Chapter 5: Immunization

The introductory text reads, Before the measles vaccine was introduced in 1963, 30 million people globally contracted measles each year. About 2 million of them died, usually because they were both malnourished and sick. (World Health Organization, April 28, 2017). Thankfully, worldwide vaccination efforts now mean that no child need die of measles. Measles is highly infectious, so 95 percent of the population needs to be immunized in order for ‘herd immunity’ to protect the entire community. The United States achieved that: A decade ago, the measles incidence was close to zero. Experts thought measles would soon be eliminated in all developed countries, so public health workers focused on the very poorest nations.
A subheading reads, Estimated Measles Vaccine Coverage – Selected Nations. The following text reads, By June 2019, more than 1,000 measles cases had been reported in 28 states, the most since 1992 (measles was declared eliminated in 2000) (Centers for Disease Control and Prevention, June 17, 2019). To understand what went wrong, note that many states allow personal or religious exemptions to immunization requirements. Thus, as the U.S. map shows, several states are not at that safe 94 percent— leaving many vulnerable, not only to discomfort but also to complications, including pneumonia, encephalitis, and even death.
A world map shows the estimated measles vaccine coverage in percentage as follows.
90 percent or greater: U S A; most of Middle America; Venezuela; Colombia; Guyana; Brazil; Paraguay; Chile; Morocco; Tunisia; Libya; Egypt; Sudan; Eritrea; Djibouti; Senegal; The Gambia; Burundi; Tanzania; Zimbabwe; Zambia; Botswana; Lesotho; most of Europe; most of Asia; and Australia.
80 to 89 percent: Canada; Dominican Republic; Guatemala; El Salvador; Ecuador; Peru; Bolivia; Argentina; Algeria; Guinea-Bissau; Sierra Leone; Liberia; Burkina Faso; Democratic Republic of Congo; Uganda; Kenya; Mozambique; Namibia; Eswatini; Ukraine; Romania; Serbia; Croatia; India; Laos; Cambodia; and the Philippines.
70 to 79 percent: Mauritania; Côte d'Ivoire; Benin; Niger; Cameroon; Congo; Lebanon; Iraq; Pakistan; and Indonesia.
Less than 70 percent: Mali; Guinea; Chad; Nigeria; Central African Republic; Equatorial Guinea; Gabon; Angola; South Africa; Ethiopia; Somalia; Madagascar; Bosnia and Herzegovina; Montenegro; Syria; Yemen; and Afghanistan.
A map shows M M R Coverage and Exemption Rates in the United States as follows.
Confirmed measles cases -2019: Washington; Oregon; Idaho; California; Nevada; Arizona; Colorado; New Mexico; Texas; Oklahoma; Iowa; Missouri; Illinois; Michigan; Indiana; Kentucky; Tennessee; Georgia; Florida; Virginia; Maryland; Pennsylvania; New Jersey; New York; Connecticut; Massachusetts; New Hampshire; and Maine.
Nonmedical exemption rate above U. S. median (2 percent): Montana; Utah; North Dakota; Kansas; Arkansas; Minnesota; Wisconsin; Ohio; Alabama; South Carolina; Delaware; Washington D C; Vermont; Rhode Island; Alaska; and Hawaii.
M M R Vaccination rate above 94 percent: Washington; Oregon; Idaho; Nevada; Arizona; Montana; Utah; Colorado; Kansas; Oklahoma; Minnesota; Iowa; Arkansas; Indiana; Alabama; Kentucky; Ohio; Georgia; Florida; Washington D C; and New Hampshire.