Kansas City was named as one 15 urban "hotspots" vulnerable to infectious disease outbreaks in a new national study of non-medical vaccine exemptions.
The study was published just one day after the second of two simultaneous measles outbreaks in the metro area officially ended.
The timing was just a coincidence, but study co-author Peter Hotez said he had been following the outbreaks, and the study's results put them in a new context.
“I think you have to worry this could become a new normal for Kansas City,” said Hotez, the dean of the National School of Tropical Medicine at the Baylor College of Medicine in Houston and a vaccine developer.
Jackson County was designated a hotspot by researchers because it had more than 400 non-medical exemptions during the 2016-2017 school year.
Rex Archer, the director of the Kansas City Health Department, said that didn't mean the county has higher exemption rates than others in Missouri. It's just more populous than most.
But he said the county's 412 non-medical exemptions do create risk, and vaccine resistance played a role in the 13 measles cases in the outbreak that occurred on the Missouri side of the metro.
The study tracked how many people claimed non-medical exemptions from vaccine requirements in 18 states that allow people to opt out for philosophical reasons. Most states only allow exemptions on medical and religious grounds, and a couple don't allow any non-medical exemptions.
Missouri was unique among the 18 states in that it allows philosophical exemptions for kids in daycare but not schools. Once Missouri kids hit kindergarten, they either have to present proof of vaccination, a doctor's note saying they can't be vaccinated or a note from a parent saying they have a religious objection.
In the other states, philosophical exemptions are available for school-age kids as well.
Still, Missouri was one of 12 states where non-medical exemptions among kindergartners have risen since 2009.
The outbreak that sickened 22 people on the Kansas side was spread mostly among kids too young to be vaccinated in a Johnson County daycare.
Archer said Missouri should scrap its philosophical exemption for daycare kids of vaccination age, even if Kansas didn't prevent that outbreak by not allowing it.
Archer said he's not against religious exemptions, but he thinks most people aren't actually exercising them for religious reasons because few mainstream faith groups oppose vaccination. Instead, he said some people take religious exemptions because they think vaccines are unsafe.
He traced that sentiment to British physician Andrew Wakefield's debunked claim that the measles-mumps-rubella shot causes autism.
"Unfortunately, a researcher who was dishonest 20 years ago published a study that was sensational and tried to link certain conditions with vaccines," Archer said. "And that’s been universally rejected by every major medical body since then.”
State and national vaccination levels have not changed much in the last decade, but Hotez said his study shows vaccine resistance is prevalent in scattered communities across the country, leaving them vulnerable to infectious disease.
“It’s clear that Kansas City is one of the hotspot areas of the country where young children are not getting vaccinated," Hotez said, "and measles is often the first breakthrough infection we see because it’s so highly transmissible.”