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City commissioners consider ways to encourage vaccinations

David Floyd • Updated Jul 29, 2019 at 10:12 PM

As of July 25, there have been 1,164 cases of measles confirmed in the United States in 2019, according to the Centers for Disease Control and Prevention.

This is the largest number of cases reported in the U.S. since 1992 and since measles was considered eradicated in 2000, according to the CDC website.

At least five of those cases have occurred in Tennessee.

During an agenda review meeting on Monday, Johnson City commissioners started discussing options for promoting greater vaccination participation among local residents — especially children.

“I would hate to see what’s happening in some other places in the U.S. and the world happen here, where all of a sudden we have an outbreak of measles that we could’ve done something about,” said Commissioner Larry Calhoun, who brought the issue to his colleagues.

Calhoun invited two speakers to the meeting, Dr. David Kirschke, the medical director at the Northeast Tennessee Regional Health Department, and Dr. Leigh Johnson, a physician with East Tennessee State University Family Medicine, to share information with the commission about vaccinations.

“Vaccine hesitancy,” the reluctance or refusal to receive a vaccination, poses a big challenge, Johnson said.

“The World Health Organization has named vaccine hesitancy one of the top 10 threats to global health,” Johnson said, “so this is not a small thing, this is not a local thing. This is a threat to worldwide health.”

In Tennessee, Johnson said vaccination rates are “pretty decent.”

“They’re about average,” she said. “They’re perhaps below average in certain places.”

But even a 90% vaccination rate, which Johnson said is approximately the rate of immunization for school-age kids in Tennessee, is not enough to completely stop the spread of measles.

“If I’m not vaccinated and I have measles and I walk into a room with 10 of ya’ll and none of you are vaccinated, nine of you will get measles just from being in the same room with me,” Johnson said. “Not coughing, not sneezing, not sharing a drink, not shaking hands. It’s just extremely contagious.”

Although measles is less prevalent in the U.S. compared to other countries across the globe, Johnson said children can’t receive a measles vaccination until after their first birthday, meaning that infants are particularly vulnerable if their parents take them outside of the country.

About 0.2% of people who get measles die, Johnson said.

“I’ve read some things from people who say. ‘Well that’s not a very high death rate. Measles isn’t a very deadly disease. We shouldn’t be worried about it,’” Johnson said. “I would argue that if I’m the mom of that one kid who was the 0.2%, it’s a big deal. One death from a vaccine-preventable illness is too many.”

The measles vaccine, Kirschke said, has led to a greater than 99% reduction in measles in the United States.

One of the problems with measles is that there’s no treatment, he said.

“I’m not sure if you’ve seen on TV shows like ‘The Waltons’ where the doctor comes and just sits there with the kid all night waiting to see if they live or die,” Kirschke said. “Unfortunately, even with all our medical advances, we’re still in that same position. If you get the measles, we don’t have any medicine we can give you to get rid of it, so the only thing we can do is prevent you from getting it in the first place.”

Kirschke said Tennessee does allow medical exemptions for vaccines, which can apply to children who have a severe allergic reaction to a vaccine or have a compromised immune system. The state also allows for religious exemptions, but Kirschke said most religions have no prohibition against vaccines.

City Manager Pete Peterson told commissioners that they likely have some power to encourage families to vaccinate their kids, noting that, for example, they could require that children enrolled in the city’s voluntary Parks and Recreation programs receive vaccinations before participating.

“We could probably find some things like that to incentivize vaccinations,” he said.

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