/p>\n\u003cp>In a statement, Berkeley health officer Dr. Janet Berreman encouraged people in Berkeley to \"make sure they and their children have received the required two doses. Obtaining records of your vaccination could prove critical in the event of a local outbreak.\"\u003c/p>\n\u003cp>Measles is marked by a red rash that starts on the head and spreads to the rest of the body. Other symptoms include fever, runny nose and red eyes. According to the \u003ca href=\"http://www.cdc.gov/measles/about/parents-top4.html\" target=\"_blank\">Centers for Disease Control\u003c/a>, one out of four people who develop measles will require hospitalization.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Berkeley officials asks that anyone who develops symptoms and believes they may have been exposed to contact their doctor.\u003c/p>\n\u003cp>A measles outbreak tied to\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\"> Disneyland theme parks\u003c/a> in Orange County started last December and spread across the state and beyond. It ultimately sickened more than 130 people in California before health officials \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">declared it over\u003c/a> in April.\u003c/p>\n\u003cp>UC Berkeley's health services\u003ca href=\"http://www.uhs.berkeley.edu/home/news/measles.shtml\" target=\"_blank\"> recommends\u003c/a> that anyone who is not already immunized to get vaccinated. If you are unsure of your vaccination status, you can be immunized -- extra doses of the vaccine are not harmful, experts say.\u003c/p>\n\u003cp>In addition to those who are not vaccinated, those at highest risk from measles are infants, pregnant women and people with compromised immune systems, such as cancer or HIV patients. Those who have had the recommended two doses of the MMR vaccine are at very low risk, officials said.\u003c/p>\n\u003cp>Starting next fall, all students in the University of California system \u003ca href=\"http://www.universityofcalifornia.edu/news/uc-plans-require-vaccinations-incoming-students\" target=\"_blank\">will be required\u003c/a> to be vaccinated against several diseases, including measles. Currently, students are only required to be vaccinated against hepatitis B.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Bay City News contributed to this report. \u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Berkeley health officials are \u003ca href=\"http://www.ci.berkeley.ca.us/City_Manager/Press_Releases/2015/2015-08-31_Measles_Case_in_Berkeley.aspx\" target=\"_blank\">alerting the public\u003c/a> that a UC Berkeley student has a confirmed case of measles. The student rode public transportation in the Berkeley area and was on campus before being diagnosed and placed in isolation on Saturday.\u003c/p>\n\u003cp>The student has not been identified. Officials say the student was likely contagious as early as last Monday, Aug. 24. Measles is contagious before a person shows any symptoms, and both city and state health officials are working with the university to identify people who have been living or working in close contact with the student.\u003c/p>\n\u003cp>Measles is one of the most contagious pathogens known and can linger up to two hours after the infected person has left. The measles vaccine is considered more than 99 percent effective.\u003c/p>\n\u003cp>In a statement, Berkeley health officer Dr. Janet Berreman encouraged people in Berkeley to \"make sure they and their children have received the required two doses. Obtaining records of your vaccination could prove critical in the event of a local outbreak.\"\u003c/p>\n\u003cp>Measles is marked by a red rash that starts on the head and spreads to the rest of the body. Other symptoms include fever, runny nose and red eyes. According to the \u003ca href=\"http://www.cdc.gov/measles/about/parents-top4.html\" target=\"_blank\">Centers for Disease Control\u003c/a>, one out of four people who develop measles will require hospitalization.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Berkeley officials asks that anyone who develops symptoms and believes they may have been exposed to contact their doctor.\u003c/p>\n\u003cp>A measles outbreak tied to\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\"> Disneyland theme parks\u003c/a> in Orange County started last December and spread across the state and beyond. It ultimately sickened more than 130 people in California before health officials \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">declared it over\u003c/a> in April.\u003c/p>\n\u003cp>UC Berkeley's health services\u003ca href=\"http://www.uhs.berkeley.edu/home/news/measles.shtml\" target=\"_blank\"> recommends\u003c/a> that anyone who is not already immunized to get vaccinated. If you are unsure of your vaccination status, you can be immunized -- extra doses of the vaccine are not harmful, experts say.\u003c/p>\n\u003cp>In addition to those who are not vaccinated, those at highest risk from measles are infants, pregnant women and people with compromised immune systems, such as cancer or HIV patients. Those who have had the recommended two doses of the MMR vaccine are at very low risk, officials said.\u003c/p>\n\u003cp>Starting next fall, all students in the University of California system \u003ca href=\"http://www.universityofcalifornia.edu/news/uc-plans-require-vaccinations-incoming-students\" target=\"_blank\">will be required\u003c/a> to be vaccinated against several diseases, including measles. Currently, students are only required to be vaccinated against hepatitis B.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Bay City News contributed to this report. \u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Boy Leukemia Patient Weighs in as Big Vaccine Exemption Vote Nears",
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"content": "\u003cp>Rhett Krawitt, the 6-year-old Marin leukemia patient who became a vaccination poster child during the state measles outbreak that began in Disneyland, is going to Sacramento Wednesday to speak out in favor of \u003ca href=\"http://leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_277&sess=CUR&house=B\" target=\"_blank\">SB277\u003c/a>.\u003c/p>\n\u003cp>[contextly_sidebar id=\"v8Ovi7xz9WGdWEKH3AAQM5EBBRKjmqD0\"]That bill, which would require all California children to be vaccinated in order to attend school, could come up for a floor vote in the state Assembly this week. SB277 has already passed the Senate.\u003c/p>\n\u003cp>Currently, parents can opt out of vaccinations through a personal belief exemption.\u003c/p>\n\u003cp>The debate over the bill has become a major battleground in the ongoing conflict between those who urge everyone to get vaccinated -- a group that includes the scientific and medical community -- and those who think the decision is personal. Many in that category believe vaccines are responsible for the rising autism rate, a proposition that has never been proved in any way, shape or form. As anyone knows who has gone down the rabbit hole of reading user \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/#comment-1820007057\" target=\"_blank\">comments on certain vaccine posts\u003c/a>, the back-and-forth between the two camps can get mega-vitriolic.\u003c/p>\n\u003cp>One interested party who's been following the progress of SB277 is Carl Krawitt, Rhett's father. Rhett could not be vaccinated during the measles scare because his immune system was still too weak, and was thus dependent on \u003ca href=\"http://www.vaccines.gov/basics/protection\" target=\"_blank\">herd immunity.\u003c/a> So his father publicly chastised those who voluntarily forgo vaccines, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">telling KQED's Lisa Aliferis\u003c/a>, “If you choose not to immunize your own child and your own child dies because they get measles, OK, that’s your responsibility, that’s your choice. But if your child gets sick and gets my child sick and my child dies,\" he said, \"then … your action has harmed my child.