Immunizations in Washington are still below an ideal threshold. Why that's putting kids at a risk for mumps

May 09--An unusually high rate of parents in Washington state are preventing their children from getting vaccinated, an issue health officials say might be contributing to a statewide mumps outbreak.

The state Department of Health reported Monday that nearly 5 percent of kindergartners in Washington weren't immunized for the 2016-17 school year because of the personal beliefs of their parents or for medical reasons.

The rate hasn't changed much since 2011, but it's still more than double the national average of 2 percent, according to the department.

It's also noteworthy, officials say, as Washington deals with its highest number of mumps cases since 1976.

The high exemption rate is part of why the state falls below a national goal of immunizing 95 percent of kindergartners, a benchmark meant to "ensure a communicable disease can't spread easily through a population," said Paul Throne, a spokesman for the health department's immunization office. Some children also don't get vaccines because they lack access to them.

Lower rates of vaccination allow a faster spread of mumps, Throne said: "We'd have a lot more (cases) if we had more people who weren't vaccinated."

Health Department data show 680 reported cases of mumps in 2017 as of April 29, up from 155 cases in 2016 and seven in 2015.

While the vaccination exemptions can be granted as a medical necessity, the large majority of waivers are taken by parents refusing to vaccinate their children for philosophical or religious objections. Some believe the vaccines are dangerous, Throne said.

Those fears, which officials say are unfounded, sparked a group of lawmakers in 2015 to try and take the choice to immunize out of parents' hands altogether by ending the philosophical exemption.

The measure's sponsor, state Rep. June Robinson, D-Everett, said Monday the bill was aimed at protecting "the larger community" from disease.

Her ban was met with fierce resistance, however, and failed to gain much support. Some opponents said it infringed on parents' right to protect their children, and others said it was government intrusion into private lives.

State Rep. Joe Schmick, R-Colfax, said he voted against Robinson's measure in the House Health Care Committee because the choice to immunize should be "up to the parent" -- even if not vaccinating a child could make another one sick.

"Well, I am not opposed to immunization and I think that kids should be immunized," he said. "But I do believe that is a parental decision."

The state has made it more difficult over the years to gain an exemption, though.

Officials made it less convenient to fill out the waiver paperwork in 2008. The exemption rate dropped afterwards from a peak of nearly 8 percent that school year.

The Legislature then enacted new restrictions on the waiver in 2011, requiring parents to meet with a health care provider before they can get an official exemption.

Since 2011, the rate has been steadily around above 4 percent.

Throne said trying to win over parents skeptical of the need or safety of vaccines remains a focus for slowing and preventing outbreaks.

Officials in Minneapolis blame a recent measles outbreak there on parents who fear the measles-mumps-rubella vaccine causes autism.

Vaccine information posted online by the health department and the federal Center for Disease Control and Prevention cite studies that conclude immunization is safe and not linked to autism or other behavioral disorders.

"We're kind of fighting a battle of science against opinion," Throne said.

Even so, the waivers aren't the only reason children don't get vaccinated. Only 85 percent of kindergartners in Washington state had the required vaccinations to start the latest school year.

Some kids are counted as not vaccinated because they weren't fully up to speed with their immunizations, or they got vaccinations but didn't complete necessary paperwork.

Throne said many barriers to health care can push children into that category. A parent who can't afford to skip a work day to get their children immunized is one example, he said.

Others might be without immunization for personal reasons but aren't counted as such because they didn't submit an official waiver.

Robinson said she's been focused on working outside of the Legislature to reach families who aren't rejecting vaccines but have kids who aren't getting immunized.

She's also been focused on improving immunization data by working with the state Office of the Superintendent and the health department.

Throne said there are other factors in the mumps outbreak, too. The vaccine is not as effective against mumps as it against measles, he said. About two-thirds of the people who caught mumps in the recent rash of mumps already had the vaccine, which is typically about 88 percent effective, Throne said.

The state is studying to see why the outbreak has been so big.

But Washington's high philosophical exemption remains a hurdle to preventing the spread of disease, according to the health department.

"It is worrisome that we still don't have enough kids immunized to prevent an outbreak," Robinson said.

Walker Orenstein: 360-786-1826, @walkerorenstein

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