Amid the current measles outbreak affecting California and other states, the Krawitt family has asked Reed Elementary in Tiburon in Marin County, California to ban unvaccinated students from campus — to protect 6-year-old Rhett who cannot receive the measles vaccine because of a weakened immune system from chemotherapy after battling leukemia for the past four and a half years.
Measles, or rubeola, is a highly contagious respiratory disease caused by the measles virus that is spread through contaminated droplets from the nose, mouth, or throat of an infected individual. Coughing and sneezing are the most common ways in which the measles virus is passed from person to person. Symptoms of the measles occur eight to ten days after exposure and include bloodshot eyes, cough, fever, sensitivity to light, muscle pain, eye redness and irritation, runny nose, sore throat, tiny white spots inside the mouth, and a telltale rash.
Three out of ten people who contract measles will develop one or more complications including pneumonia, encephalitis, ear infections, and diarrhea. One to two of every 1,000 children infected with the virus will die.
Only the measles vaccine, given as the combination measles-mumps-rubella (MMR) vaccine, can prevent infection with the virus. The Centers for Disease Control and Prevention (CDC) currently recommends all children receive two doses of the MMR vaccine, with the first dose given between 12 and 15 months and the second dose between 4 and 6 years. One of the most effective vaccines currently available, the measles vaccine is up to 99 percent effective in preventing measles infections.
However, certain individuals should not receive the MMR vaccine including pregnant women, individuals who have had a previous life-threatening allergic reaction to the vaccine, and individuals with compromised immune systems.
Rhett cannot receive the MMR vaccine, putting him at increased risk for infection. His weakened immune system from chemotherapy also puts him at risk for infection and complications.
The young boy therefore relies on herd immunity, which occurs when a certain percentage of the population becomes immune to an illness. Even if the disease enters the population, individuals who are not immune are protected by herd immunity because the disease cannot find enough non-immune hosts to infect. requires 83% for herd immunity. Herd immunity is especially important for high risk individuals such as the very young and people who cannot receive vaccines for legitimate medicals reasons.
Explains oncologist Dr. Robert Goldsby of the University of California in San Francisco, who treated Rhett:
“When your immune system isn’t working as well, it allows many different infections to be worse. It’s not just Rhett. There are hundreds of other kids in the Bay Area that are going through cancer therapy, and it’s not fair to them. They can’t get immunized; they have to rely on their friends and colleagues and community to help protect them.”
Unfortunately, the Krawitt family lives in a county with the dubious honor of having the highest rate of “personal belief exemptions” in the Bay Area and among the highest in the state. Despite vaccination mandates, 6.45 percent of children in Marin County have a personal belief exemption, which allows parents to lawfully send their children to school unvaccinated. Reed Elementary has a 7 percent personal belief exemption rate.
Says the father of the boy, Carl Krawitt:
“It’s very emotional for me. If you choose not to immunize your own child and your own child dies because they get measles, OK, that’s your responsibility, that’s your choice. But if your child gets sick and gets my child sick and my child dies, then … your action has harmed my child.”
Krawitt and his wife, Jodi, now want the school district to “require immunization as a condition of attendance, with the only exception being those who cannot medically be vaccinated,” as requested in an email to the district superintendent.
In response to the request, Superintendent Steven Herzog responded, “We are monitoring the situation closely and will take whatever actions necessary to ensure the safety of our students.”
U nvaccinated students at Huntington Beach High School in Orange County have already been ordered out of school for three weeks after a student contracted measles in an effect to prevent an outbreak. Thirty children were also quarantined in Alameda County after possible exposure to the disease. Marin County does not currently have any confirmed or suspected cases of measles.
The question of barring unvaccinated children from school in absence of a confirmed case of the illness includes a legal one. However, Marin County health officer Matt Willis explains that, if the outbreak progresses, requiring unvaccinated children to stay home, even without confirmed cases at a specific school, might be a step to consider to curb additional cases.
Herlihy, Stacy Mintzer & E. Allison Hagood. 2012. Your baby’s best shot: Why vaccines are safe and save lives. Rowman & Littlefield Publishers, Inc.: Lanham.
To Protect His Son, A Father Asks School to Bar Unvaccinated Children: http://www.npr.org/blogs/health/2015/01/27/381888697/to-protect-his-son-a-father-asks-school-to-bar-unvaccinated-children
Classroom Library: https://commons.wikimedia.org/wiki/File:ClassroomLibrary.jpg