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.vimeo.com/video/118290318\" width=\"500\" height=\"281\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The story was picked up nationally, and the family has been using Rhett's high profile to push for the bill. Tomorrow, Rhett will speak at a press conference given by Assemblyman Marc Levine (D-San Rafael). Rhett will also deliver to the governor a \u003ca href=\"https://www.change.org/p/california-governor-eliminate-the-personal-belief-vaccine-exemption-that-s-putting-sick-california-kids-at-risk?source_location=petition_footer&algorithm=curated_trending\">Change.org petition\u003c/a> with more than 32,000 signatures calling for the bill's passage. (The site has \u003ca href=\"https://www.change.org/search?q=sb277\" target=\"_blank\">many petitions related to the bill\u003c/a>, it should be noted, both for and against.)\u003c/p>\n\u003cp>Carl Krawitt says he thinks the Assembly will pass the bill, but is concerned about Gov. Jerry Brown's position.\u003c/p>\n\u003cp>\"He has been very silent,\" Krawitt says. \"We know that [bill co-sponsor] Sen. Pan’s office has had meetings with the governor’s office, but there is no indication of the governor’s position on this issue. For me that’s troubling, because the governor is very outspoken on other issues of science -- global warming, the drought, for example. And SB277 is really rooted in scientific proof ... .\"\u003c/p>\n\u003cp>That may be true, but as noted on KQED's \u003ca href=\"http://ww2.kqed.org/news/2015/06/19/california-budget-deal-explained-kqed-politics-podcast/\" target=\"_blank\">California Politics Podcast\u003c/a> last week, some Capitol observers think the fact that Brown's cabinet secretary, Dana Williamson, testified in support of SB277 at the Assembly's Health Committee hearing was an indication of which way the wind is blowing, even though Williamson emphasized she was speaking on her own behalf.\u003c/p>\n\u003cp>By the way, Rhett, now 7 and in full remission, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">began his schedule of vaccinations\u003c/a> in February.\u003c/p>\n\u003cp>\"We're very excited he's vaccinated,\" his father says. \"When he wasn't vaccinated, we didn't travel much. ... We avoided crowded places.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Now that he's vaccinated, I would feel perfectly safe going to Disneyland.\"\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Rhett Krawitt, the 6-year-old Marin leukemia patient who became a vaccination poster child during the state measles outbreak that began in Disneyland, is going to Sacramento Wednesday to speak out in favor of \u003ca href=\"http://leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_277&sess=CUR&house=B\" target=\"_blank\">SB277\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>That bill, which would require all California children to be vaccinated in order to attend school, could come up for a floor vote in the state Assembly this week. SB277 has already passed the Senate.\u003c/p>\n\u003cp>Currently, parents can opt out of vaccinations through a personal belief exemption.\u003c/p>\n\u003cp>The debate over the bill has become a major battleground in the ongoing conflict between those who urge everyone to get vaccinated -- a group that includes the scientific and medical community -- and those who think the decision is personal. Many in that category believe vaccines are responsible for the rising autism rate, a proposition that has never been proved in any way, shape or form. As anyone knows who has gone down the rabbit hole of reading user \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/#comment-1820007057\" target=\"_blank\">comments on certain vaccine posts\u003c/a>, the back-and-forth between the two camps can get mega-vitriolic.\u003c/p>\n\u003cp>One interested party who's been following the progress of SB277 is Carl Krawitt, Rhett's father. Rhett could not be vaccinated during the measles scare because his immune system was still too weak, and was thus dependent on \u003ca href=\"http://www.vaccines.gov/basics/protection\" target=\"_blank\">herd immunity.\u003c/a> So his father publicly chastised those who voluntarily forgo vaccines, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">telling KQED's Lisa Aliferis\u003c/a>, “If you choose not to immunize your own child and your own child dies because they get measles, OK, that’s your responsibility, that’s your choice. But if your child gets sick and gets my child sick and my child dies,\" he said, \"then … your action has harmed my child.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://player.vimeo.com/video/118290318\" width=\"500\" height=\"281\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>The story was picked up nationally, and the family has been using Rhett's high profile to push for the bill. Tomorrow, Rhett will speak at a press conference given by Assemblyman Marc Levine (D-San Rafael). Rhett will also deliver to the governor a \u003ca href=\"https://www.change.org/p/california-governor-eliminate-the-personal-belief-vaccine-exemption-that-s-putting-sick-california-kids-at-risk?source_location=petition_footer&algorithm=curated_trending\">Change.org petition\u003c/a> with more than 32,000 signatures calling for the bill's passage. (The site has \u003ca href=\"https://www.change.org/search?q=sb277\" target=\"_blank\">many petitions related to the bill\u003c/a>, it should be noted, both for and against.)\u003c/p>\n\u003cp>Carl Krawitt says he thinks the Assembly will pass the bill, but is concerned about Gov. Jerry Brown's position.\u003c/p>\n\u003cp>\"He has been very silent,\" Krawitt says. \"We know that [bill co-sponsor] Sen. Pan’s office has had meetings with the governor’s office, but there is no indication of the governor’s position on this issue. For me that’s troubling, because the governor is very outspoken on other issues of science -- global warming, the drought, for example. And SB277 is really rooted in scientific proof ... .\"\u003c/p>\n\u003cp>That may be true, but as noted on KQED's \u003ca href=\"http://ww2.kqed.org/news/2015/06/19/california-budget-deal-explained-kqed-politics-podcast/\" target=\"_blank\">California Politics Podcast\u003c/a> last week, some Capitol observers think the fact that Brown's cabinet secretary, Dana Williamson, testified in support of SB277 at the Assembly's Health Committee hearing was an indication of which way the wind is blowing, even though Williamson emphasized she was speaking on her own behalf.\u003c/p>\n\u003cp>By the way, Rhett, now 7 and in full remission, \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">began his schedule of vaccinations\u003c/a> in February.\u003c/p>\n\u003cp>\"We're very excited he's vaccinated,\" his father says. \"When he wasn't vaccinated, we didn't travel much. ... We avoided crowded places.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Now that he's vaccinated, I would feel perfectly safe going to Disneyland.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.\u003c/p>\n\u003cp>But something else happened.\u003c/p>\n\u003cp>Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.\u003c/p>\n\u003cp>Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.\u003c/p>\n\u003cp>\"In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,\" says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.\u003c/p>\n\u003cp>The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>Now, it's your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I'm honored to be the moderator. 'Vaccine War' producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Feel free to leave a question now and please join us at noon for the chat!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://wwwssl.coveritlive.com/embed.html?altcastCode=0fc95ef8b6&srcdom=www.coveritlive.com&srcdomsec=wwwssl.coveritlive.com&height=550&entryLoc=top&commentLoc=top&titlePage=off&replayContentOrder=chronological&embedType=stream&titleImage=%2Ftemplates%2Fcoveritlive%2Fimages%2FbuildPage%2FNewsImage.jpg\" style=\"width:100%;height:550px\" height=\"550px\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.\u003c/p>\n\u003cp>The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>Now, it's your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I'm honored to be the moderator. 'Vaccine War' producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Feel free to leave a question now and please join us at noon for the chat!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://wwwssl.coveritlive.com/embed.html?altcastCode=0fc95ef8b6&srcdom=www.coveritlive.com&srcdomsec=wwwssl.coveritlive.com&height=550&entryLoc=top&commentLoc=top&titlePage=off&replayContentOrder=chronological&embedType=stream&titleImage=%2Ftemplates%2Fcoveritlive%2Fimages%2FbuildPage%2FNewsImage.jpg\" style=\"width:100%;height:550px\" height=\"550px\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Low Vaccination Rates Helped Stoke Disneyland Measles Outbreak",
