Centers for Disease Control and Prevention released a report last month confirming over 1,200 individual cases of measles in 31 different states since the beginning of the year, the highest number of cases reported in the U.S. since 1992.
Although North Carolina is not currently among the long list of states affected by the measles outbreaks, a growing amount of unvaccinated children may increase the threat of contraction in schools across the country. The CDC reported that the majority of cases were found in communities that had lower vaccination rates.
Tracy Sanders, nurse coordinator for Chapel Hill-Carrboro City Schools, said despite the district’s history of high vaccination rates, health officials are monitoring measles closely to prevent outbreaks and potential quarantines of affected students.
“If measles were to come through, measles is much more contagious than pertussis (whooping cough) and is much more easily spread,” Sanders said.
Last spring, Sanders said, school nurses were required to contact all students who had not received two doses of the measles, mumps and rubella vaccine, the state-mandated vaccine requirement to prevent measles, to inform their parents of the possible threat. The DTH reported earlier this year that in 2017, 92.2 percent of children aged 19-25 months had received their first MMR vaccine, down one percent from 2016.
Mike DeFranco of the Orange County Health Department said the department also hosted a “measles symposium” to raise awareness of the required measles vaccine and how to address the disease, should it spread to North Carolina. The OCHD is responsible for administering guidelines to both Orange County Schools and Chapel Hill-Carrboro City Schools concerning outbreaks and preventative care on a case-by-case basis.
“We reached out to a lot of community partners, some schools, just to say, ‘Hey, let’s have this conversation.’ We haven’t had a case in North Carolina or South Carolina, but in adjacent states, we have,” DeFranco said.
Vaccination requirements and exemptions
According to North Carolina General Statute 130A-152, every child in the state is required to be immunized against several different illnesses and diseases, including measles and whooping cough, upon entering kindergarten and the seventh grade. Students are given a 30-day grace period from their first day of enrollment to provide documentation proving they have been vaccinated or are exempt. Should the documentation not be provided, they are not permitted to go to school.
There are only two ways in which a child may be exempt from such policies: by a licensed physician’s request, or by a statement of “bona fide religious belief.” According to General Statute 130A-156, if a physician licensed by the state of North Carolina deems a required immunization detrimental to a person’s health (i.e. allergic reaction), they have the authority to advise against vaccination.
A statement of “bona fide religious belief” against immunization, however, does not need to be notarized nor signed by a religious leader or attorney. A parent, guardian or person in loco parentis of a child may write a document expressing why vaccination requirements conflict with their religious belief.
Although personal or philosophical beliefs against vaccinations do not qualify as legal exemptions, there is no formal process of verifying whether a religious statement is truly applicable to a student.
“It can’t really be checked,” said Penny Rosser, a nurse for Orange County Schools. “We just have to trust the parents.”
Growing religious exemptions
The North Carolina Department of Health and Human Services reported that 1.2 percent of children entering kindergarten for the 2017-2018 school year were exempted from state-mandated vaccinations for religious reasons, a 0.1 percent increase from the previous year.
Western counties hold the highest percentage of unvaccinated students in the state, with Buncombe County — where Asheville is located — holding the highest percentage of unvaccinated students – about 5.7 percent of the 2,542 kindergartners of Buncombe County exempt from vaccines through religious exemptions. The state’s metropolitan hubs also saw an increase in religious exemptions in the past year – news station Fox 46 Charlotte reported that Mecklenburg County saw a 2.5 percent increase in non-vaccinated kindergartners and a "sharp" increase in non-vaccinations in Wake County.
Rosser said that although parents do have a right to a religious exemption, she urges them to contact their health provider to make an informed decision.
“Prevention is the name of the game,” Rosser said. “Talk to your doctor and ask for valid research on vaccines and potential complications.”
The measles vaccine is not a fool-proof form of prevention, but Sanders said immunization guards against contraction and high-risk symptoms.
“Vaccines are not 100 percent effective," Sanders said. "It’s not necessarily that people are not getting vaccinated and therefore, we’re getting all of these cases coming in. It’s just that if they get it, their symptoms will be much worse.”
Sanders said although it’s too early in the 2019-2020 school year to know current immunization rates, Chapel Hill-Carrboro City Schools hope to have 100 percent compliance of all students by the 30th day of school.
“The benefits far outweigh the risk,” Sanders said. “Vaccinations are the number one defense against many communicable diseases that can be deadly.”
For parents on the fence about vaccinating their child, DeFranco said it’s important to investigate the research behind vaccines and their effects.
“Clean water and vaccines have really, really helped push forward human longevity and I think there’s something to be said about that.”
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