In Mississippi, strong vaccine laws keeping measles at bay
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* Kim Krisberg

In April, a traveler with measles visited Mississippi. But unlike two dozen other states this year, not a single person in Mississippi was infected with the highly contagious virus.

Thomas Dobbs, MD, MPH, state health officer at the Mississippi State Department of Health, attributed the prevention success to the state’s especially high immunization rates and its strong vaccine laws.

“For decades, the state health department has led a very strong immunization program, and we have a medical community here that really understands the value of protective immunizations,” Dobbs, an APHA member, told The Nation’s Health. “That’s in addition to our vaccine law, which is really the backstop to making sure we keep our (vaccination) rates high.”

Mississippi has some of the highest vaccination rates in the country, with more than 99% of school-age children in the state having received a full dose of the measles-mumps-rubella vaccine, according to the Centers for Disease Control and Prevention. In addition, more than 99% of Mississippi kindergartners have been immunized with the diphtheria-tetanus-pertussis and chickenpox vaccines.

Mississippi is also home to strict school-entry vaccine requirements, being one of only four states — along with California, Maine and West Virginia — to prohibit all non-medical vaccine exemptions.

“We’ve had some fortunate history here,” Dobbs said, referring to a 1979 court case that struck down religious exemptions to the state’s childhood vaccine laws.

Mississippi adopted its first compulsory vaccination law in 1900, adding a religious exemption in 1960. Almost 20 years later, in 1979, the religious exemption was challenged in court, with the plaintiff arguing that the state must expand the exemption to include any religion, not just religions officially recognized by the state. In response, the Mississippi Supreme Court struck down religious exemptions altogether, ruling that non-medical vaccine exemptions violate people’s constitutional right to equal protection under the law.

The decision was a big win for public health, but it certainly has not stopped attempts to water down Mississippi’s vaccine rules. Between 1998 and 2012, according to a 2016 analysis published in Health Affairs, 39 vaccine bills were introduced in the state’s Legislature, 25 of which proposed nonmedical exemptions. Just this year, a handful of vaccine bills were introduced, including three that would have allowed religious and philosophical exemptions for children and first responders, though none made it to the governor’s desk.

In response to anti-vaccine proposals and misinformation, Dobbs said “engaging with and understanding people’s concerns” is an important long-term strategy. But in the short-term, public health must stand firmly with the science.

“We should not have exemptions that aren’t based in science,” he told *The Nation’s Health.* “If someone has a medical exemption, that’s science. If someone doesn’t want a vaccine because they saw a scary video online, that’s not science…Our main effort must be the proper communication of science, facts and truth.”

U.S. measles cases have reached a 25-year high this year, with the Centers for Disease Control and Prevention reporting 971 cases as of May 30.

For more information on immunizations in Mississippi, visit [www.msdh.state.ms.us](http://www.msdh.state.ms.us).

*   Copyright The Nation’s Health, American Public Health Association