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Northeast Ohio doctors warn of potential measles outbreak amid declining vaccinations

This Friday, May 17, 2019 file photo shows a vial of a measles, mumps and rubella vaccine in Mount Vernon, Ohio.
Paul Vernon
This Friday, May 17, 2019, file photo shows a vial of a measles, mumps and rubella vaccine in Mount Vernon, Ohio.

Health officials are warning of a potential measles outbreak in Northeast Ohio.

The Centers for Disease Control and Prevention said measles is one of the most contagious of all infectious diseases, but despite this risk, officials face an intractable problem in preventing its spread — growing numbers of parents who refuse to vaccinate their children.

Morning Edition host Amy Eddings spoke with health reporter Stephen Langel about the threat measles presents and the challenge that vaccine hesitancy represents to doctors and other medical professionals trying to head off an outbreak of the disease.

EDDINGS: I thought that measles was eliminated in the U.S. years ago. Is that no longer true?

LANGEL: Well, Amy, it was essentially eliminated as a public health threat in 2000. But cases have begun to be reported in Northeast Ohio over the past several years. The Ohio Department of Health said the state has had at least one case so far this year, one case in 2023 and 90 cases in 2022, which were the first in the state since 2019.

Experts said we are seeing measles cases again because fewer children are receiving the MMR — measles, mumps and rubella vaccine. This trend can be seen in the state’s 2022-2023 immunization study report, which showed drops in immunization rates for students over the past five years.

This included areas in Northeast Ohio where opposition to vaccines is particularly highest, such as Holmes County, where nearly 25% of kindergartners and 11% of seventh graders were not vaccinated due “for reasons of conscience or religious objection.”

EDDINGS: Why are some parents declining to get their kids vaccinated? For years, this was a common practice.

LANGEL: Well, according to University Hospitals’ Dr. Amy Edwards, who is an infectious disease specialist, there is growing skepticism about the safety of vaccines in some pockets around Northeast Ohio.

"Having sporadic measles cases in and around Ohio is going to be the new normal until, you know, we figure out how to convince parents that the measles vaccine is safe," Edwards said.

Edwards noted that in her daily clinical practice, she has seen an increasing number of patients over the past five to six years who say their vaccinations are not up to date.

She added that prior to 2020, the patients who were hesitant to vaccinations were from wealthier suburbs with socioeconomic status dictating that hesitancy. Since then, she has observed politics as the driving factor with more conservative patients from more rural locations not being updated on their immunizations.

“I can stand here all I want, and I can talk to you about the dozens and dozens of published data on the safety of the MMR vaccine," Edwards said. "But we already know that doesn't actually sway people's opinions, because their opinions are not based on fact. It's based on emotion, and that is driven by the anti-vaccine campaign.”

EDDINGS: So, is there no way to break through to them?

LANGEL: Cuyahoga County health board medical director Dr. Prakash Ganesh said the key to breakthrough is developing personal relationships.

“Those that are vaccine-hesitant, I think over time as we build that relationship, I am able to make inroads and build trust," he said. "Over time, I have seen more people come around to vaccines.”

But Ganesh, who is a staff physician at Neighborhood Family Practice, said doctors don’t always have time to spend with patients and gain that trust.

EDDINGS: What about children who are vaccinated? Are they at risk if exposed to children who have measles?

LANGEL: Not really. The CDC said very few, maybe three out of 100 who get two doses of measles vaccine, will still get measles if exposed to the virus.

The CDC added fully vaccinated people who get measles seem more likely to have a milder illness and seem less likely to spread the disease to other people.

EDDINGS: I see. Since measles spreads so quickly, what kind of health risks does this represent, especially to unvaccinated kids?

LANGEL: Unfortunately, there are severe risks, especially for young children. Edwards said between 40% and 50% of infected children will become ill enough to require hospitalization.

"There's a high risk of it killing young, vulnerable children, particularly children under the age of one,” she said.

She added one out of every 1,000 children infected will die. The disease can also cause brain inflammation, swelling and lung damage.

Case Western Reserve University School of Medicine’s Dr. Stephanie Langel — no relation — said measles can undermine a child’s immune system for the rest of their lives.

“That immunity that children have developed against other pathogens, where they built up immunity to provide protection, measles can actually decrease that memory response and make those children more susceptible to other pathogens in the future,” she said.

EDDINGS: Are there any other dangers from reduced vaccination rates?

LANGEL: Yes. Edwards said it creates an environment where other diseases, such as whooping cough, can flourish.

“The threat that it can represent is enormous because, you know, measles is what we call sentinel illness because it is so contagious," she said. "It is the one that we expect to see first as vaccine rates drop, but there are others behind it.”

The Ohio Department of Health reported there have been 105 cases of whooping cough so far this year. Last year, there were 810 cases, the highest number since 2014.

EDDINGS: So, what is the big picture here in terms of the impact of parents’ refusal to vaccinate and resulting outbreaks of diseases like measles?

LANGEL: Dr. Langel said the consequences are dire.

“The less we’re vaccinated, the more kids die," she said.

EDDINGS: Well, that certainly makes it clear what’s at stake here.

Stephen Langel is a health reporter with Ideastream Public Media's engaged journalism team.