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"content": "\u003cfigure id=\"attachment_23586\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-e1421892431232.jpg\">\u003cimg class=\"size-large wp-image-23586\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-640x426.jpg\" alt=\"Five Disney staff members are among California's cases. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Hensley,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2015/03/16/393336901/vaccination-gaps-helped-fuel-disneyland-measles-spread\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>California has been dealing with a big measles outbreak since December, when cases emerged among visitors to Disneyland.\u003c/p>\n\u003cp>Measles spread quickly afterward. As of Friday, the state \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_update_3_-_13_-_2015_public.pdf\" target=\"_blank\">had confirmed 133 measles cases\u003c/a> among residents since December.\u003c/p>\n\u003cp>Of the people who got sick -- and for whom the state could determine vaccination status -- 57 people hadn't been vaccinated against measles and 20 people had had at least one shot of the vaccine.\u003c/p>\n\u003cp>Researchers analyzed the California outbreak data as well as information gleaned from news reports and the Internet to figure out how big a factor the lack of vaccination was. The short answer, as you might have guessed, is big.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The rate of growth [in cases] gives us a good idea about the percentage of people in the population who are immune,\" says Maimuna Majumder, health fellow in the \u003ca href=\"http://www.healthmap.org/site/ceg\" target=\"_blank\">Health Map Computational Epidemiology Group\u003c/a> at Boston Children's Hospital.\u003c/p>\n\u003cp>\"This preliminary analysis indicates that substandard vaccination compliance is likely to blame for the 2015 measles outbreak,\" she and her co-authors \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=2203906\" target=\"_blank\">wrote in a research letter\u003c/a> that was published online Monday by \u003cem>JAMA Pediatrics. \u003c/em>By their calculations, vaccination rates among the people exposed to the infection might have been as low as 50 percent and probably not more than 86 percent.\u003c/p>\n\u003cdiv id=\"res393362383\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>The rapid spread of the measles in California and beyond has put a spotlight on vaccination rates.\u003c/p>\n\u003cp>Widespread vaccination led the U.S. to \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=1787786\" target=\"_blank\">declare measles eliminated\u003c/a> from the country in 2000. Infected people have entered the U.S. from countries where measles is endemic and isolated outbreaks have sprung up periodically.\u003c/p>\n\u003cp>A resurgence of measles in the past two years has \u003ca href=\"http://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s\" target=\"_blank\">stoked public health concerns\u003c/a>. In late January, the Centers for Disease Control and Prevention's Dr. Anne Schuchat \u003ca href=\"http://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s\" target=\"_blank\">said the uptick in measles cases\u003c/a> \"is a wake-up call to make sure measles doesn't get a foothold back in our country.\"\u003c/p>\n\u003cp>Measles is one of the most contagious viruses on the planet. But the measles-mumps-rubella vaccine against it is highly effective — about 95 percent effective in preventing infection.\u003c/p>\n\u003cp>When enough people are in a community are vaccinated against measles or have been previously infected with the virus, there's a protective effect called herd immunity that interrupts the spread of the virus to vulnerable people.\u003c/p>\n\u003cdiv id=\"res393362358\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>But the vaccination rate in the community has to be very high to guard against measles — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22426372\" target=\"_blank\">96 percent or greater\u003c/a>.\u003c/p>\n\u003cp>\"Measles is one of those cases of how herd immunity is really for the common good,\" says Boston Children's Hospital's Majumder. \"Healthy kids don't die from it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But children with weakened immune systems can die, and they rely on others to break the chain of measles transmission. Majumder's conclusion: \"If you can vaccinate, do.\"\u003c/p>\n\n",
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"excerpt": "New analysis shows vaccination rates among the people exposed to the infection might have been as low as 50 percent.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23586\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-e1421892431232.jpg\">\u003cimg class=\"size-large wp-image-23586\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/84933742-640x426.jpg\" alt=\"Five Disney staff members are among California's cases. (David McNew/Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Scott Hensley,\u003c/strong> \u003ca href=\"http://www.npr.org/blogs/health/2015/03/16/393336901/vaccination-gaps-helped-fuel-disneyland-measles-spread\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>California has been dealing with a big measles outbreak since December, when cases emerged among visitors to Disneyland.\u003c/p>\n\u003cp>Measles spread quickly afterward. As of Friday, the state \u003ca href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_update_3_-_13_-_2015_public.pdf\" target=\"_blank\">had confirmed 133 measles cases\u003c/a> among residents since December.\u003c/p>\n\u003cp>Of the people who got sick -- and for whom the state could determine vaccination status -- 57 people hadn't been vaccinated against measles and 20 people had had at least one shot of the vaccine.\u003c/p>\n\u003cp>Researchers analyzed the California outbreak data as well as information gleaned from news reports and the Internet to figure out how big a factor the lack of vaccination was. The short answer, as you might have guessed, is big.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The rate of growth [in cases] gives us a good idea about the percentage of people in the population who are immune,\" says Maimuna Majumder, health fellow in the \u003ca href=\"http://www.healthmap.org/site/ceg\" target=\"_blank\">Health Map Computational Epidemiology Group\u003c/a> at Boston Children's Hospital.\u003c/p>\n\u003cp>\"This preliminary analysis indicates that substandard vaccination compliance is likely to blame for the 2015 measles outbreak,\" she and her co-authors \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=2203906\" target=\"_blank\">wrote in a research letter\u003c/a> that was published online Monday by \u003cem>JAMA Pediatrics. \u003c/em>By their calculations, vaccination rates among the people exposed to the infection might have been as low as 50 percent and probably not more than 86 percent.\u003c/p>\n\u003cdiv id=\"res393362383\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>The rapid spread of the measles in California and beyond has put a spotlight on vaccination rates.\u003c/p>\n\u003cp>Widespread vaccination led the U.S. to \u003ca href=\"http://archpedi.jamanetwork.com/article.aspx?articleid=1787786\" target=\"_blank\">declare measles eliminated\u003c/a> from the country in 2000. Infected people have entered the U.S. from countries where measles is endemic and isolated outbreaks have sprung up periodically.\u003c/p>\n\u003cp>A resurgence of measles in the past two years has \u003ca href=\"http://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s\" target=\"_blank\">stoked public health concerns\u003c/a>. In late January, the Centers for Disease Control and Prevention's Dr. Anne Schuchat \u003ca href=\"http://www.npr.org/blogs/health/2015/01/29/382436262/rise-in-measles-cases-marks-a-wake-up-call-for-u-s\" target=\"_blank\">said the uptick in measles cases\u003c/a> \"is a wake-up call to make sure measles doesn't get a foothold back in our country.\"\u003c/p>\n\u003cp>Measles is one of the most contagious viruses on the planet. But the measles-mumps-rubella vaccine against it is highly effective — about 95 percent effective in preventing infection.