The Poorest State in America Ranks No. 1 When It Comes to Vaccines

Mississippi has taken an aggressive stance on vaccination, barring parents from avoiding vaccinating kids because of philosophical exemptions.

(Photo: Joe Readle/Getty Images)

Feb 4, 2015· 2 MIN READ
Hayley Fox is a regular contributor to TakePart who has covered breaking news and the occasional animal story for public radio station KPCC in Los Angeles.

It’s an unfortunate reality: Mississippi regularly ranks last in a lot of things—lowest education rate, highest poverty rate, and a lack of LGBT equality.

Yet, the state is coming up a winner in one unlikely category: It is completely measles free, despite a national surge that has infected more than 100 people in 14 states this year.

At least in part, that’s thanks to the fact that Mississippi has the highest vaccination rate for school-age children in the country. Kids in Mississippi may have a better chance of avoiding diseases such as the measles because it’s one of only two states—along with West Virginia—that doesn’t allow parents to refuse vaccinations because of personal philosophies or religious beliefs. In Mississippi, children can’t enroll in school until their immunizations are up-to-date.

In the 2013–2014 school year, 99.7 percent of Mississippi kids entering kindergarten were vaccinated, according to data from the Centers for Disease Control and Prevention. That’s a few points higher than the national median vaccination rate of 94.7 percent.

“If the [immunization] rates are higher, you have a much less chance of having an outbreak,” said Mobeen Rathore, chief of pediatric infectious diseases and immunology at Wolfson Children’s Hospital in Jacksonville, Florida.

If a critical portion of a community is immunized against a certain contagious disease, there’s little opportunity for outbreak, experts say. Even people who aren’t vaccinated receive some level of protection, because the disease is contained.

In Mississippi and West Virginia, the only reason parents can refuse to vaccinate their kids is if the child has a legitimate medical condition that precludes it. These situations are rare but may include children with a severe immune deficiency or HIV/AIDS, for example, said Rathore.

Mississippi and West Virginia are not without their challenges. The two states are consistently ranked as among the poorest in the country, with large rural populations that may face limited access to medical services. An outbreak in a small, isolated community could be deadly and damaging. To prevent that, the Mississippi State Department of Health has developed its own Vaccines for Children Program that works with rural health centers and others to provide free immunizations for kids up to the age of 18.

Mississippi and West Virginia are in the vaccination minority though, with most states allowing parents to cite “sincere religious beliefs” to opt out of vaccinating their child. As a Muslim, Rathore says he understands this compulsion. Up until recently, the meningitis vaccine contained a gelatin made from pigs, which violates his religious beliefs. Still, he would have administered the immunization to his child. “If you don’t have an option you use what you have, because you want to protect your children,” he said.

In addition to the religious exemption, 20 states, including California, Texas, and Oregon, have a “philosophical” exemption, according to the National Conference of State Legislatures. This permits parents to avoid vaccination if it contradicts their personal or moral beliefs. In California, this is the most common reason parents refuse vaccines—and about 90 percent of kindergarteners overall were vaccinated heading into this school year, according to state health officials. California also happens to be where “the happiest place on earth” became ground zero for this year’s measles outbreak at Disneyland.

“A vast majority of [those affected] were unimmunized children,” said Rathore. “I think absolutely if the children were immunized they would have been protected.”

Measles often takes seven to 10 days to manifest symptoms and can cause fever, a hacking cough, lack of appetite, and then a full-body rash. The worst cases cause brain swelling and death.

The outbreak in California has spawned an outpouring of testimony from the medical community, pleading with parents to get their kids vaccinated. If you haven’t received the vaccination and come in contact with an infected person, you have a 90 percent chance of contracting measles, said Sandra G. Hassink of the American Academy of Pediatrics in a statement. When measles was more common in the U.S., it claimed hundreds of children’s lives each year, she added.

“The fact that this disease has resurfaced for the first time in more than a decade has prompted pediatricians to reiterate the same recommendation to parents that we’ve made for decades with renewed urgency: Vaccines work,” Hassink said.

The popularity of vaccines in the U.S. remains in flux, as California lawmakers are now pushing for tighter vaccination requirements in the Golden State while a parent group in Mississippi supports less-stringent requirements and more exemptions.

Until a disease is completely eradicated, said Rathore, there is a huge danger of it returning, especially without proper vaccination.