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Washington state’s measles outbreak coincides with low rates of immunization

Washington state is experiencing an outbreak of measles, with 35 confirmed cases in a single county. The disease's flare-up is reinforcing concerns about insufficient immunization in some communities. Hari Sreenivasan talks to Dr. Anthony Fauci of the National Institutes of Health about why measles remains a serious disease and how to address misinformation within the anti-vaccination movement.

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  • Amna Nawaz:

    A measles outbreak in the Northwest part of the country is leading to new concerns about a lack of vaccinations in some communities, and just who may have been exposed to the infectious disease.

    Public health officials in Washington, across the Columbia River from Portland, Oregon, say there are 35 confirmed cases in Clark County; 25 of them are in kids who are 10 years old or younger. At least 31 of those cases are among those not immunized. Two other cases are confirmed in Oregon and Washington.

    The area's considered a hot spot, so to speak, when it comes to lack of vaccinations.

    Hari Sreenivasan spoke about that very issue yesterday for "NewsHour" weekend with Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases at the NIH.

    Hari asked Dr. Fauci if he was surprised that so many of the infected were not immunized.

  • Dr. Anthony Fauci:

    I'm surprised and disheartened that there are so many people still who are not vaccinated against measles.

    The idea that the overwhelming majority of the people who got measles who were unvaccinated is not surprising at all. That is exactly what you would expect, because the measles vaccine is one of the most effective vaccines of all vaccines that we have.

    If you get the two doses that are prescribed that you should get during childhood, one at 11 to 12 months and one at 4 to 6 years, it's 97 percent protective.

  • Hari Sreenivasan:

    This is — Clark County is on the southern border of the state with Portland, Oregon — or, I say, the state of Oregon.

    And it's kind of seeping out. There are concerns in the Portland area as well. But it is up and down the state that, in that state, there seem to be clusters, similar to other states.

    How do you change that? Because there are lots of states that actually give families the option to not vaccinate their children.

  • Dr. Anthony Fauci:

    Well, I think that you have to be much more strict about the flexibility that you give to so-called philosophical objection to getting vaccinated, because that gets abused.

    And when you get below a certain level of the percent of people in the community that are vaccinated, that's a disaster waiting to happen. You have to have at least 92 and as much as 95 or more percent of everyone in the community vaccinated in order to get that umbrella of what we call herd immunity protection.

    Once you get down below a certain level, it's just waiting to have the kinds of outbreaks that you're seeing now in Washington state and that we have seen and are seeing even in New York City and in New York state, where, among certain populations, such as the Orthodox Jews, who have a lower level of vaccination, that same sort of danger and vulnerability.

    So we have got to get past that and get people educated to realize that this is a serious disease. And when you stop vaccinating, or give excuses for not vaccinating, these are the kind of things that are going to happen.

    And the thing that people need to appreciate is that the idea that measles is a trivial disease is completely incorrect. Before vaccines were available, measles was one of the most terrifying diseases that you could have. Globally, there were millions of deaths each year.

    And in the United States, before we had the vaccine that was widely distributed in the '60s, there were a couple of million cases, 400 to 500 deaths a year and 1,000 cases of encephalitis, which is an inflammation of the brain.

    We don't want to go back there, even if it's in individual communities. That's a terrible place to be.

  • Hari Sreenivasan:

    Put measles in perspective. What happens with measles, and why is it so contagious?

  • Dr. Anthony Fauci:

    OK, so the typical case of measles is a child gets a fever, they get a runny nose, they get a conjunctivitis, or inflammation of the eyes, they get a cough, and then they get a rash.

    A couple of days later, they get a rash, starts off in the face, goes through the body. Most of the time, it recovers. It's very uncomfortable for the child. But if you look at the statistics, one in 10 who get measles get ear infections that can lead to deafness. One in 20 get pneumonia.

    One in 1,000 get encephalitis, which is an inflammation of the brain. And one to three or so per 1,000 individuals who get measles actually die from it. So the idea that anybody saying it's not a serious or potentially serious disease is just incorrect, period.

  • Hari Sreenivasan:

    To put this number in perspective, this is already about 31 cases that we're talking about just in the state of Washington.

    But this is — in the larger trend line, is this getting better, is this getting worse?

  • Dr. Anthony Fauci:

    It's getting worse.

    And, unfortunately, the anti-vax movement in certain segments of the population, certainly not generalized, is just growing, and it's getting worse. And it's based fundamentally on misinformation.

    You don't want to denigrate people who make those kinds of decisions and essentially attack them. That doesn't work. You have got to understand they have these beliefs. And the way you try and get them to understand the importance of getting vaccinated is talk about the facts, talk about the evidence. Don't attack them.

    And sometimes people tend to pooh-pooh them and attack them. You have got to understand, they have these beliefs. But if you present them with the facts, you may be able to win back a substantial proportion of them.

    I think some of them, you never will win back to the issue of being able to realize the importance of vaccination. But I think you can try — and I know you can try — to get the facts to them, and some of them will change their mind.

    One of the things that's really interesting that people don't seem to appreciate, that it's an interesting bilateral thing, where, on the one hand, measles is one of the most contagious infections in history, and, on the other hand, we have a vaccine that's one of the most effective vaccines of any in history.

    And it just seems such a shame that you have a disease that, if left unchecked, can rampantly spread, and yet you have a tool, a safe tool, a proven safe tool, that can stop it in its tracks. That's the evidence that we have got to get to people of why it's so important to vaccinate yourself with a safe vaccine, which is the measles vaccine.

  • Amna Nawaz:

    That was Dr. Anthony Fauci of the NIH.

    We will continue to watch this outbreak in the coming days.

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