\u003c/p>\n\u003cp>When enough people are in a community are vaccinated against measles or have been previously infected with the virus, there's a protective effect called herd immunity that interrupts the spread of the virus to vulnerable people.\u003c/p>\n\u003cdiv id=\"res393362358\" class=\"bucketwrap internallink insettwocolumn inset2col \">\u003c/div>\n\u003cp>But the vaccination rate in the community has to be very high to guard against measles — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22426372\" target=\"_blank\">96 percent or greater\u003c/a>.\u003c/p>\n\u003cp>\"Measles is one of those cases of how herd immunity is really for the common good,\" says Boston Children's Hospital's Majumder. \"Healthy kids don't die from it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But children with weakened immune systems can die, and they rely on others to break the chain of measles transmission. Majumder's conclusion: \"If you can vaccinate, do.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_23925\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/RhettGetsVaccine-e1423893179584.jpg\">\u003cimg class=\"size-large wp-image-23925\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/RhettGetsVaccine-640x480.jpg\" alt=\"Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Child-care facilities and preschools would be prevented from employing anyone who has not been vaccinated against influenza, pertussis and measles under a bill introduced in the California state Senate last week\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB792\" target=\"_blank\">SB792\u003c/a>, sponsored by state Sen. Tony Mendoza (D-Artesia) would amend the state Health and Safety Code to add the requirement that workers be vaccinated.\u003c/p>\n\u003cp>“Children under the age of five are one of the most vulnerable age groups for contracting infection and developing complications from these very serious diseases, so it is critical that we use all available methods to protect them,” Mendoza said in a press release announcing the legislation.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.latimes.com/local/lanow/la-me-ln-vaccines-for-daycare-workers-20150304-story.html\" target=\"_blank\">L.A .Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Currently, there are no vaccine requirements for day-care workers. Across schools, restaurants and the workplace, adults generally are not tracked for vaccinations as closely as young children entering school.\u003c/p>\u003c/blockquote>\n\u003cp>Since a December outbreak that started in Disneyland, \u003ca href=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_3_-_2_-_2015_public.pdf\" target=\"_blank\">131 cases of measles in California\u003c/a> have been confirmed, the Department of Public Health said Monday. Among those individuals for whom the department has vaccination documentation, 55 were unvaccinated and 18 had one or more doses of the Measles, Mumps and Rubella (MMR) vaccine. In the Bay Area, Alameda County has seen six cases, and Marin, San Mateo, Santa Clara and Solano counties have each experienced a handful.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A previously introduced bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, would eliminate parents' right to leave their children unvaccinated due to a personal belief exemption if enrolled in school or a child-care facility.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23925\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/RhettGetsVaccine-e1423893179584.jpg\">\u003cimg class=\"size-large wp-image-23925\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/RhettGetsVaccine-640x480.jpg\" alt=\"Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine. (Lisa Aliferis/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Rhett Krawitt, of Corte Madera, received the measles, mumps, rubella vaccine. (Lisa Aliferis/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>Child-care facilities and preschools would be prevented from employing anyone who has not been vaccinated against influenza, pertussis and measles under a bill introduced in the California state Senate last week\u003c/p>\n\u003cp>\u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB792\" target=\"_blank\">SB792\u003c/a>, sponsored by state Sen. Tony Mendoza (D-Artesia) would amend the state Health and Safety Code to add the requirement that workers be vaccinated.\u003c/p>\n\u003cp>“Children under the age of five are one of the most vulnerable age groups for contracting infection and developing complications from these very serious diseases, so it is critical that we use all available methods to protect them,” Mendoza said in a press release announcing the legislation.\u003c/p>\n\u003cp>From the \u003ca href=\"http://www.latimes.com/local/lanow/la-me-ln-vaccines-for-daycare-workers-20150304-story.html\" target=\"_blank\">L.A .Times\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Currently, there are no vaccine requirements for day-care workers. Across schools, restaurants and the workplace, adults generally are not tracked for vaccinations as closely as young children entering school.\u003c/p>\u003c/blockquote>\n\u003cp>Since a December outbreak that started in Disneyland, \u003ca href=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_3_-_2_-_2015_public.pdf\" target=\"_blank\">131 cases of measles in California\u003c/a> have been confirmed, the Department of Public Health said Monday. Among those individuals for whom the department has vaccination documentation, 55 were unvaccinated and 18 had one or more doses of the Measles, Mumps and Rubella (MMR) vaccine. In the Bay Area, Alameda County has seen six cases, and Marin, San Mateo, Santa Clara and Solano counties have each experienced a handful.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>A previously introduced bill, \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, would eliminate parents' right to leave their children unvaccinated due to a personal belief exemption if enrolled in school or a child-care facility.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "When A Court Ordered Kids Vaccinated -- Against Parents' Will",
"title": "When A Court Ordered Kids Vaccinated -- Against Parents' Will",
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"content": "\u003cfigure id=\"attachment_23949\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000057849064_Large-e1424368592567.jpg\">\u003cimg class=\"size-large wp-image-23949\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000057849064_Large-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong style=\"font-size: 14px\">By Anders Kelto,\u003c/strong> \u003ca style=\"font-size: 14px\" title=\"http://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will\" href=\"http://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>A highly contagious disease was sweeping across the United States. Thousands of children were sick and some were dying. In the midst of this outbreak, health officials did something that experts say had never been done before and hasn't been done since. They forced parents to vaccinate their children.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The church ran a school with about a thousand kids. None had been vaccinated. \u003c/aside>\n\u003cp>It sounds like something that would have happened a hundred years ago. But this was 1991 — and the disease was measles.\u003c/p>\n\u003cp>Dr. Robert Ross was deputy health commissioner of the hardest-hit city, Philadelphia, where the outbreak was centered around the Faith Tabernacle Congregation in the northern part of town.\u003c/p>\n\u003cp>\"This church community did not believe in either immunizations or medical care,\" says \u003ca href=\"http://www.calendow.org/about/Leadership/R_Ross_Bio.aspx\">Ross\u003c/a>. Today, he heads The California Endowment, a private health foundation, based in Los Angeles.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The church ran a school with about a thousand kids. Ross says that none had been vaccinated. One day, his office got a phone call from a grandparent, saying that a lot of children at the school were sick. They had developed rashes from head to toe and fevers — telltale signs of measles.\u003c/p>\n\u003cp>Ross and his colleagues approached the church and pleaded with the pastor to allow health officials to examine and immunize the children. But the pastor refused. So Ross and his colleagues went door to door, to church members' homes.