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MLC Health & Human Services Committee: Lawmakers hear why vaccination rates decline, and how states can respond to disease outbreaks

by Jon Davis ~ August 2019 ~ Stateline Midwest »
A national measles outbreak this year, following closely after one in Minnesota in 2017, prompted the Midwestern Legislative Conference’s Health & Human Services Committee to look at “The Science of Vaccinations” in July at the MLC Annual Meeting in Chicago.
Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, walked legislators through the CDC’s handling of vaccines while Kristen Ehresmann, director of the Minnesota Department of Public Health’s Infectious Disease Epidemiology, Prevention and Control Division, discussed Minnesota’s outbreak.
Vaccines are one of the 20th century’s public health success stories, having eliminated or almost eliminated diseases — including smallpox, polio, diphtheria, mumps, rubella, tetanus and measles — that once terrified parents, Messonnier said.
According to the CDC, 1.3 percent of children under 3 years of age went without any vaccines in 2017; that’s up from 0.8 percent in 2008 and above the target of 1 percent, she said.
As of July, Messonnier added, there were 1,418 cases of measles in 30 states. While we need “great local situational awareness” to learn why local outbreaks occur, nationally “the reason we’re having these outbreaks now is misinformation,” she said.
According to Ehresmann, the seeds of Minnesota’s 2017 measles outbreak, which was the state’s worst in 30 years and concentrated in the Somali community, were sown in a 2008 TV news story on parents’ concerns over a disproportionate number of Somali children in special-education programs.
One parent blamed vaccines, and anti-vaccine advocates began contacting the Somali community, she said.
As a result, Ehresmann said, the measles immunization rate among Somali children dropped from 92 percent in 2004 to 42 percent in 2014 (when children affected in the 2017 outbreak were born). The non-Somali rate, meanwhile, stayed constant, at just below 90 percent.
Exclusion — the ability to keep an infected child out of school or day care during the disease’s 21-day incubation period, thus preventing further cases — and accurate information were crucial in containing the outbreak, Ehresmann said.
For information to be disseminated effectively, she said, it had to come from within the Somali community itself. As a result, state outreach included hiring Somali speakers and crafting messages targeting schools, child care centers and the faith community. Somali imams helped, for example, by asking for information that they could pass on to their congregations.


Article written by Jon Davis, CSG Midwest staff liaison to the Midwestern Legislative Conference Health & Human Services Committee.