This is a chart of reported measles cases in the US.
In the 1950s, measles was one of those diseases that nearly every child got.
It caused a high fever and a spotty rash all over the body.
And while most recovered easily, it still killed around 500 children each year.
Then in 1963, a vaccine became available.
And measles became an easily preventable and unnecessary disease.
By 2000, measles was officially eliminated in the US.
And for a time, less than a hundred Americans a year got it.
But In the last decade, that number has started to grow.
Now, there have been more cases through the first three months of 2019 than all of 2018.
Measles is back.
And to understand why, you have to understand where it’s back.
Measles can be quite serious, but now no one needs to get them.
Here are those recent measles cases again.
If we look at the 2013 spike, we notice something.
A good chunk of those cases can be attributed to an outbreak among Orthodox Jews in New York.
That huge spike in 2014?
Most of those cases are all from one outbreak among the Amish in Ohio.
2017?
One outbreak in the Somali-American community in Minnesota,.
2018?
Different communities of New York Orthodox Jews.
And again in 2019.
What all of this shows is that the return of measles isn’t as widespread as you might think.
75% of recent cases have happened in these close-knit communities.
People in these communities tend to read the same news, watch the same TV programs, speak
the same language.
Julia Belluz, Vox health reporter.
They go to school together, they worship together.
When not enough of them are vaccinated - you know, it tends to spread like wildfire.
Like in early 2019 outside Vancouver, Washington where a measles outbreak sickened 73 people.
It originated at a local Slavic church, likely from someone who picked up the disease in
Eastern Europe.
It quickly spread through the community, infecting mostly small children who weren’t immunized.
One reason this happened is that the Slavic community in Washington has one of the lowest
rates of vaccination in the state.
Some of the people in this community don’t trust doctors.
Yuriy is a member of that community.
He’s also a health data analyst.
They have a view that big pharma is too ingrained with the medical establishment.
They are much more willing to listen to members of the community.
Anti-vaccination misinformation can reach anyone - but it’s in these small communities
where it does the most damage.
Most people in these communities are vaccinated.
The problem starts when not enough people are vaccinated - it prevents them from reaching
what’s called herd immunity.
Here’s how it works.
With every vaccine you need a certain perc entage of the community to be immunized in
order for the vaccine to work.
If a group of people comes into contact with one person contagious with measles - and none
of them are vaccinated - virtually everyone will get sick.
If 50% of the group is vaccinated, that’s not enough - the rest are likely to get sick
and spread the disease.
But at a certain point, if enough people are vaccinated, - they can actually protect the
few that aren’t vaccinated from getting sick, stopping the spread of the disease —
herd immunity.
This is important because there are people who can’t get vaccinated because of their
immune system: people like cancer patients and newborn babies.
And with measles because it’s so contagious, that number is just really really high - it's 95%
So basically everyone who can get vaccinated needs to be vaccinated.
We’re protecting all those people who can’t get vaccines.
That 95% number doesn't leave much wiggle room, and a lot of US states are now struggling
to meet it.
These are the states where the number of kindergarteners
vaccinated for measles is below the herd immunity threshold.
It's half of states.
So how do we make sure everyone who can get vaccinated does?
It might help it look at it this way.
These are the states that allow parents to opt-out for religious reasons.
And these are the states that allow parents to opt out for any philosophical reason.
And then, there are a few states that allow neither.
The two states that have had no exemptions for a very long time - Mississippi and West Virginia -
they haven’t seen outbreaks in recent years.
Part of why Washington’s Slavic community has such low vaccination rates is simply because
Washington allows them to easily opt-out.
In parts of the state, including where the outbreak occurred, the amount of vaccinated
kindergarteners has fallen way below the amount needed for herd immunity.
But since the outbreak, Legislators in Washington have introduced a bill to get rid of non-medical
vaccine exemptions.
Maybe the best way to make sure all communities reach herd immunity, and protect those that
can’t be vaccinated, is just to not let them opt out in the first place.
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