\u003c/p>\n\u003cp>He says that most of the parents were pleasant and cooperative, and allowed health officials to enter their homes. Many of the children they saw had measles. Ross says the majority were doing fine, but some were very sick, including an 8-year-old girl.\u003c/p>\n\u003cp>\"[She] was lying on the couch in front of the television, ashen and pale, and with a very rapid respiratory rate. I felt that she may die within hours if we didn't get her to treatment,\" Ross says.\u003c/p>\n\u003cp>He went to the family's living room to call a judge, who was on call and ready to issue a court order, requiring any gravely ill children to be taken to a hospital. But as Ross held the phone, the girl's grandmother grabbed his arm and tried to prevent him from dialing.\u003c/p>\n\u003cp>\"She began lecturing me about believing in the power of the Lord,\" Ross says. \"It was a viscerally disturbing episode that left me quite shaken.\"\u003c/p>\n\u003cp>Ross eventually reached the judge, and the girl was taken to a local hospital. She survived.\u003c/p>\n\u003cp>But across the city, hundreds more were sick. So Ross and his colleagues did something unprecedented: They got a court order to force parents at Faith Tabernacle to have their children vaccinated.\u003c/p>\n\u003cp>Ross says it was the right thing to do, because it was in the best interest of the children. But it was deeply traumatizing to the parents.\u003c/p>\n\u003cp>\"I recall we lined the children up and gave the immunizations, and many of the parents were actually weeping,\" he says.\u003c/p>\n\u003cp>The court order had taken a few weeks. By the time \u003ca href=\"http://articles.latimes.com/1991-03-09/news/mn-2208_1_court-order\" target=\"_blank\">the vaccines were administered\u003c/a>, the measles outbreak was subsiding in Philadelphia. Only nine children from the church were ultimately vaccinated, and Ross says the intervention probably didn't affect the spread of the disease.\u003c/p>\n\u003cp>In the end, nine kids across Philadelphia died, including six from Faith Tabernacle. The church is still operating the school today but declined to comment.\u003c/p>\n\u003cp>Some experts say it's rather surprising that the parents were forced to have their children vaccinated.\u003c/p>\n\u003cp>\"There was a law that protected these church members' right to refuse vaccination on religious ground,\" says \u003ca href=\"http://www.chop.edu/doctors/offit-paul-a\" target=\"_blank\">Dr. Paul Offit\u003c/a>, director of the Vaccine Education Center at Children's Hospital of Philadelphia.\u003c/p>\n\u003cp>But the U.S. Supreme Court had ruled years earlier that parents can't deny life-saving medical treatments to their children for religious reasons. That ruling set a precedent that made it difficult for Faith Tabernacle to find legal representation.\u003c/p>\n\u003cp>\"Even the American Civil Liberties Union, which was perfectly willing to represent an unpopular cause, \u003ca href=\"http://articles.philly.com/1991-03-02/news/25790822_1_first-century-gospel-church-faith-tabernacle-congregation-court-ordered-measles-vaccinations\" target=\"_blank\">declined to take the case\u003c/a>, because they felt that it was not [the parents'] right to martyr their children to their beliefs,\" Offit says.\u003c/p>\n\u003cp>So the question now is this: If there were a similar outbreak today, could the courts force parents to vaccinate their children?\u003c/p>\n\u003cp>Offit says it's possible. \"Were things ever to get as bad, even approaching as bad as things were in Philadelphia in 1991, yes, there are certainly legal remedies to make sure that we can compel parents to protect their children,\" he says.\u003c/p>\n\u003cp>Ross, who led the fight against measles in Philadelphia, says health officials must go to great lengths to educate parents about the importance of vaccines. He believes courts should only intervene when parents are clearly putting their children's lives at risk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It should be 'break glass in case of emergency,'\" he says.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23949\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000057849064_Large-e1424368592567.jpg\">\u003cimg class=\"size-large wp-image-23949\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/iStock_000057849064_Large-640x427.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong style=\"font-size: 14px\">By Anders Kelto,\u003c/strong> \u003ca style=\"font-size: 14px\" title=\"http://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will\" href=\"http://www.npr.org/blogs/health/2015/02/19/386040745/why-a-court-once-ordered-kids-vaccinated-against-their-parents-will\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>A highly contagious disease was sweeping across the United States. Thousands of children were sick and some were dying. In the midst of this outbreak, health officials did something that experts say had never been done before and hasn't been done since. They forced parents to vaccinate their children.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The church ran a school with about a thousand kids. None had been vaccinated. \u003c/aside>\n\u003cp>It sounds like something that would have happened a hundred years ago. But this was 1991 — and the disease was measles.\u003c/p>\n\u003cp>Dr. Robert Ross was deputy health commissioner of the hardest-hit city, Philadelphia, where the outbreak was centered around the Faith Tabernacle Congregation in the northern part of town.\u003c/p>\n\u003cp>\"This church community did not believe in either immunizations or medical care,\" says \u003ca href=\"http://www.calendow.org/about/Leadership/R_Ross_Bio.aspx\">Ross\u003c/a>. Today, he heads The California Endowment, a private health foundation, based in Los Angeles.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The church ran a school with about a thousand kids. Ross says that none had been vaccinated. One day, his office got a phone call from a grandparent, saying that a lot of children at the school were sick. They had developed rashes from head to toe and fevers — telltale signs of measles.\u003c/p>\n\u003cp>Ross and his colleagues approached the church and pleaded with the pastor to allow health officials to examine and immunize the children. But the pastor refused. So Ross and his colleagues went door to door, to church members' homes.\u003c/p>\n\u003cp>He says that most of the parents were pleasant and cooperative, and allowed health officials to enter their homes. Many of the children they saw had measles. Ross says the majority were doing fine, but some were very sick, including an 8-year-old girl.\u003c/p>\n\u003cp>\"[She] was lying on the couch in front of the television, ashen and pale, and with a very rapid respiratory rate. I felt that she may die within hours if we didn't get her to treatment,\" Ross says.\u003c/p>\n\u003cp>He went to the family's living room to call a judge, who was on call and ready to issue a court order, requiring any gravely ill children to be taken to a hospital. But as Ross held the phone, the girl's grandmother grabbed his arm and tried to prevent him from dialing.\u003c/p>\n\u003cp>\"She began lecturing me about believing in the power of the Lord,\" Ross says. \"It was a viscerally disturbing episode that left me quite shaken.\"\u003c/p>\n\u003cp>Ross eventually reached the judge, and the girl was taken to a local hospital. She survived.\u003c/p>\n\u003cp>But across the city, hundreds more were sick. So Ross and his colleagues did something unprecedented: They got a court order to force parents at Faith Tabernacle to have their children vaccinated.\u003c/p>\n\u003cp>Ross says it was the right thing to do, because it was in the best interest of the children. But it was deeply traumatizing to the parents.\u003c/p>\n\u003cp>\"I recall we lined the children up and gave the immunizations, and many of the parents were actually weeping,\" he says.\u003c/p>\n\u003cp>The court order had taken a few weeks. By the time \u003ca href=\"http://articles.latimes.com/1991-03-09/news/mn-2208_1_court-order\" target=\"_blank\">the vaccines were administered\u003c/a>, the measles outbreak was subsiding in Philadelphia. Only nine children from the church were ultimately vaccinated, and Ross says the intervention probably didn't affect the spread of the disease.