BY: MORGAN CHILSON
Kansas Reflector
TOPEKA — Five of the six southwest Kansas counties reporting measles cases have seen kindergarten vaccination rates drop, one showing a 24 percentage point dip over a four-year period.
Vaccination rates are one focus of many Kansas county health officers and medical experts as they work to educate against misinformation about vaccines in the hopes of staving off a growing measles outbreak. As of April 2, Kansas has 24 confirmed measles cases in Grant, Gray, Haskell, Kiowa, Morton and Stevens counties, with one case added in the last week.
For herd immunity to be achieved — the point where enough people are vaccinated that those who are unvaccinated will be protected — 95% of a population must be vaccinated against measles, according to the World Health Organization. The Kansas measles immunization rate of kindergarteners dropped from 94.47% in 2019 to 90.21% in 2023, Kansas Department of Health and Environment data shows.
Jennifer Bacani McKenney, a family physician and county health officer in Wilson County, said she saw vaccine hesitancy increase after the COVID-19 pandemic.
“COVID made it more OK for people to decline vaccines for themselves and for children,” she said.
The idea, though, that some counties are seeing kindergarten vaccination rates drop — such as Gray County, where the rate declined from 85% in 2019 to 61% in 2023 — is concerning, Bacani McKenney said.
“When we’re getting to those points when barely the majority are vaccinated, that’s when these diseases have a chance to come back,” she said. “We know vaccines work. Polio is still probably the No. 1 example. For the longest time, so was measles, and now we’re at the point where we can’t use measles as an example.
“We are very voluntarily not protecting ourselves against a very preventable illness,” Bacani McKenney said. “The people who are suffering are really not us adults. It’s going to be our children.”
Haskell County also hit a double-digit drop in vaccination rates, with 21% fewer kindergarteners being vaccinated over that same four-year period.
Vaccinations are required for school in Kansas unless there is a religious or medical exemption. KDHE and the Kansas State Department of Education track the percentage of kindergarteners who have vaccine exemptions, and those rates are increasing too — in Haskell County from 11% in 2019 to over 25% in 2023 and in Gray County jumping from about 2% to 11%.
In Barton County, where kindergarten immunization rates dropped by nearly 7 percentage points from 2019 to 2023, Karen Winkelman, a registered nurse and director of the Barton County Health Department said she is receiving numerous questions from parents about vaccine safety. She said her team made the decision to be proactive once they heard that measles cases were reappearing nationwide.
Winkelman stresses having productive, positive conversations.
“We need to take a positive approach on this and hold down that hysteria,” she said. “We know this disease. We know the vaccine. We have something available for protection.”
It isn’t like the COVID-19 pandemic, she said, where the vaccine information changed frequently. They are disseminating information carefully, using only reliable sources, such as the Centers for Disease Control and Prevention, KDHE, the American Academy of Family Physicians and others.
“We are going with factual information. The more we can educate and provide the factual, the better it is,” Winkelman said. “We’re never going to be able to control on social media or in normal conversations what is being said. We just have to really focus on those organizations that are reliable and accurate.”
The Barton County Health Department is holding an immunization clinic from 10 a.m. to noon Saturday, outside of their regular business hours, to make sure staff is available to answer questions and offer vaccinations, Winkelman said.
“We’re not going to force anyone to get the vaccine,” she said. “I just want to have all of those things available to the public for them to make an educated decision. It might be a conversation with their primary care also.”
Stevens County, which was the first Kansas county to report a measles case on March 13, currently has had six measles cases. Cammie Heaton, administrator for the county’s health department, is taking the same approach as Barton County — educate and be available to answer questions.
“We’re actually, knock on wood, sitting better now than we were three weeks ago. We are hopeful that we aren’t going to have any more,” she said. “We’re still monitoring some susceptible individuals.”
Like Barton County, her staff have offered walk-in clinics for measles vaccinations or boosters. Stevens County, according to KDHE data, has seen its vaccination rate among kindergarteners drop by 14 percentage points, from 87% in 2019 to 73% in 2023.
All measles cases in Stevens County were in unvaccinated individuals, Heaton said.
Dana Hawkinson, an internal medicine and infectious disease physician, spoke about the measles outbreak at a recent University of Kansas Health System news briefing.
“I think people should be concerned, particularly if they’re in communities that have decreased vaccination rates,” he said. “Measles is probably the most infectious viral disease that we know of. It is spread through airborne means, so people will express it into the air when they cough or breathe. Measles can linger in the air in a room for two hours.”
Combatting misinformation about the disease is critical, Hawkinson said, pointing to social media algorithms that can play into the information people receive online. But there are other factors, as well.
“We know misinformation is significant but we can’t be myopic in thinking that is the only thing we need to understand,” he said. “There are other factors in play as well.”
Those include people seeking less medical care after the pandemic, states offering increased options for vaccine exemptions, significant mistrust of science and public health medicine, as well as mistrust of physicians, Hawkinson said.
“All of these things are playing a role now to increase the risk of an individual and a community against things like this which were otherwise vaccine preventable,” he said.