Michigan has seen its highest number of measles cases in decades in 2019, as this week’s confirmation of two new cases from the state Department of Health and Human Services brought the total to 41.
That’s the biggest outbreak since 1991, when the state confirmed 65 cases. Almost all of this year’s cases have occurred in Oakland County, with one case each in Washtenaw and Wayne counties, as of Wednesday.
Three Southeast Michigan counties — Oakland, Wayne and Macomb — ranked in the top 15 metropolitan areas nationwide for their number of non-medical vaccine exemptions, according to a study last year by a group of Texas researchers.
In 2000, the Centers for Disease Control and Prevention (CDC) declared that measles had been eliminated before it made a return over the last two decades due to declining vaccination rates.
Abram Wagner, an epidemiologist at the University of Michigan, said that those rates tend to be lower than average in more affluent areas — making Oakland County, one of the 10 wealthiest counties in the nation as of the 2010 census, especially vulnerable.
“We did see [in a study] in Michigan that communities which were more affluent, which had more professionals, where people were more highly educated, that were higher in income — those were areas where there was a lower vaccine uptake,” Wagner told the Advance.
Wagner referenced the popularity of a fraudulent article by anti-vaccine activist Andrew Wakefield in the late 1990s and early 2000s, as well as general mistrust of the pharmaceutical industry in the wake of the numerous scandals related to opioid addiction, as contributing factors to the declining vaccination rate since 2000.
According to the DHHS, the outbreak began when a traveler brought measles to Michigan from Israel, by way of a stop in New York City. New York’s Orthodox Jewish community has been fighting a measles outbreak since October that’s now affected more than 400 people.
Isolated communities like New York’s Orthodox Jews are uniquely susceptible to such outbreaks, although Jewish authorities in both New York and Detroit have urged community members to get vaccinated. A recent report from Vox notes that only a minority of the community distrusts vaccines, and that similar outbreaks have occurred in Amish and Somali-American communities over the last decade.
This year’s Washtenaw County case occurred in an infant who had either just received or was soon to receive the standard 12-month vaccination, raising the question of how best to prevent exposure to the highly contagious virus. According to the CDC, “if one person has [measles], up to 90% of the people close to that person who are not immune will also become infected.”
“Parents are upset and frustrated that there is an unimmunized population that still makes it possible for this disease to spread even though they do everything right to protect their own children,” the Washtenaw Jewish Community Center’s director Peretz Hirshbein told the Jewish News this week.
Hirshbein also noted that the Center does not permit unvaccinated children, even with religious or philosophical waivers. This week, Birmingham’s Derby Middle School told unvaccinated students to stay home, citing a guideline from Oakland County health authorities that says they should stay home for 21 days after the site’s exposure to the virus.
In February, MLive compiled a searchable database of vaccination rates for every school and daycare in Michigan.
Michigan law allows parents to decline vaccines if there’s a medical reason or if they cite “religious or philosophical objections.” In 2014, the state implemented a new rule that required parents claiming the latter objection to take an educational course about the risk of vaccine exemption.
Wagner, the University of Michigan epidemiologist, noted that the rule led to a sharp decline in waivers the following year, but that preliminary data shows that their number is once again on the rise.
In 2017, while he was serving in the state House, state now-state Sen. Tom Barrett (R-Potterville) introduced a bill that would have prevented schools like Darby from banning unvaccinated students during an outbreak. Coincidentally, Barrett introduced his bill just days after the administration of former Republican Gov. Rick Snyder launched I Vaccinate, a public outreach campaign that aimed to increase the state’s low vaccination rates.
Another bill, introduced by former state Rep. Jeff Noble (R-Plymouth), would have made it easier for parents to obtain vaccination waivers by removing current parental education requirement and making it more difficult for DHHS to “promulgate rules regarding immunization.” Both bills died in committee.
Both bills were co-sponsored by current House Speaker Lee Chatfield (R-Levering), who said in a statement at the time, “While I have personally chosen to vaccinate my children, parents should not be required to participate in a government program in order to exercise their right to make medical decisions for their children.”
Chatfield did not immediately respond to a request for comment on whether he would encourage similar legislation in the wake of this year’s outbreak.
There have been measles outbreaks in 19 states this year, according to the CDC, with Michigan’s composing 8.8 percent of 465 cases nationwide.
The DHHS is urging those who suspect measles to “call their doctor or emergency room before arriving so they can take precautions to prevent exposure to other individuals,” and has provided a list of locations where walk-in vaccination clinics are being held.