\u003c/p>\n\u003cp>In the end, nine kids across Philadelphia died, including six from Faith Tabernacle. The church is still operating the school today but declined to comment.\u003c/p>\n\u003cp>Some experts say it's rather surprising that the parents were forced to have their children vaccinated.\u003c/p>\n\u003cp>\"There was a law that protected these church members' right to refuse vaccination on religious ground,\" says \u003ca href=\"http://www.chop.edu/doctors/offit-paul-a\" target=\"_blank\">Dr. Paul Offit\u003c/a>, director of the Vaccine Education Center at Children's Hospital of Philadelphia.\u003c/p>\n\u003cp>But the U.S. Supreme Court had ruled years earlier that parents can't deny life-saving medical treatments to their children for religious reasons. That ruling set a precedent that made it difficult for Faith Tabernacle to find legal representation.\u003c/p>\n\u003cp>\"Even the American Civil Liberties Union, which was perfectly willing to represent an unpopular cause, \u003ca href=\"http://articles.philly.com/1991-03-02/news/25790822_1_first-century-gospel-church-faith-tabernacle-congregation-court-ordered-measles-vaccinations\" target=\"_blank\">declined to take the case\u003c/a>, because they felt that it was not [the parents'] right to martyr their children to their beliefs,\" Offit says.\u003c/p>\n\u003cp>So the question now is this: If there were a similar outbreak today, could the courts force parents to vaccinate their children?\u003c/p>\n\u003cp>Offit says it's possible. \"Were things ever to get as bad, even approaching as bad as things were in Philadelphia in 1991, yes, there are certainly legal remedies to make sure that we can compel parents to protect their children,\" he says.\u003c/p>\n\u003cp>Ross, who led the fight against measles in Philadelphia, says health officials must go to great lengths to educate parents about the importance of vaccines. He believes courts should only intervene when parents are clearly putting their children's lives at risk.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It should be 'break glass in case of emergency,'\" he says.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Getting Vaccinated Against Measles: What You Need to Know",
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"content": "\u003cfigure id=\"attachment_23940\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/178270443-e1424287446474.jpg\">\u003cimg class=\"size-large wp-image-23940\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/178270443-640x427.jpg\" alt=\"(Spencer Platt/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Spencer Platt/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The measles outbreak that started in December has sickened 141 people in 17 states. California has the most cases by far: 113 as of last Friday with about half traced to Disneyland.\u003c/p>\n\u003cp>State health officials are urging anyone who is not immunized against measles to get vaccinated. To help people figure out whether they need to get vaccinated against measles or other diseases, I spoke with Dr. Roger Baxter, who co-directs Kaiser Permanente’s Vaccine Study Center in Oakland.\u003c/p>\n\u003cp>\u003cstrong>First up, children.\u003c/strong> The \u003ca title=\"http://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html\" href=\"http://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html\" target=\"_blank\">Centers for Disease Control recommends two doses \u003c/a>of the MMR (measles, mumps, rubella) vaccine as follows:\u003c/p>\n\u003cul>\n\u003cli>First dose at 12-15 months\u003c/li>\n\u003cli>Second dose at 4-6 years\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>I asked Dr. Baxter, why is a second shot needed?\u003c/strong>\u003c!--more-->\u003c/p>\n\u003cp>A. In general, we really only care that adults have had one dose because in the vast majority of people, one dose is very effective. It's a really fantastic vaccine, and one dose protects people most of the time for life. But some people don't [mount an immune response] the first time, and that's what the second dose is all about. We think if you get two doses, that covers everybody. And since it’s the school-age kids who are most at risk, you need to get that second dose into the whole group of kids.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Q. Since the MMR contains a live version of the measles virus, some people wonder if you could be contagious right after you get a shot.\u003c/strong>\u003c/p>\n\u003cp>A. It's an attenuated [weakened] live virus, so we're not really worried about it. You get an infection but it's not enough to make you contagious. It gives you a good immune response, but it doesn't cause a full-blown infection.\u003c/p>\n\u003cp>\u003cstrong>Q. If you're an adult who doesn't know your vaccination status, what should you do to ensure that you have immunity?\u003c/strong>\u003c/p>\n\u003cp>A. If you were born in 1956 or earlier, then you're considered immune because everybody got measles back then. You don't need anything at all. It's important to let people know that. For other adults, most of them have had a vaccine, but it's a little complicated because there were a few years when the vaccine didn't work very well. (Editor's note: Between 1963, when the measles vaccine was released, and 1967 people received a killed vaccine that wasn’t as effective as the current live-virus vaccine.) So we didn't consider a person vaccinated until 1968.\u003c/p>\n\u003cp>But if you don't remember if you've been vaccinated, you can just take another dose, that's fine. Some people want to get (a blood test) to see if they have antibodies. You can do that and see if you have antibodies before you get the shot. But the shot is very safe. Even if you've had it before and don't need it, it won't hurt you at all [to get an extra dose].\u003c/p>\n\u003cp>\u003cstrong>Q. A second dose of MMR was recommended in 1989 as a severe measles outbreak ultimately infected 55,000 people, including some vaccinated children. More than 120 people died. Was there a problem with the vaccine?\u003c/strong>\u003c/p>\n\u003cp>A. No, it's actually a very effective vaccine but to achieve herd immunity, to knock a virus out of the community so it actually can't get into the community at all, you really have to achieve a very high level of protection. So let's say you give a vaccine and 10 percent of kids don't take on that first dose, it may seem like the virus went away for a while but then eventually as more kids come up that aren't immune, eventually you'll have enough kids that can create the potential for an outbreak.\u003c/p>\n\u003cp>\u003cstrong>Q. What about pregnant women?\u003c/strong>\u003c/p>\n\u003cp>A: That’s a special group that can't be vaccinated for measles, because it’s a live vaccine. Not that we know it would cause a problem -- but just to be cautious. Two vaccines are recommended for pregnant women: flu and Tdap (tetanus, diphtheria, pertussis). They're both killed vaccines with no live components.\u003c/p>\n\u003cp>\u003cstrong>Q. What are the chances that a person vaccinated against measles or pertussis (also called whooping cough) can transmit the disease?\u003c/strong>\u003c/p>\n\u003cp>A. We don't think that the vaccine creates a \"carrier state\" in people who have contact with a case. Not at all. We think they provide protection for themselves, their family, their community, for everybody. Each person provides a tiny amount of herd immunity.\u003c/p>\n\u003cp>\u003cstrong>Q. Adults often don’t worry about getting vaccinated, because they think of measles, whooping cough and other vaccine-preventable diseases as childhood diseases. But aren’t some infectious diseases more dangerous for adults?\u003c/strong>\u003c/p>\n\u003cp>A. You're probably thinking of chicken pox and that's true. There were worries when the childhood chicken pox vaccine came out that it would push the age of chicken pox to older children and adults, where the disease is much more virulent, but \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/24913796\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/24913796\" target=\"_blank\">we actually recently published\u003c/a> and showed that that didn't happen. It was such a good vaccine that it took away chicken pox for everybody, it had a big herd effect.\u003c/p>\n\u003cp>But yes, diseases in childhood can be worse in adults. Measles is not an easy event for anybody. A full-blown case of measles is a rough illness for anyone.