Low and decreasing vaccination rates in Texas schools are making cities both big and small vulnerable to large outbreaks of measles, according to a new study from the University of Pittsburgh. The Texas Pediatric Society asked the university researchers to use Texas as a model for the study to show the possibility of large outbreaks, according to a press release.
Under current 2018 vaccination rates, three Texas metropolitan areas were shown to be vulnerable to large outbreaks. According to the simulation used by researchers, large outbreaks of more than 400 cases occurred in the Austin-Round Rock and the Dallas-Fort Worth-Arlington metropolitan areas at current vaccination rates. In Tyler, there’s a potential for an outbreak of more than 100 measles cases.
If vaccination rates in the state were to decrease even further, the expected number of measles cases in an outbreak would surpass 500 cases in the Austin, Dallas and Houston metropolitan areas. A five percent decrease in school vaccination rates was associated with a 40 to 4000 percent increase in outbreak size, the study found.
“At current vaccination rates, there’s a significant chance of an outbreak involving more than 400 people right now in some Texas cities,” David Sinclair, a postdoctoral researcher at the university, said in a press release. “We forecast that a continuous reduction in vaccination rates would exponentially increase possible outbreak size.”
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Vaccination figures cited in the study show that since 2003, the number of reported conscientious exemptions, which includes personal and religious exemptions, has increased from 2,300 to 64,000 in Texas students. Texas law allows parents to choose to have their children exempt from vaccines for reasons of conscience, including religious beliefs.
In the study, about 64 percent of the cases simulated by researchers occurred in children who had not been vaccinated for religious or personal reasons. But the study also found that 36 percent of measles cases would be in those who had not been vaccinated for medical reasons, had a vaccine that had failed or in adults who had not been vaccinated.
Measles, which was declared eliminated in the United States in 2000, has made a resurgence in recent years. In 2019, just over 1,200 measles cases have been reported in the country, the highest number since 1992.
According to the latest statistics from Texas health officials, 21 cases have been reported in the state this year.
The measles vaccine is highly effective in preventing the disease. The CDC says two doses of the MMR vaccine are about 97 percent effective in preventing measles while a single dose is 93 percent effective in preventing the deadly disease.
The majority of people who get measles are unvaccinated and the disease can spread when it reaches a community where groups of people haven’t received the measles, mumps and rubella, or MMR vaccine, according to the CDC. The agency says more measles cases can occur if there’s an increase in the number of travelers to the United States who have measles or if the disease spreads within pockets of unvaccinated communities.