The back-to-school push for children's vaccinations has new urgency this year as Florida health officials report an alarming rise in measles.
So far this year, seven cases have been reported in Florida, the most in 14 years. All but one involved an unvaccinated child 1 to 16 years old. Most of the children's parents had exempted them from state-required vaccinations by citing religious objections to vaccines.
More and more parents in the Tampa Bay area and around Florida are claiming such objections. But medical experts say they think the real issue often is not religion, but unfounded fears of a connection between vaccines and autism.
Cost, they say, should never be a factor. Parents who can't afford a doctor visit can take their children to county health department clinics or to a back-to-school immunization event. And insurance covers vaccinations.
"We would just encourage parents to start thinking now about what their child needs for school, and not to wait until the last minute," said Maggie Hall, spokeswoman for the Pinellas County Health Department.
Parents who wait until just before school starts may face long waits for vaccines required for school. But the health community is more concerned about the small but growing number of parents who refuse vaccines for children.
The measles vaccine, which comes in a shot that also protects against the mumps and rubella, has never contained thimerosal, the preservative that generated particular concern in the vaccines debate (although even thimerosal has been cleared of any autism connection).
Still, some parents don't appear convinced. In the past decade, the number of Florida kindergarten students whose parents claim religious exemptions has more than quadrupled, state records show. About 2,400 kindergartners statewide have religious exemptions for the current school year.
Four of the six children in Florida who got the measles this year had a religious exemption to the school immunization requirement.
Given all the debate, the Catholic Diocese of St. Petersburg has recently clarified the church's position. In a letter to pastors and parochial school principals, Bishop Robert Lynch said the church does not teach that using vaccines is "intrinsically evil," even if the vaccine was produced with controversial stem cell lines. So Catholic schools shouldn't grant vaccine exemptions on religious grounds.
Health experts fear that many people have forgotten just how bad measles can be, since the vaccine has made the disease so rare in recent decades.
Measles remains one of the most contagious diseases, said Dr. Juan Dumois, chairman of infectious diseases at All Children's Hospital in St. Petersburg. It can be acquired by breathing in air in the vicinity of a measles patient, without being right next to him or her.
About 10 days after exposure, patients who contract the infection start to develop a fever, cough, congestion and red eyes. The tell-tale measles rash, which starts on the face and spreads to the body, shows up three to four days later. Many doctors today struggle to recognize the disease because they've never seen a case.
Most children recover in about a week, but some young patients will stop eating and drinking, requiring hospitalization and intravenous fluids.
About one in 1,000 develops a brain infection that can lead to permanent neurological damage, if they survive. And one or two in 1,000 die.
"You never know when your child is going to be the one in 1,000," Dumois said. "It's sort of like playing roulette, hoping that your child won't be the one who suffers, if the argument is, 'Well, measles isn't so bad in most of the children who get it.' "
And a stricken child could pass the virus on to an elderly relative or someone else who lacks a strong immune system. For them, the disease can be especially dangerous.
So far this year, almost all of the Florida cases were linked to travel, as has been the case nationally. The 156 cases reported this year by the U.S. Centers for Disease Control and Prevention represent a 15-year high.
With measles hot spots seen in Europe, Africa, India and Southeast Asia, authorities recommend that U.S. residents traveling overseas get immunized. That means two doses of the measles vaccine for anyone 1 year or older, Dumois said, and one dose for infants between 6 and 11 months.
The travel advisory calls for earlier immunizations than the typical schedule. Children usually get their first measles shot at 12 to 15 months, with the second at 4 to 6 years.
Letitia Stein can be reached at firstname.lastname@example.org or (813) 226-3322.