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any vaccines that seniors should make sure they get?\u003c/strong>\u003c/p>\n\u003cp>A. They don't have to worry about measles at all. With the pertussis, they just have to be aware that they can get it, but pertussis is much more of a problem in infants, teens and family members. When it comes to the elderly, we're really talking about flu and pneumococcal and Zostavax (for shingles). The older they are the more likely they should get the high-dose flu shot. And the shingles vaccine is recommended at age 60 and above.\u003c/p>\n\u003cp>\u003cstrong>Q. A \u003ca title=\"http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/\" href=\"http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/\" target=\"_blank\">recent Pew study \u003c/a>found that over 40 percent of young adults, ages 18 to 29, think childhood vaccinations shouldn’t be required but should be up to parents. And a 2013 Harris Poll found that 61 percent of people think drug companies minimize vaccine risk. As head of the Vaccine Study Center you’re constantly reevaluating the safety of vaccines. How safe are vaccines compared to widely prescribed preventive drugs like statins? And what are you looking for in your studies?\u003c/strong>\u003c/p>\n\u003cp>A. What I see in what I read and hear from people is that there's a total lack of trust with regard to vaccines. They feel that there's some sort of hidden information that someone's covering up that they're really not safe. But I've been looking at this for years and we work with a lot of people who are dedicated to the safety of vaccines. There's no hidden agenda here. We care about these kids and about the people we give vaccines to. We want to ensure that the vaccine supply is extremely safe and stays safe. That's why there's ongoing surveillance. Even though we don't see signals of risk we keep looking for it.\u003c/p>\n\u003cp>The problem is that when you say you're looking for something people think it's there, so the discussion can be very difficult. When I tell someone we didn't see something in a vaccine, if they're not educated on it, they go, \"What? You thought it was there?\" It's a difficult conversation, and I'm not sure there's a simple answer to that when there's such distrust.\u003c/p>\n\u003cp>But beyond mistrust, there's also a lot of misinformation out there from people who have an extremely loud voice, on the internet, and are giving information that is neither true nor appropriate. I've actually had patients tell me that they thought their search on the internet was worth more than their visit with me.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>How safe are vaccines? I think vaccines are unbelievably safe. The bar for vaccine safety is probably 100 times higher than it is for medications. It's because we give them to our most vulnerable population, little babies. For the little babies, we're really fanatic about ensuring safety from the vaccines.\u003c/p>\n\n",
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"excerpt": "For starters, if you've just been vaccinated, you cannot spread measles to others.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23940\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/178270443-e1424287446474.jpg\">\u003cimg class=\"size-large wp-image-23940\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/02/178270443-640x427.jpg\" alt=\"(Spencer Platt/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Spencer Platt/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>The measles outbreak that started in December has sickened 141 people in 17 states. California has the most cases by far: 113 as of last Friday with about half traced to Disneyland.\u003c/p>\n\u003cp>State health officials are urging anyone who is not immunized against measles to get vaccinated. To help people figure out whether they need to get vaccinated against measles or other diseases, I spoke with Dr. Roger Baxter, who co-directs Kaiser Permanente’s Vaccine Study Center in Oakland.\u003c/p>\n\u003cp>\u003cstrong>First up, children.\u003c/strong> The \u003ca title=\"http://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html\" href=\"http://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html\" target=\"_blank\">Centers for Disease Control recommends two doses \u003c/a>of the MMR (measles, mumps, rubella) vaccine as follows:\u003c/p>\n\u003cul>\n\u003cli>First dose at 12-15 months\u003c/li>\n\u003cli>Second dose at 4-6 years\u003c/li>\n\u003c/ul>\n\u003cp>\u003cstrong>I asked Dr. Baxter, why is a second shot needed?\u003c/strong>\u003c!--more-->\u003c/p>\n\u003cp>A. In general, we really only care that adults have had one dose because in the vast majority of people, one dose is very effective. It's a really fantastic vaccine, and one dose protects people most of the time for life. But some people don't [mount an immune response] the first time, and that's what the second dose is all about. We think if you get two doses, that covers everybody. And since it’s the school-age kids who are most at risk, you need to get that second dose into the whole group of kids.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q. Since the MMR contains a live version of the measles virus, some people wonder if you could be contagious right after you get a shot.\u003c/strong>\u003c/p>\n\u003cp>A. It's an attenuated [weakened] live virus, so we're not really worried about it. You get an infection but it's not enough to make you contagious. It gives you a good immune response, but it doesn't cause a full-blown infection.\u003c/p>\n\u003cp>\u003cstrong>Q. If you're an adult who doesn't know your vaccination status, what should you do to ensure that you have immunity?\u003c/strong>\u003c/p>\n\u003cp>A. If you were born in 1956 or earlier, then you're considered immune because everybody got measles back then. You don't need anything at all. It's important to let people know that. For other adults, most of them have had a vaccine, but it's a little complicated because there were a few years when the vaccine didn't work very well. (Editor's note: Between 1963, when the measles vaccine was released, and 1967 people received a killed vaccine that wasn’t as effective as the current live-virus vaccine.) So we didn't consider a person vaccinated until 1968.\u003c/p>\n\u003cp>But if you don't remember if you've been vaccinated, you can just take another dose, that's fine. Some people want to get (a blood test) to see if they have antibodies. You can do that and see if you have antibodies before you get the shot. But the shot is very safe. Even if you've had it before and don't need it, it won't hurt you at all [to get an extra dose].\u003c/p>\n\u003cp>\u003cstrong>Q. A second dose of MMR was recommended in 1989 as a severe measles outbreak ultimately infected 55,000 people, including some vaccinated children. More than 120 people died. Was there a problem with the vaccine?\u003c/strong>\u003c/p>\n\u003cp>A. No, it's actually a very effective vaccine but to achieve herd immunity, to knock a virus out of the community so it actually can't get into the community at all, you really have to achieve a very high level of protection. So let's say you give a vaccine and 10 percent of kids don't take on that first dose, it may seem like the virus went away for a while but then eventually as more kids come up that aren't immune, eventually you'll have enough kids that can create the potential for an outbreak.\u003c/p>\n\u003cp>\u003cstrong>Q. What about pregnant women?\u003c/strong>\u003c/p>\n\u003cp>A: That’s a special group that can't be vaccinated for measles, because it’s a live vaccine. Not that we know it would cause a problem -- but just to be cautious. Two vaccines are recommended for pregnant women: flu and Tdap (tetanus, diphtheria, pertussis). They're both killed vaccines with no live components.\u003c/p>\n\u003cp>\u003cstrong>Q. What are the chances that a person vaccinated against measles or pertussis (also called whooping cough) can transmit the disease?\u003c/strong>\u003c/p>\n\u003cp>A. We don't think that the vaccine creates a \"carrier state\" in people who have contact with a case. Not at all. We think they provide protection for themselves, their family, their community, for everybody. Each person provides a tiny amount of herd immunity.