With “anti-vaxxers” driving a measles outbreak in Washington state and other barriers to vaccines leaving 6 percent of children unprotected, the director of the Centers for Disease Control and Prevention says it’s time to find new ways to get Americans immunized.
Dr. Robert R. Redfield said options include making shots available to students and their families at schools and examining whether drugstores can play bigger roles in doling out routine vaccinations.
The situation has taken on new urgency in the face of an alarming measles outbreak that has hit 10 states and resulted in at least 127 cases so far this year.
About half of the cases were part of an outbreak in Washington. Gov. Jay Inslee, a Democrat, declared a local emergency to get a handle on a cluster of cases in Clark County, where a large share of parents opted not to get their children vaccinated. Many feared adverse effects from vaccines based on unfounded information on the internet.
More than 90 percent of the nationwide cases involve unvaccinated children.
“I would like to use the measles outbreak in the United States as sort of an opportunity to try and re-engage those individuals who have chosen not to get vaccinated,” Dr. Redfield told The Washington Times. “What are the ways that we’re going to better enable to get people to get vaccinated? I don’t think we have that answer yet, but I can tell you we’re going to work hard to figure that out.”
The measles vaccine is considered to be safe and highly effective. Two doses offer 97 percent protection against the once-common and potentially fatal childhood disease.
Dr. Redfield said he thinks social media and information on the internet feed a resistance among some parents to vaccines. In other cases, families just can’t get access to medical care. People in the rural South, especially, struggle to find care, leading to lower immunization rates.
Dr. Redfield said the CDC is trying to determine whether schools are good sites to deliver vaccines in jurisdictions willing to run pilot programs. He noted that some places in the U.S. already are using the schools in this way.
“We are going to be looking at alternative ways to see vaccines delivered in a way that may be more accessible,” he said. “The majority of people still get vaccines in their doctors’ offices, but obviously in parts of rural America, they may have limitations.”
Measles is a highly contagious viral disease that typically affects children and is associated with fever and a rash. Adding to the danger is the fact that patients can be infectious for three or four days before they show symptoms.
Most parents — 94 percent — do get their children inoculated for measles, mumps and rubella, a shot known as the MMR vaccine.
“But we would still like to get the last 6 percent to vaccinate their children,” Dr. Redfield said. “We see more and more vaccine-preventable disease in individuals who’ve chosen not to be vaccinated.”
The World Health Organization cited an uptick in measles cases around the globe. It added “vaccine hesitancy” to its list of top health concerns this year and said the trend could reverse hard-won gains in public health.
The CDC recommends that children get their first dose of the MMR vaccine at 12 to 15 months and the second dose at 4 to 6 years old.
Public schools often require routine immunizations before children are admitted, though many states have patchworks of exemptions for parents who cite religious or philosophical objections. The exemptions can result in holes in the herd immunity that keeps the disease at bay, especially protecting the elderly, newborns and people who cannot be vaccinated for health reasons.
President Trump posted a tweet in 2014 suggesting a possible link between vaccines and autism.
Dr. Redfield said he hasn’t spoken directly with the president about the subject or using his bully pulpit to promote vaccination, and will “let the president decide for himself how he can best use his position.”
The doctor said his efforts to increase uptake in the U.S. shouldn’t be viewed as a federal mandate.
“No one’s taking away parental consent. It’s always going to be in the context of parent consent and within the context of the vaccination requirements of the different states,” he said.
He said he wants parents to remember that scientists have made great strides toward eradicating diseases, including smallpox and polio, worldwide.
“There’s only one reason: vaccination,” he said. The more we can do to continue to encourage, support, congratulate parents and individuals that get fully vaccinated against vaccine-preventable diseases, the better.”
Dr. Redfield said he is tracking influenza, which killed 80,000 last season and is estimated to have killed up to 16,000 in the U.S. so far this season, according to CDC figures released Friday.
Though flu activity has risen in recent weeks, this has been a milder season than last year in part because the vaccine better matched what turned out to be the predominant strains. The development can’t be reliably predicted or prevented after the strains become known.
Flu vaccination rates in the U.S. sit at 40 percent to 50 percent. Dr. Redfield said he has an “aspirational goal” as head of the CDC to raise those rates to 80 percent to 85 percent.
“Flu is the most serious infectious disease threat that we have in the world today, and it’s the most serious threat we had 100 years ago,” he said. “It hasn’t changed.”