Not long ago, health officials declared measles “eliminated.” But this spring, the U.S. Centers for Disease Control and Prevention reported more cases since the beginning of 2019 than in any single year since 1994.
“Measles should be taken seriously, because it can sometimes lead to pneumonia, swelling of the brain (known as encephalitis) and death,” Dr. Alexia Harrist, Wyoming Department of Health state health officer and state epidemiologist, said in May.
Everyone from public school children and those attending a child-care facility or preschool to University of Wyoming students must prove immunity to measles, mumps and rubella, according to both UW and the Health Department. Immunity comes from at least two doses of the MMR vaccine, administered after 1956.
While there hasn’t been a reported case of measles in Wyoming since 2010, of the 700 measles cases reported across the nation this year, the majority involved unvaccinated people, according to the Department of Health.
In 2018, the department updated its immunization requirements to include a pneumococcal shot and rotavirus vaccine, in addition to other immunizations like the MMR vaccine. State officials have said they are confident in the process that leads to Wyoming’s recommendations and requirements.
“Wyoming’s vaccine requirements are based on very well-established research, and we have a Wyoming advisory committee that looks at what the national experts are recommending. They say, ‘OK, these are the ones we are going to require for school attendance, and these are the ones that we are going to recommend and not necessarily require,’” said Kim Deti, spokeswoman for the Department of Health.
“The process is basically that we look at what the national experts are recommending, and we have our state experts look at Wyoming specifically,” she said.
Between Jan. 1 and April 26, a total of 704 measles cases were reported in 22 states, and patient ages ranged from infancy to over 50. Overall, 66 patients were hospitalized, and 24 had pneumonia. No deaths or cases of encephalitis were reported to the CDC.
Measles is still common in many parts of the world, including some countries in Europe, Asia, the Pacific and Africa. People in the United States still get measles in rare situations.
“Every year, unvaccinated people get measles during international travel, bring the disease into the United States and spread it to others who are unvaccinated,” Harrist said. “Ongoing spread of the disease is a risk in communities with pockets of unvaccinated people and can lead to outbreaks.”
The measles vaccine is “a safe and effective vaccine that provides protection against three diseases: measles, mumps and rubella,” according to the CDC. Children should get one dose at 12-15 months old, and then another between the ages of 4 and 6.
In Wyoming, a child cannot attend a public school or child-care facility for more than 30 days without proof of immunization. When a child become school-age, a parent is responsible for taking a child’s records to their school.
“The way the process works in Wyoming is the school or the child-care facility, preschool or day care is supposed to check immunization records,” Deti explained. “If the record is incomplete, they would probably be provided information on the exemption process, if that was something that was the right choice for that family because of their beliefs … but there are 30 days for parents to get children to meet the requirements before they are excluded from school.”
The vast majority of Wyoming children meet the requirements by kindergarten.
When a vaccine is required by the state, it can also be paid for by the state, meaning no cost is passed on to the patient, Deti said. Children who are home-schooled but participate in public or private school activities also need to meet Wyoming’s immunization requirements, as well as any child who attends a child-care facility.
Vaccines create immunity and reduce disease, and any differences in vaccines are not in how they work, but are among the diseases themselves and how contagious they are.
“Herd immunity,” or the idea that when enough people are vaccinated against a certain disease, the germs can’t travel as easily from person to person – and thus the entire community is less likely to get the disease – is just one concept the state considers when making its requirements, Deti said.
“We want to protect Wyoming’s children from a whole bunch of diseases, and there are some that used to be very common, a real danger for children, that are very rare now because of the success of immunizations. We want to keep that success going,” Deti said.