Image: Pete Ryan

When Jessica Booth gave birth to her son 12 years ago she immediately had to choose: vaccinate or not. A simple choice, right? Vaccination is a sound way to protect against highly contagious, sometimes fatal diseases like whooping cough and measles. Booth knew this. But she wavered, wary of rumored side effects. “I felt scared at the time,” she says. “It felt like autism was linked to vaccinations.”

She’s not alone.

Washington’s one of 17 states that gives parents the choice to excuse their child from vaccinations because of personal or moral beliefs. In 2017, over 33,000 students statewide were exempt from the measles-mumps-rubella (MMR) vaccine. For kindergartners our exemption rate is 4.7 percent—more than twice the national average. The state, obviously, is far from reaching measles’ “herd immunity,” or 95 percent immunization, the threshold that protects the population.   

Clearly Washington has a problem. And our recent measles outbreak is merely a symptom; even an educated, freethinking state can fall victim to dangerous vaccine hesitancy.

At the end of January 2019, the outbreak, centered in southwest Washington, escalated to over 50 confirmed cases. The majority of incidents were children ages one through 10. Governor Jay Inslee declared a state of emergency on January 25. That same day, the legislature introduced House Bill 1638, an attempt to eliminate personal exemptions for MMR. In February, Senate Bill 5841 took it further, proposing to eliminate personal exemptions for all vaccines. Meanwhile, the Washington State Department of Health continued to work on reducing the rising rate of “out of compliance” kids, those who haven’t submitted immunization records or filed for an exemption.

And this is a problem that extends into left-leaning Seattle. Capitol Hill’s Bright Water Waldorf School—a nexus of free thought, like Evergreen for grade schoolers—encourages parents to vaccinate, but still 11 percent of its students have exemptions filed. Board of trustees chair John Healy suggests that in a progressive community like Capitol Hill there could be some level of antiauthoritarianism.

Sarah Mackenzie, a senior lecturer of public health at the University of Washington, agrees. She says the middle-class, college-educated community is more likely to turn to alternative medicine and away from traditional care, despite the fact that the MMR vaccine is known to be 97 percent effective with two doses.

Not that the anti-vax movement is anything new. In the 1920s alternative medicine practitioners in Washington promoted “drugless healing,” and opposed the use of smallpox vaccines. More notably, in 1999, former British scientist Andrew Wakefield released a study in The Lancet medical journal where, despite being unable to establish a link between autism and the MMR vaccine, his research successfully terrified parents.

Mackenzie suggests that maybe the anti-vax movement is actually a product of our individualistic culture: As Americans we tend to evaluate things on a personal level, even though the goal of vaccines is to protect the whole. And, despite the evidence, people usually stick to what they feel is true, says Douglas Diekema, a professor of pediatrics at UW and emergency physician at Seattle Children’s Hospital. “It doesn’t matter what the data shows,” he says. “A story will always trump data.”

Social media—today’s prevailing storytelling platform—is home to a vast anti-vax movement. A cursory Twitter search of the anti-vax hashtag reveals some extremist dissidents, warning against government conspiracies. Others are more credible. When Bernadette Pajer’s son had an allergic reaction to a vaccine component as an infant, she stopped vaccinating altogether. Now, as copresident of Informed Choice Washington, she’s determined to save Washington’s personal exemption. But UW’s Diekema says hesitations like Pajer’s are unfounded. He notes the most common side effects for MMR are fever and rash, and around 0.3 percent of those few who develop a fever might experience a seizure.

So where does this put Washington now? In 2008, exemption rates for kindergartners hit a high of nearly 8 percent. But by 2011, when the state added a required health care provider signature on exemption forms, the rate decreased by nearly half and has stayed steady. What’s more, January’s measles outbreak served as motivation for the unvaccinated. While Clark County typically administers 219 MMR vaccines during the fifth week of the year, this January saw 1,002. King County usually administers 1,225. It tallied 2,069.

As for Jessica Booth, she did vaccinate her son. Now, as an educator working with parents, she’s willing to start a conversation about vaccine concerns. Booth understands parents’ fears—potential vaccine risks or the risk of viral infections—but she says, “You have to decide which side you want to be fearful on.”

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