As more children go without vaccinations, risk of measles outbreak in Florida increases

The number of students entering Florida schools without vaccines is on the rise, and health officials worry that the highly infectious measles virus — once eradicated across the United States — could get another chance to cause an outbreak.

“Measles is like that shark that’s always looking for the hole in the net,” said Dr. Kenneth Alexander, chief of the division of infectious diseases at Nemours Children’s Hospital in Orlando. “It’s one of the most infectious diseases there is.”

In Dade, Broward and Palm Beach counties, more than 4,000 students entered public kindergartens this school year with some form of exemptions from required vaccinations — that’s almost 7 percent of the 54,000 students. The numbers for private schools are even higher.

Across the state, about 11,500 children started public school in kindergarten this school year with some form of exemption from required vaccinations — that’s almost 6 percent of Florida’s 200,000 students.

“The worry is that anti-vaccination is going to get stronger and stronger and we’re going to see the vaccination rates go down. And that’s the concern,” Liller said. “The state of Florida has a lot of visitors. We have people out and about and if we don’t have herd immunity, if we lose that immunity, that virus is going to spread.”

Florida’s goal is to have 95 percent of the kids immunized by the time they enter kindergarten, according to the Florida Department of Health. But fewer than half of its counties have achieved that goal.

Broward County came the closest in South Florida to meeting that goal, with an almost 94 percent immunization rate. Palm Beach County has a 93.1 percent rate, and Miami-Dade a 92.8 percent rate. All lag well behind Franklin County in the Panhandle, which ranked first in the state at a 99.2 percent immunization rate.

Meanwhile, there are neighborhoods within each county where the rate of religious exemptions — the number of unvaccinated children — is higher than average, making it easier for a virus like measles to spread.

“If you look at the exemption rates nationally, or at the state level, it’s quite low, but they tend to cluster geographically and they tend to cluster socially,” said Dr. Daniel Salmon, professor and director of the Institute for Vaccine Safety at Johns Hopkins School of Public Health.

“So if you have a child in that school or in that community, it doesn’t really matter what the national rate is even at the state level. The question is, what is the likelihood of your child coming into contact with an unvaccinated child?” Salmon said.

Any likelihood concerns Province Zamek, a Miami mother of two teenage daughters.

“It bothers me for two reasons. First, measles is so contagious and second, because I feel like if you do your homework, you will end up vaccinating,” she said. “Getting vaccinated is less dangerous than not, and you’re putting other people’s kids at risk.”

Florida parents are able to learn the number of unvaccinated children in a specific school — public and private — but not in an individual classroom.

An interactive map, compiled by the state health department and based on county subdivisions, further highlights where clusters of families in Florida with religious exemption live. While the overall rate of schoolchildren in Florida with religious exemptions averages 3 percent, in certain pockets of each county the exemption rates can be as high as 30 percent.

For instance, several clusters in Pinellas County, which had a measles outbreak last year, especially in the coastal areas near Clearwater, have exemption rates as high as 33 percent.

There is no cure for measles, just treatment of the symptoms.

Dr. Maria Pilar Gutierrez, a pediatric infectious diseases specialist with Joe DiMaggio Children’s Hospital urges parents to get their children vaccinated.

“It is unforgivable to have a child contract a disease that could have been preventable,” she said.

Before a measles vaccine became available in the early 1960s, 400 to 500 people died each year, according to the Centers for Disease Control and Prevention. By 2000, the disease was eliminated in the United States.

Diseases crop up more frequently

Meanwhile, measles isn’t the only vaccine-preventable disease surfacing in the state. Florida’s children have experienced the spread of other diseases in the last few years such chicken pox and pertussis (known as whooping cough). So far, Florida has been spared from mumps cases although the disease has hit colleges in the Northeast.

With preventable diseases cropping up more often, Amy Silver said it hasn’t swayed her decision not to vaccinate her two children in the Hillsborough County Public Schools and one in private preschool. Silver said her family has a history of autoimmune weakness, which influenced her decision.

“I felt like if I vaccinated them, I would be playing Russian roulette,” she said. Silver has secured temporary medical exemptions for her children that need to be renewed annually.

She said she doesn’t keep it secret that her children are unvaccinated. With clean water and sanitation, Silver said she considers diseases like measles less serious than previous times in history.

“I don’t feel there’s any harm to others being around my kids.”

Pediatricians, who find themselves being asked to give medical exemptions, tend to give more temporary than permanent. Last year, students in Florida’s public and private schools were granted more temporary medical exemptions than religious. But with the strengthening anti-vaccine movement, some pediatricians are refusing to care for unvaccinated children. Large practices like Pediatric Associates in South Florida no longer accept unvaccinated patients.

But Dr. Thomas Lacy, division chief for primary care and urgent care at Nemours, said he treats unvaccinated children, although he continues counseling the parents about the benefits of vaccination every visit.

“To not immunize is basically going back to the pre-modern times when kids got sick and died. I mean, it’s just a step backwards,” he said.

cgoodman@sunsentinel.com, 954-356-4661, Twitter and Instagram @cindykgoodman