When epidemiologist Sophia Newcomer tries to evaluate how well Montana might be able to ward off the measles outbreak spreading across the U.S., she doesn\u2019t have much data to work with. <\/p>\n
A federal state-by-state survey<\/a> last year showed that just over 86% of Montana\u2019s 2-year-olds had recently received the measles, mumps, and rubella immunization. That figure has decreased in recent years, according to earlier surveys, and Newcomer, an associate professor<\/a> at the University of Montana, said the latest rate is \u201cwell below\u201d the ideal 95% threshold for community protection against highly contagious diseases.<\/p>\n But beyond that statewide estimate, information about Montana\u2019s local and regional immunization trends is hard to come by. State officials no longer collect aggregated vaccination reports from schools and child care centers, or the included data about medical and religious exemptions. The administration of Republican Gov. Greg Gianforte discontinued the practice after he signed a 2021 bill<\/a> striking the requirement.<\/p>\n The last of the localized reports were from the 2018-19 school year, before the disruptions of covid-19. Without the information, Newcomer said, local and state officials have struggled to strategically prevent the spread of vaccine-preventable disease.<\/p>\n \u201cState averages are helpful, but really drilling down to county level or smaller geographic levels are really what we need to assess risk of outbreaks,\u201d she said.<\/p>\n Montana is the only state that no longer collects immunization reports from local schools, creating a data gap for the Centers for Disease Control and Prevention. The information shortage also affects city and county health officials who may not have their own data-sharing agreements with school districts.<\/p>\n Supporters of the 2021 measure to stop collecting data said they were aiming to protect students\u2019 personally identifiable information and medical records and did not intend to cancel the reporting system in its entirety.<\/p>\n \u201cI wasn\u2019t trying to bomb the system. I was just trying to make sure children had their privacy respected,\u201d said Jennifer Carlson, a former Republican legislator and the sponsor of the bill the state health department cites as the reason for discontinuing the data collection.<\/p>\n State lawmakers are considering a bill<\/a> to undo the 2021 policy, while keeping privacy protections for individual student records. After stalling earlier this session, the Democratic-sponsored HB 364<\/a> advanced in March with bipartisan support, clearing the House with a 66-31 vote.<\/p>\n The bill, sponsored by Democratic Rep. Melody Cunningham<\/a>, has also received support from the state health department, an agency within the Gianforte administration.<\/p>\n Republican Rep. John Fitzpatrick<\/a> said that he believes the bill is good policy for the state.<\/p>\n \u201cIt\u2019s important that public health authorities have access to aggregate information so they can track where vaccinations are not being used,\u201d he said.<\/p>\n Montana hasn\u2019t confirmed a case of measles since 1990<\/a>. But with more than 480 cases reported<\/a> across Texas, New Mexico, and 17 other states, one child confirmed to have died from the disease, and another death under investigation, Newcomer said she and other disease experts are \u201con edge\u201d about Montana\u2019s defenses. Three cases have been confirmed in March south of Calgary, in the Canadian province of Alberta, which shares a border with Montana.<\/p>\n \u201cI like to say that when vaccination rates drop in a community, it is not a question of if. It\u2019s a question of when measles is going to come, because it is so incredibly contagious,\u201d said David Higgins, a pediatrician and researcher at the University of Colorado Anschutz Medical Campus.<\/p>\n Higgins used to work in Montana when the law requiring schools and state officials to share data was still in place. He said he\u2019s disappointed in the 2021 rollback, given how outbreaks begin at the hyperlocal level.<\/p>\n \u201cWhen community leaders don\u2019t have a good understanding of the local level of vaccination and community immunity, that\u2019s a significant challenge,\u201d Higgins said. \u201cThey\u2019re hamstrung without having that data readily available.\u201d<\/p>\n Measles is one of the world\u2019s most contagious diseases, according to the World Health Organization<\/a>, much more so than covid. It can be very dangerous, especially for infants and children under 5 who have not completed the two-dose vaccination series. Infectious particles can hang in the air and on surfaces for up to two hours. People carrying the virus can spread it up to four days before they begin showing symptoms.<\/p>\n \u201cIf we do have a measles case arrive in Montana, and particularly if it arrives in a community that has low vaccination coverage, we\u2019re going to see spread over like a multi-week or even multi-month period,\u201d Newcomer said. \u201cSo an unvaccinated person can get sick simply by going into a school, store, or home where someone infected with measles recently was.\u201d<\/p>\n The infection can have short-term and long-term consequences for people who are not immunized, including encephalitis, pneumonia, deafness, blindness, and death. State and community health departments have been advertising free MMR vaccinations at clinics throughout the state for anyone who needs them.<\/p>\n While HB 364 is aimed at increasing data collection, other vaccine measures in the state legislature are advancing that would make it easier for children to be exempted from standard immunizations required to attend schools or child care centers.<\/p>\n A recent version of SB 474<\/a>, which has been amended several times, would create an \u201cinformed consent\u201d exemption in which a parent or guardian could decline immunizations for school-age children without stating a reason.<\/p>\n Supporters of the bill said that some families struggle to receive exemptions on the grounds of religious beliefs or medical causes and want broader flexibility to opt out of requisite vaccinations against measles and other infectious diseases, such as pertussis. According to Montana\u2019s most recent reporting, from the 2018-19 school year, roughly 3% of children in public schools had a religious or medical exemption.<\/p>\n SB 474 also would strike another part of state law that allows schools and day cares to deny admission to children because they are unvaccinated, an exemption included in a 2021 law aimed at protecting unvaccinated people from discrimination. The lawmaker sponsoring the current bill called the carve-out for schools and day cares an \u201caberration\u201d in Montana law.<\/p>\n \u201cThere\u2019s no reason that they should be discriminating based on vaccine status,\u201d Republican Sen. Daniel Emrich<\/a> said during a March debate on the Senate floor.<\/p>\n Emrich and others framed the bill as enabling individual decision-making around vaccinations based on how well a parent knows their own child.<\/p>\n \u201cVaccines are pretty effective,\u201d Emrich said. \u201cIf you\u2019re concerned about unvaccinated children, you have the option to get your kid a vaccine to protect them in whatever way you want. This bill is really about choice.\u201d<\/p>\n During the debate, opponents of the bill contended that the lower Montana\u2019s overall immunization rate drops, the more at risk many community members are, including those who, because of age or medical issues, can\u2019t be vaccinated.<\/p>\n Sen. Cora Neumann<\/a>, a Democrat representing Bozeman, said that vaccinated Montanans, including children, are acting as \u201cshields\u201d against contagious diseases like measles and pertussis. But if vaccination rates continue to drop, Neumann said, that protection will only get weaker.<\/p>\n \u201cWe just saw a kid die of measles [in Texas]. It\u2019s going to continue, and it is going to be scary. It is going to be deadly,\u201d Neumann said. \u201cIt feels like a luxury right now. We can choose. It is not going to be if we continue down this path.\u201d<\/p>\n The bill passed the state Senate on a 28-21 vote. It is now under consideration in the House.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n