Insight & Analysis / A Disease Declared Defeated Comes Roaring Back
Fifteen years after the U.S. declared a big victory over measles, Americans are monitoring a surprising development: The highly contagious disease is back in the news following an outbreak that began in December at Disneyland. The Anaheim, Calif., amusement park served as an ideal place to spread measles because of its popularity, particularly with families.
More than 60 cases of the preventable disease from the Disneyland outbreak have been reported so far, including one case in Colorado. Nearly two dozen more cases in California do not have a confirmed link to the park. The majority of those infected had not received the measles-mumps-rubella (MMR) vaccine. This includes infants who were too young to receive the shot.
Last year, the U.S. saw 23 separate outbreaks that led to 644 confirmed cases. This was in stark contrast to the period from 2001 to 2013, when the average was less than 90 cases a year.
Colorado may be at greater risk than many states for new measles cases. It is tied with West Virginia and Ohio for last place in MMR vaccine coverage among young children, according to the 2013 U.S. National Immunization Survey. Colorado’s coverage rate for toddlers between 19 and 35 months old is estimated at 86.0 percent. That proportion is closer to Guam’s MMR coverage rate than it is to the national rate of 91.9 percent. The top-ranking state, New Hampshire, sits at 96.3 percent.
In both the U.S. and Colorado, Hispanic children are more likely to be vaccinated than non-Hispanic white children, the survey found. Colorado has estimated 90.0 percent MMR coverage for Hispanic children compared with 83.1 percent for non-Hispanic whites. Colorado data are not available for other racial and ethnic groups.
Unlike most measures of public health, an inverse relationship exists between family income and MMR vaccination rates. MMR coverage for children living below the poverty level in Colorado (89.8 percent) is more than five percentage points higher than for children living at or above the poverty level (84.5 percent). This finding hints that cost or availability may not be the driving forces behind coverage rates. It also may speak to the success of the Medicaid program in paying for immunizations for low-income Coloradans. Medicaid covers vaccines for those 20 years and younger without a co-pay as long as they are recommended by the U.S. Department of Health and Human Services.
Colorado allows parents to exempt their children from vaccines for medical, religious and personal beliefs. Proposals to raise immunization rates have been introduced in the legislature in recent years, but they have failed to pass.