These Are the Riskiest Cities and Counties For Infectious Disease Epidemics

Eighteen states allow parents to opt their children out of immunizations for non-medical reasons. And in those states, the high exemption rate is putting kids at risk for contracting and spreading vaccine-preventable pediatric diseases including whooping cough and measles.



A new study has identified pockets of vulnerability in two-thirds of those 18 states. Of the top 10 counties with the highest exemption rates, eight are in Idaho, according to findings, which were published in the journal PLOS Medicine on Tuesday.

The study also ranked urban areas and found 15 with the most exemptions including Seattle, Phoenix, Houston, Fort Worth, and Pittsburgh. Other metro areas with the most exemptions include Portland, Ore., Kansas City, and Salt Lake City and Provo, Utah.

Even though vaccines have been widely proven to be safe, parents forego childhood immunizations for a number of non-medical reasons such as religious or philosophical beliefs. Americans don’t trust vaccines as much as they used to, according to a recent report.

It’s important to note that actual vaccination rates have not dropped significantly. But opting out of immunizations reduces the benefits of so-called herd immunity, in which a large percentage of the population is immune and cannot contract or spread an infectious disease.

The study offers a more systemic look at what has been a known, growing problem, with county-specific data adding to state-level information. “We were able to identify some scary trends,” said one of the study’s authors, Peter Hotez, dean of the National School of Tropical Medicine at the Baylor College of Medicine.

Refusing vaccinations for a few children can have a domino effect on public health, with outbreaks of otherwise preventable disease occurring with renewed frequency. Ahead of this year’s Kentucky Derby, health officials in the Bluegrass State urged the public to get immunized amid a Hepatitis A outbreak. In Europe, measles cases have skyrocketed, with 35 reported deaths to the preventable disease in 2017 alone.

Despite concerns that anti-vax rhetoric will make immunization rates take a nosedive, over 80% of kids have had their vaccines for Haemophilus influenzae (which can cause pneumonia and acute bacterial meningitis in children), diphtheria, tetanus, pertussis, and pneumococcal infections. More than 90% of children under the age of 3 have been vaccinated against measles, mumps, rubella, hepatitis B, chickenpox, and polio.

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