When Matt Hogenauer walks the hallways at Falmouth High School, he wonders whether he is being exposed to preventable infectious diseases – a dangerous health risk for him that wouldn’t be a major concern if Maine didn’t have so many unvaccinated students.

“There’s the potential that all of these things would make me very sick,” said Hogenauer, a senior.

Hogenauer has non-rheumatoid arthritis, and the medications he takes to suppress his immune system make him vulnerable to infectious diseases like pertussis, measles, mumps and chickenpox.

Maine has one of the highest vaccination opt-out rates in the nation, as parents forgo school-required immunizations for their children, according to the U.S. Centers for Disease Control and Prevention. That means the state is susceptible to outbreaks of infectious diseases, and has the worst rate of pertussis – whooping cough – in the country.

On Wednesday, the Legislature’s education committee will hold a public hearing on a bill sponsored by Rep. Ryan Tipping, D-Orono, that would eliminate all non-medical exemptions to school-required vaccinations. If it’s approved, Maine will join California, West Virginia and Mississippi as the only states to do so.

Washington state and New York City are grappling with measles outbreaks caused by unvaccinated people spreading the infectious disease. Seventy-one people have so far fallen ill with measles in Washington, and 133 have been sickened in New York City, according to state and city health officials. In one private school in Brooklyn, one unvaccinated student infected at least 21 others with measles, The New York Times reported.

From Jan. 1 to Feb. 28 of this year, 206 cases of measles were reported in 11 states, from Washington to Connecticut, the Maine CDC said in a Friday. The last reported measles case in Maine was in 2017, the agency said, and the person who was infected had acquired the disease after traveling overseas.

“Measles is still common in many parts of the world, including countries in Europe, Asia, the Pacific, and Africa,” Maine CDC said in the statement. “People who are not vaccinated can contract measles while traveling, then bring it back to the U.S. and infect others who are unvaccinated.”

Meanwhile, Maine has the worst per capita rate of pertussis in the nation, with 446 cases in 2018, a rate that’s more than five times the national average. Through February, 95 pertussis cases were reported in Maine this year, tracking ahead of 2018.

Dr. Laura Blaisdell, a Yarmouth pediatrician, says the people who perpetuate scientific falsehoods about vaccines are “infuriating … and unfair.” Staff photo by Gabe Souza

Hogenauer will already be out of Maine schools by the time the bill would go into effect – he’s due to go into a pre-medicine program at Haverford College near Philadelphia this fall – but he said for the health benefits for other Maine students he’s become a strong advocate for the bill.

“I compare not getting vaccinated to drunk driving. You’re not only putting yourself at risk, but you could hurt others,” he said.

Hogenauer, 17, said he contracted pertussis in 2016, and he suspects – although he can’t prove it – that fellow students he knew were unvaccinated and spread the disease to him.

“That’s when the anti-vaccine movement became a real, tangible thing to me,” Hogenauer said. “I had a really nasty cough for two to three weeks.”

Hogenauer’s health depends heavily on “herd immunity,” which is the protection granted to the immune-compromised or children too young for vaccines. When nearly everyone is vaccinated, the diseases aren’t circulating as much, which means they have a much more difficult time spreading.

Some of Maine’s schools have reported dangerously low vaccination rates, compromising herd immunity. For some infectious diseases, herd immunity can be weakened if there’s less than 95 percent of students vaccinated.

The Maine CDC said 31 public elementary schools were reporting 15 percent or higher rates of unvaccinated kindergarten students in the 2017-18 school year, the latest year for which statistics were available.

In 2017-18, 5 percent of Maine children entering kindergarten – about 600 children statewide – had non-medical exemptions for immunizations, with their parents opting out on philosophic or religious grounds.

Dr. Laura Blaisdell, a Yarmouth pediatrician and advocate for vaccines, said immune-compromised people are not uncommon.

For instance, people who have had organ transplants, adults with cancer, diseases like lupus and arthritis and people who take long-term steroids all have potentially weakened immune systems. Even people with a common condition like asthma can be temporarily immune-compromised when they are taking certain medications.

“There are many individuals in our communities living in an immune-compromised state,” Blaisdell said. “If these preventable diseases are circulating, it is unsafe for them. It’s the same reason we don’t allow smoking in our schools because we’ve determined that’s not safe.”

Research has proven that vaccines are overwhelmingly safe and effective and have prevented millions of diseases and thousands of deaths in the United States since the 1950s, when the polio vaccine was first introduced. Vaccines for measles, mumps and other common diseases became available in the 1960s, while the chickenpox vaccine was introduced in the 1990s.

Myths that vaccines cause autism have been debunked, and 1998 research that claimed a link was withdrawn and retracted. A new study of 650,000 children in Denmark studied over a decade and released this March again showed no link between autism and vaccines.

Blaisdell said people perpetuating scientific falsehoods about vaccines are “infuriating, fundamentally unnecessary and unfair. The parents who are deciding not to vaccinate their children, for the most part, don’t have to deal with the consequences of their decisions,” she said.

Bre and Doug Sanderson of Kennebunk have a daughter, Ashley, who was immune-compromised as a kindergartner in 2015 when she was finishing chemotherapy treatments for leukemia. She had to be re-immunized for all preventable diseases.

Bre Sanderson, a nurse, said it was a harrowing time, knowing that Ashley would be vulnerable to chickenpox, measles and other diseases that could have resulted in hospitalization or even death. But they also believed it was important for Ashley to attend school, so they closely monitored her classroom for illnesses, and a few times kept her home if too many kids were ill.

No one in her class had chickenpox or measles, but there was one case of pertussis that year in the school. Ashley, now 9, has fully recovered from leukemia and is no longer immune-compromised.

“I feel very lucky it didn’t happen to us. It’s scary,” Bre Sanderson said. “Our child, regardless of her health, deserved an education. A school should be a safe zone for all kids.”

Tipping, the lawmaker sponsoring the bill, said he’s sensing momentum behind his measure, especially with the news of other infectious disease outbreaks in the Pacific Northwest and elsewhere.

“I’m hearing more from families and parents who want this (bill) to happen in Maine, seeing what’s happening to families in the Northwest. There is an urgency,” Tipping said.

Former Gov. Paul LePage vetoed a similar bill in 2015, and the Legislature came up a few votes short in a veto override attempt. Gov. Janet Mills has not said whether she supports Tipping’s bill, but in general she has been more supportive of public health efforts than her predecessor.

Hogenauer, the Falmouth High student, hopes to learn more about the immune system in his college premed studies. If he has to miss weeks of college by contracting an infectious disease, that could set back his schooling. But he hopes Maine and other states strengthen vaccine requirements.

“We should use the public schools as leverage to get as many to vaccinate as possible,” he said.

Joe Lawlor can be contacted at 791-6376 or at:

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