Dozens of people are sick with measles after an outbreak in Clark County, Wash. Use our tool to look up vaccination rates in your kids' school.

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Why would some parents not protect their child from a serious disease when a safe and effective vaccine exists?

That’s the question many here are asking as Washington battles an unprecedented epidemic of measles — 50 confirmed cases this year, including 49 in Clark County and one in King. Gov. Jay Inslee declared a state of emergency Jan. 25.

“There are some families in Washington who choose not to vaccinate when they could,” said Danielle Koenig from the Department of Health.

Indeed, Washington has one of the highest rates of student vaccine exemptions in the nation. A Centers for Disease Control and Prevention report published last year found that the percentage of Washington kindergartners with a vaccine exemption was more than twice the national median. Interestingly, the Northwest has the highest exemption rates in the country, with Oregon, Idaho and Alaska the top three states, in that order. Washington ranks eighth.

All 50 states allow student-vaccine exemptions for medical reasons, and nearly all do for religious beliefs. But only 17, including Washington, grant exemptions for those with moral, personal or philosophical objections to vaccines. Roughly three out of four exemptions in Washington are for those reasons, including the belief vaccines can cause autism, which has been disproved by CDC studies.

For the 2017-2018 school year, about 4 percent of K-12 students in Washington received a nonmedical exemption excusing the student from one or more vaccinations. Another 1 percent received an exemption for medical reasons.

Specifically for the measles-mumps-rubella (MMR) vaccine, 3 percent of Washington students received an exemption — that’s roughly 33,000 kids.

“That’s how diseases can spread — when we get too many nonimmunized people in a population, it lets the disease have an inroad,” Koenig said. “If everyone who can get vaccinated does, then they’re protecting and surrounding those who can’t get vaccinated for medical reasons.”

Achieving this “herd immunity” for measles, which is particularly contagious, requires a vaccination rate above 90 percent.

Alarmingly, data for the 2017-2018 school year from the Department of Health show that there are 75 schools in King, Snohomish, Pierce and Kitsap counties where at least 10 percent of K-12 students received an exemption for the MMR vaccine.

The highest rate of exemptions was at the Tacoma Christian Academy, where 56 percent of the 275 students had an MMR exemption. Among public schools, the highest rate was at Vashon Island’s Family Link, at 31 percent.

In Seattle proper, the Seattle Waldorf School had the highest rate, with 22 percent of students excused from the MMR vaccine. No public school in the city comes anywhere close to that. Summit Atlas, a public charter school in West Seattle, was highest with 7 percent of students exempt.

In Bellevue, the highest rate was at another campus of the Seattle Waldorf School, called Three Cedars, which closed last summer. More than one-third of students there received an MMR exemption. At one public school on the Eastside — Emerson K-12 in Kirkland, a “Choice School” that partners with families who home school their kids — one quarter of students were exempted.

As high as the exemption rate is in Washington, it has come down from its peak of about 10 years ago, when nearly 8 percent of kindergartners had received an exemption statewide.

“It started trending really high after all that false information came out a number of years ago about the dangers of vaccines,” Koenig said. “Once those myths got busted, and the state also made exemptions a little harder to get, we’ve seen the rates start to fall.”

The state began requiring parents to bring the vaccine-exemption form to a doctor to have a conversation about the risks of not vaccinating. Then the doctor has to sign off on the form, Koenig says.

Even so, there are still a handful of Washington counties where at least one in 10 K-12 students have a vaccine exemption. The highest rate — 13.5 percent in the 2017-2018 school year — is in Jefferson County, where Port Townsend is located.

In the Seattle area, Snohomish County has the highest rate of exemptions, at 6 percent. King is around 4 percent.

The lowest rate in the state is in Yakima County, at less than 2 percent.

Because the anti-vaccination movement can often be found clustered in affluent, liberal areas like Marin County in California — or locally, on Vashon Island — it is sometime described as the left’s version of climate-change denial. Both movements reject well-established science.

But vaccine deniers are not all just liberal hippies. Some religious communities are also strongly against vaccinations. In the Department of Health data, we see that private schools in the Seattle area — in particular religious and progressive-education schools — have a significantly higher rate of students with vaccine exemptions than public schools.

Koenig points out that not all parents who don’t vaccinate their kids do it out of some philosophical or religious objection.

“There are some access issues with vaccination, especially in rural counties where people may not be able to get to a doctor,” she said. “There maybe some transportation issues. And a lot of families are busy and just may forget or put off going to the doctor.”

Koenig says that after an outbreak, like the one we’re now experiencing, there is usually a spike in immunizations.

“But then the rate starts to drop again,” she said.

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