Last month, a new report identified Cook County as the county with the highest likelihood of a measles outbreak nationally during 2019. Chicago’s high number of international air travelers and our large number of unvaccinated school children were identified as major risk factors. As if on cue, just a few days later, an international visitor became Chicago’s first measles case of the year. In the days prior to diagnosis, the visitor arrived at O’Hare, took the el downtown, visited Millennium Park, shopped State Street, and went to the UIC campus. We are still waiting to hear just how many people were infected, but what is absolutely clear is that we are vulnerable.
While we may not be able to avoid visitors from abroad bringing measles to us, we must look at other ways to mitigate our risk. The report specifically called out our high rate of non-medical exemptions from childhood vaccination. In Illinois, children can obtain religious exemptions from mandated vaccines. In 2015, Illinois tightened the religious exemption requirement—parents claiming a religious exemption now must obtain certification from a physician that they have received education on vaccine safety. The logic at the time was that the number of religious exemptions in Illinois would fall.
Unfortunately, we were wrong. In 2013, before the law’s passage, there were 13,000 Illinois children claiming a religious exemption. This past year, the number of religious exemptions was up 46 percent, to over 19,000.Today, more than 100,000 Illinois schoolchildren attend a school with a measles vaccine rate of less than 95 percent. This is the threshold for “herd immunity,” meaning these schools are at increased risk of an outbreak. The large increase in religious exemptions also makes clear that parents opt-out of vaccination because of misinformation, not religious practice. The social media echo chamber has so frightened parents that some now don’t even trust their pediatrician.
So now what? The General Assembly needs to take up legislation in the fall veto session eliminating the religious exemption. That is what California did after a 2014 outbreak that started in Disneyland infected nearly 150 people. At that time, the vaccination rate in California was 92 percent. It is now nearly 98 percent.
In the meantime, there are steps the state can take now. The Illinois State Board of Education should issue a public report listing schools with low vaccination rates. Parents deserve to know if they are putting their children at risk. Additionally, the IDPH religious exemption process must be redesigned to prevent fraud. At present, all someone wanting a religious exemption for their child must do is give a doctor a form to sign that says the parent received vaccine-safety education. It’s all done on paper and there is no process to verify that a licensed clinician signed the form.
We all had hoped the that law passed in 2014 would increase vaccination rates. We were wrong. The General Assembly must again step in and prevent Illinois from becoming the next ground zero for measles.
Elyse Forkosh Cutler is president and founder of Sage Health Strategy in Chicago.