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Thanks to a highly effective vaccination program in the United States, measles was declared eliminated in 2000. Since then, imported cases of measles have caused numerous outbreaks in vulnerable populations throughout the country, and experts warn that the disease could easily make a comeback if vaccination rates continue to drop.
"In the last decade, the rates of measles in this country have consistently tracked with communities of lower immunization rates," Matthew Zahn, MD, chair of the Infectious Diseases Society of America's Public Health Committee, told Infectious Diseases in Children. "What we are seeing now is not a surprise, unfortunately, and it is typical for what we have seen for several years"
The problem is compounded by nonmedical vaccine exemptions. Eighteen states currently allow them for personal or philosophical reasons.
"The battleground is those 18 states, and they're mostly Western and some Midwestern states allowing nonmedical exemptions for personal or philosophical beliefs," Peter J. Hotez, MD, PhD, professor of pediatrics and dean of the National School of Tropical Medicine at Baylor College of Medicine and co-director of the Center for Vaccine Development at Texas Children's Hospital, told Infectious Diseases in Children.
Even slight reductions in measles, mumps and rubella (MMR) vaccine coverage caused by vaccine hesitancy could result in a threefold increase in measles cases, according to research published in JAMA Pediatrics.
Infectious Diseases in Children spoke with pediatric infectious disease, public health and legal experts to explore how nonmedical vaccine exemptions - particularly those for personal or philosophical beliefs - are damaging to public health, as well as efforts that are underway to make it more difficult for people to opt out.
'The big problem'
According to the CDC, people should be exempt from immunizations based on their medical status. These include people who have had a life-threatening allergic reaction to a component of the vaccine; people living with HI V/AIDS or another disease that affects the immune system; people who are treated with drugs that affect the immune system; and people who have any kind of cancer, who are being treated for cancer with radiation or drugs or who have a blood disorder.
Hotez said only three states allow vaccine exemptions exclusively for medical reasons: California, Mississippi and West Virginia. Although...