\u003c/p>\n\u003cp>\u003cstrong>Q. Adults often don’t worry about getting vaccinated, because they think of measles, whooping cough and other vaccine-preventable diseases as childhood diseases. But aren’t some infectious diseases more dangerous for adults?\u003c/strong>\u003c/p>\n\u003cp>A. You're probably thinking of chicken pox and that's true. There were worries when the childhood chicken pox vaccine came out that it would push the age of chicken pox to older children and adults, where the disease is much more virulent, but \u003ca title=\"http://www.ncbi.nlm.nih.gov/pubmed/24913796\" href=\"http://www.ncbi.nlm.nih.gov/pubmed/24913796\" target=\"_blank\">we actually recently published\u003c/a> and showed that that didn't happen. It was such a good vaccine that it took away chicken pox for everybody, it had a big herd effect.\u003c/p>\n\u003cp>But yes, diseases in childhood can be worse in adults. Measles is not an easy event for anybody. A full-blown case of measles is a rough illness for anyone.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any vaccines that seniors should make sure they get?\u003c/strong>\u003c/p>\n\u003cp>A. They don't have to worry about measles at all. With the pertussis, they just have to be aware that they can get it, but pertussis is much more of a problem in infants, teens and family members. When it comes to the elderly, we're really talking about flu and pneumococcal and Zostavax (for shingles). The older they are the more likely they should get the high-dose flu shot. And the shingles vaccine is recommended at age 60 and above.\u003c/p>\n\u003cp>\u003cstrong>Q. A \u003ca title=\"http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/\" href=\"http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/\" target=\"_blank\">recent Pew study \u003c/a>found that over 40 percent of young adults, ages 18 to 29, think childhood vaccinations shouldn’t be required but should be up to parents. And a 2013 Harris Poll found that 61 percent of people think drug companies minimize vaccine risk. As head of the Vaccine Study Center you’re constantly reevaluating the safety of vaccines. How safe are vaccines compared to widely prescribed preventive drugs like statins? And what are you looking for in your studies?\u003c/strong>\u003c/p>\n\u003cp>A. What I see in what I read and hear from people is that there's a total lack of trust with regard to vaccines. They feel that there's some sort of hidden information that someone's covering up that they're really not safe. But I've been looking at this for years and we work with a lot of people who are dedicated to the safety of vaccines. There's no hidden agenda here. We care about these kids and about the people we give vaccines to. We want to ensure that the vaccine supply is extremely safe and stays safe. That's why there's ongoing surveillance. Even though we don't see signals of risk we keep looking for it.\u003c/p>\n\u003cp>The problem is that when you say you're looking for something people think it's there, so the discussion can be very difficult. When I tell someone we didn't see something in a vaccine, if they're not educated on it, they go, \"What? You thought it was there?\" It's a difficult conversation, and I'm not sure there's a simple answer to that when there's such distrust.\u003c/p>\n\u003cp>But beyond mistrust, there's also a lot of misinformation out there from people who have an extremely loud voice, on the internet, and are giving information that is neither true nor appropriate. I've actually had patients tell me that they thought their search on the internet was worth more than their visit with me.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "First Measles Case in Contra Costa; BART Riders Potentially Exposed",
"title": "First Measles Case in Contra Costa; BART Riders Potentially Exposed",
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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A Contra Costa Country resident commuting to and from work in San Francisco last week may have exposed some BART riders to measles, health officials said today.\u003c/p>\n\u003cp>Officials with Contra Costa Health Services and the San Francisco Department of Public Health said risk of contracting measles by being exposed to the disease on BART is low, but riders should nonetheless be aware of the situation.\u003c/p>\n\u003cp>The person traveled between the Lafayette and Montgomery BART stations during the morning and evening commutes from 6 a.m. to 8 a.m. and from 7 p.m. to 9 p.m. last Wednesday, Thursday and Friday. The person also spent time at E&O Kitchen and Bar, a restaurant located at 314 Sutter St. in San Francisco, on Feb. 4 between 5:30 p.m. and 7:30 p.m.\u003c!--more-->\u003c/p>\n\u003cp>People who are vaccinated or have had measles are unlikely to catch the disease, health officials said. However, those who have not previously been vaccinated are at high risk if exposed.\u003c/p>\n\u003cp>It's the first confirmed case of measles in Contra Costa County since the statewide outbreak in December, county health officials said. The state reported \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_2-9-2015.pdf\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_2-9-2015.pdf\" target=\"_blank\">107 measles cases on Monday\u003c/a>, in the outbreak that began in late December.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Measles is a highly contagious illness, and if someone coughs or sneezes, virus droplets linger in the air and on surfaces up to two hours. Because BART trains circulate through the system, anyone who used BART during that time could have been exposed.\u003c/p>\n\u003cp>\"Measles is circulating in the Bay Area and we don’t know yet where this person was exposed,” said Erika Jenssen, Communicable Disease Program Chief with Contra Costa Public Health.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The ongoing measles outbreak in California highlights the need for people to be vaccinated, and this is just another example of how interconnected our region is and how important it is for everyone to be up to date on their immunizations.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>A Contra Costa Country resident commuting to and from work in San Francisco last week may have exposed some BART riders to measles, health officials said today.\u003c/p>\n\u003cp>Officials with Contra Costa Health Services and the San Francisco Department of Public Health said risk of contracting measles by being exposed to the disease on BART is low, but riders should nonetheless be aware of the situation.\u003c/p>\n\u003cp>The person traveled between the Lafayette and Montgomery BART stations during the morning and evening commutes from 6 a.m. to 8 a.m. and from 7 p.m. to 9 p.m. last Wednesday, Thursday and Friday. The person also spent time at E&O Kitchen and Bar, a restaurant located at 314 Sutter St. in San Francisco, on Feb. 4 between 5:30 p.m. and 7:30 p.m.\u003c!--more-->\u003c/p>\n\u003cp>People who are vaccinated or have had measles are unlikely to catch the disease, health officials said. However, those who have not previously been vaccinated are at high risk if exposed.\u003c/p>\n\u003cp>It's the first confirmed case of measles in Contra Costa County since the statewide outbreak in December, county health officials said. The state reported \u003ca title=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_2-9-2015.pdf\" href=\"http://www.cdph.ca.gov/HealthInfo/discond/Documents/Measles_update_2-9-2015.pdf\" target=\"_blank\">107 measles cases on Monday\u003c/a>, in the outbreak that began in late December.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Measles is a highly contagious illness, and if someone coughs or sneezes, virus droplets linger in the air and on surfaces up to two hours. Because BART trains circulate through the system, anyone who used BART during that time could have been exposed.\u003c/p>\n\u003cp>\"Measles is circulating in the Bay Area and we don’t know yet where this person was exposed,” said Erika Jenssen, Communicable Disease Program Chief with Contra Costa Public Health.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“The ongoing measles outbreak in California highlights the need for people to be vaccinated, and this is just another example of how interconnected our region is and how important it is for everyone to be up to date on their immunizations.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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