About 1,000 school-aged children in Kentucky, a little less than one percent, are exempt from being vaccinated for medical or religious reasons, but state officials say the Commonwealth remains well-protected from the measles.
Overall about 96.4 percent of school-aged children in Kentucky have been vaccinated, according to statistics from the Cabinet for Health and Family Services. While 981 school-aged children in Kentucky have exemptions, there are 3,060, or 2.7 percent more students who don't have the required paperwork on file to prove they have been vaccinated.
A parent or guardian must fill out a sworn statement to obtain a religious exemption. A licensed medical provider must sign a statement for the medical exemption.
Still, the state's overall rate of vaccination exceed standards for what is called "herd immunity," which, according the Centers for Disease Control and Prevention, is the point when a population reaches a certain level of vaccination — 90 to 95 percent of the total population — that makes it more difficult for a disease to spread.
Vaccination has been a hot topic in recent weeks after measles spread from Disneyland in California to 102 people in 14 states. The measles were effectively eliminated in 2000, according to the CDC, but last year the United States had, 644 cases in 27 states, the most since 2000.
There have been no reported cases of measles this year and Kentucky has not been directly affected by the outbreak tied to Disneyland, according to the state Department of Public Health.
Kentucky Sen. Rand Paul created controversy when he said recently that vaccination should be not be mandatory but voluntary. Paul, considered a presidential hopeful, backed away from the firestorm surrounding those comments on Tuesday when he rolled up his sleeve for a vaccination photo-op and declared his children had been vaccinated.
The official government line about vaccination is firm: They are safe and effective.
"Senator Paul sets policy," said Dr. Rice Leach, Lexington Fayette-County's Commissioner of Public Health, "I try to help people be healthy."
"As a public health physician I support the requirement that children be immunized against vaccine preventable diseases where the benefits far outweigh the risks," Leach said. "Measles vaccination is one of those situations where the benefit is far greater than the risk."
Leach, who will be 75 in April, said members of his generation remember vividly the impact of measles on their family and friends. As that trauma gains distance, people aren't as attuned to the risks of the disease, he said. It's not just the unvaccinated who are at risk from the disease, but also people like himself who have a suppressed immune system because of chronic illness. Leach is currently undergoing chemotherapy for a reoccurrence of cancer.
As a state with high rates of chronic illness, Kentucky has a large population of people at potential risk, Leach said.
According to the state Department of Public Health, measles is highly infectious and can lead to serious health complications, such as pneumonia or encephalitis, and even death. Children younger than five and adults older than 20 are at high risk of getting a serious case of measles. About one in four unvaccinated people who get measles will be hospitalized. About one in 500 may die.
If someone thinks they have the measles, they should seek medical attention, said Katie Myatt, epidemiology coordinator for Fayette County. If it appears measles is present, the health department must be notified within 24 hours. Then an investigation begins.
If there is a chance that the person has been infected with measles the health department will determine and notify those people who may have come in contact with the infected person shortly before the symptoms appeared. If a measles diagnosis is confirmed, she said, she and other health workers will call those with exposure and make sure they have access to proper medication.
Myatt, who has worked with the health department since 2011, said in her first month at her job she had a potential case of the measles which turned out to be something else. Measles outbreaks are rare in Kentucky, she said, but she understands why people are concerned.
"It is scary," she said.