Washington state health secretary: We’re falling short on vaccine-preventable diseases

As of Feb. 24 Washington state is eight weeks into a measles outbreak that has sickened 66 people in our state. Two have been hospitalized. Four additional persons in Oregon, and three in Georgia were also sickened from this outbreak; and Washington is not alone.

New York State has three measles outbreaks already this year and one in Texas. This outbreak has cost Washington over $1 million and sparked, again, a national conversation about how to balance personal choice and community health. All of us — public policy makers, public health officials and parents — have responsibilities to keep our kids and communities healthy and safe.

{mosads}As the secretary for the Washington State Department of Health, my agency’s mission is to protect and improve the lives of all people of Washington. But this outbreak is just one reminder of how we are falling short.

Governmental public health systems at every level are crumbling due to chronic underfunding and increasing population size. As a result, we’re constantly reacting to crises rather than working to prevent them.

We respond to emerging and reemerging infectious diseases like measles and Ebola, react to increasing suicides and opioid-related overdoses and get caught off guard by skyrocketing increases in vaping by our youth. We pay the toll with declining life expectancy even here in the U.S. All this means prevention — the most fundamental work of public health — is put on the back burner.

To address this, many public health officials around the country are identifying the necessary core public health services on which every American should be able to depend and the resources needed to provide them.

Those services would prevent outbreaks like measles and tuberculosis, reduce suicide and drug use, provide tools for parents to raise healthy, resilient children ready for school and keep communities safe and healthy — the kinds of places businesses want to be located and where economies can be strong. In Washington State alone, we’ve itemized the additional funding needed for these basic public health services at $225 million a year.

State legislatures, Congress, health care and business leaders need to understand the threat and respond together to restore health to the very part of our system responsible for prevention. One immediate response Congress can take is to fund the request of the Association of State and Territorial Health Officials and over 80 other organizations to raise the budget of the Centers for Disease Control and Prevention by 22 percent by 2022. Doing so will immediately begin to save lives, promote optimal health for all, bolster our prevention services and reduce health-care costs.

Fighting disease outside the U.S., as well as inside, promotes everyone’s health security. Most measles outbreaks start after a traveler gets infected in another country then spreads the disease to unvaccinated people in the U.S. This can also happen when an unvaccinated U.S. traveler brings it home. This is why we must fund the CDC and other health organizations to maintain disease-control activities globally.

We also need to adequately fund school nurses. Fifty years ago, I had access to school nurse Millie Gardner every day. She made sure we had our immunizations, provided health screenings and took care of us when we were ill or hurt. Our schools today are woefully understaffed with school nurses. Many schools share a nurse and they may only see their nurse once a week. This does not put our children first; and school nurses partner with public health to keep our kids safe and healthy. We see consequences of too few school nurses in our current measles outbreak. Immunizations are up in Clark County since the outbreak — more school nurses, like nurse Gardner, can help parents stay on track without an emergency.

As policy makers and parents, we must ensure community immunity. Community immunity means enough people are vaccinated to prevent outbreaks in child care centers, schools, churches, towns and cities. For measles, this requires that we have at least 95 percent of our population vaccinated against measles. In Clark County, vaccine exemption rates are 7.9 percent. This rate is well below what’s needed to protect those who can’t be vaccinated because of medical reasons or a weakened immune systems.

Washington is one of 17 states that allow parents to send their children to school and child care unvaccinated for personal or philosophical reasons. Two state lawmakers from Clark County have each introduced legislation designed to protect more children from preventable disease. One bill would eliminate the philosophical exemption for the MMR vaccine.

The other would eliminate that exemption for all vaccines required for school or child care entry. This approach honors the responsibility we all have to protect each other. This proposed policy change is a good step forward and one I support. Vaccines are the best protection we have: They are safe, readily available and proven to be effective.

My public health colleagues and I will continue the work we’re doing in our individual states and jurisdictions to raise immunization rates, provide science-based information and answer parents’ questions. But if we’re going to eliminate vaccine-preventable diseases in Washington, New York, Texas, or your home state, we have to see the big picture. That big picture means adequately funding governmental public health — this country’s community prevention system, working globally for our health security, funding our school nurse partners and making public policy that protects our most vulnerable.

Dr. John Wiesman, DrPH, MPH, was appointed secretary of health by Gov. Jay Inslee and joined the Department of Health in April 2013. He’s has more than 22 years of local public health experience and focuses on whole systems approaches to improving health.