Feb 10, 2015, 2:49pm EST Kent Hoover Washington Bureau Chief Parents who decided against having their children vaccinated are the main reason for this year's measles outbreak, public health officials told Congress Tuesday. While measles had been eradicated in the U.S. and the rest of the western hemisphere, "the disease is still endemic in many parts of the world," said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. "Outbreaks can occur in the United States when unvaccinated groups are exposed to imported measles virus," Schuchat. And that's apparently what happened this year. Most of the 121 cases of measles reported so far this year are part of an outbreak linked to Disneyland in California. "We assume that someone got infected overseas, visited the parks and spread the disease to others," Schuchat said. "Infected people in this outbreak here in the United States this year have exposed others in a variety of settings including school, day cares, emergency departments, outpatient clinics and airplanes." "Most of those infected were intentionally unvaccinated," added Dr. Mark Sawyer, a professor of clinical pediatrics in the Division of Infectious Diseases at the University of California San Diego and Rady's Children's Hospital in San Diego. Some decline vaccinations for medical reasons; others for religious reasons. But a growing number of parents are deciding against having their children vaccinated because of the mistaken belief that vaccinations can cause autism or have other harmful side effects. Others think measles is no longer a danger and therefore think their children don't need to get vaccinated. Many states, including California, allow parents to opt out of having their children vaccinated for personal or philosophical reasons. Families who exercise these exemptions often live near each other, Schuchat said, citing research recently published in the journal Pediatrics. "We think these micro-communities are making it difficult to control the spread of measles and are making us vulnerable to having the virus re-establish itself in our country again," she said. "In addition, they put others at risk who cannot get vaccinated because they are too young or they have specific health conditions." These pockets of unvaccinated children often are in "wealthier and higher educated locales," Sawyer noted. "In some areas of Los Angeles, 60 to 70 percent of parents at certain schools have filed a personal belief exemption," said Sen. Lamar Alexander, R-Tenn., who chairs the Senate committee that held Tuesday's hearing. "In these elementary schools, vaccination rates are as low as those in Chad or South Sudan." In Alexander's home state, the rate for vaccination exemptions is four times as high in Williamson County, Tennessee's wealthiest county, as it is in adjoining Davidson County, which is home to Nashville, said Dr. Kelly Moore, director of the immunization program for the Tennessee Department of Health. "I hope people in those communities realize that the threat is real," Schuchat said. "The increase in measles cases should be seen as a wake-up call," she said. Sawyer, however, said the threat to public health posed by contagious diseases such as measles is so severe that Americans can't rely on parents who got bad information from friends or the Internet to see the light. He thinks philosophical exemptions from vaccinations should be eliminated. "Many parents believe that their own decision not to vaccinate is an isolated one, and that it only affects their child," he said. "Unfortunately, this is not true."
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