### Oregon’s Measles Epidemic: A Wake-Up Call About Vaccination Necessity
#### Introduction
Oregon is facing its most significant measles epidemic in many years, a development that has reignited worries regarding falling vaccination rates. To date, the state has documented 31 measles cases, all occurring in unvaccinated people. This epidemic, which began escalating in mid-June, represents the highest total in Oregon since 2000, when the Centers for Disease Control and Prevention (CDC) asserted that measles had been eliminated in the United States.
#### The Current Situation
This epidemic is mainly centered in Clackamas, Marion, and Multnomah counties, with Clackamas and Multnomah situated within the Portland metropolitan region. Health authorities have voiced concerns as the case count has exceeded the state’s prior record of 28 cases established in 2019, which was associated with a significant outbreak in nearby Washington state.
Paul Cieslak, medical director for communicable diseases and immunization at the Oregon Health Authority, highlighted the seriousness of the issue: “Prior to 2019, you have to reach back to the early 1990s to find case counts at this level. The reason being, we maintained very high vaccination rates and robust population immunity. Sadly, we’ve witnessed a decline in the number of individuals getting vaccinated against measles.”
#### The Decline in Vaccination Rates
The re-emergence of measles in Oregon is directly related to a troubling downturn in vaccination rates. In 2000, when measles was declared eradicated, only about 1 percent of kindergarteners in Oregon had exemptions from childhood vaccinations, including the measles, mumps, and rubella (MMR) vaccine. However, in recent times, Oregon has distinguished itself as one of the states with the highest exemption percentages in the nation.
During the 2022-2023 academic year, 8.2 percent of Oregon kindergarteners had exemptions from vaccinations, according to CDC data. This percentage has since climbed to 8.8 percent, as reported by the Oregon Health Authority. For perspective, any exemption figure exceeding 5 percent is alarming as it hampers the ability to achieve the 95 percent vaccination coverage needed to avert ongoing transmission of infectious diseases like measles.
Oregon’s exemption percentage ranks second only to Idaho, where 12.1 percent of kindergarteners are not vaccinated. Other states with similarly elevated exemption percentages include Utah (8.1 percent), Arizona (7.4 percent), and Wisconsin (7.2 percent).
#### The Dangers of Measles
Measles is one of the most transmissible viruses known to science, able to persist in the air for up to two hours after an infected individual has vacated the area. For unvaccinated persons who are exposed, the likelihood of infection is extremely high—up to 9 out of 10 will contract the virus.
The onset of measles symptoms generally includes a high fever, runny nose, cough, and conjunctivitis (pink eye), followed by the emergence of a distinctive rash. In many instances, the infection can result in severe complications, such as pneumonia, encephalitis (brain inflammation), and a progressive neurological condition called subacute sclerosing panencephalitis, which may develop years after the original infection.
Furthermore, measles can induce “immune amnesia,” a state wherein the virus wipes out existing antibodies and immune defenses against other pathogens, making individuals more vulnerable to additional diseases.
#### The Role of Vaccination
The MMR vaccine is incredibly effective, offering 97 percent protection against measles after two doses. This protection is regarded as lifelong, making vaccination the most effective measure to prevent the virus’s spread.
Despite the vaccine’s availability and efficacy, the current epidemic in Oregon highlights the perils of diminishing vaccination rates. Health officials are urging parents to ensure their children are vaccinated, not only for the protection of their own families but also to help shield the wider community.
#### The National Picture
Oregon’s epidemic is part of a larger pattern of increasing measles cases across the United States. This year alone, 236 measles cases have been reported nationwide, with 40 percent of the cases occurring in children under 5 years old. Alarmingly, 87 percent of those infected were either unvaccinated or had an unknown vaccination status, and 44 percent of cases resulted in hospitalization.
While Oregon’s outbreak has set a state record, the largest outbreak in the U.S. this year occurred in Illinois, reporting 67 cases, primarily amongst residents of a migrant shelter in the Chicago area.
The national count for 2024 is already substantially higher than the 59 cases documented in 2023, though it still remains below the 1,274 cases recorded in 2019, when the U.S. came close to losing its measles elimination status.
#### Conclusion
