Mississippi: Number One in Vaccinations

One silver lining of the furor over vaccinations associated with the current measles outbreak has been to allow a very unlikely story to be told in a web exclusive by Melissa Bass and Austin Vitale, a faculty member and student, respectively, at the University of Mississippi. That state, so accustomed to being last in almost everything good, is actually first in immunization rates for kids. Yep, number one.

As a poor, rural state in the hot, humid south, Mississippi historically has been more prone to infectious disease outbreaks than many other states and less prepared to address them through private-market health care. As a result, the state has a century-long history of public health efforts to combat the spread of communicable diseases, supported by the state health department and the state legislature.

In line with this history, when states began passing legislation in the early 1970s requiring children to be vaccinated before attending school, Mississippi passed a particularly strong law: it required children planning to attend public or private school to have the required vaccinations, allowed for medical exemptions only when the local health officer determined that the exemption would not cause undue risk to the community, and had a strict religious exemption policy.

That strict religious exemption policy was actually turned into no religious exemption policy by the state courts, so there were few ways to get around immunization.

Mississippi backed its mandate with policies that made vaccinations available to all, regardless of income, race, or location. The head of the state’s Department of Health, Alton Cobb, made vaccination accessibility a top priority, and he held his post for 20 years, from 1973 to 1993.

This history largely accounts for Mississippi’s – and to a large degree West Virginia’s – high kindergarten vaccination rates. But West Virginia’s immunization rate for younger children is among the nation’s lowest, and Mississippi’s again the highest. Here Mississippi again built on past policies, expanding the state’s vaccination commitment to infants and toddlers. In 1994, the state legislature passed the Mississippi Child Immunization Act, which directed the state health department to “focus on children receiving all recommended immunizations by twenty-four (24) months of age.” The legislation required the department to “improve parent compliance,” and took as hard a stance against doctors’ discretion as parents’: it specifically states that “The administration of vaccine shall not be delayed due to a reluctance of the health-care provider to administer multiple immunizations in a visit.” The Act also charged the health department with creating a statewide childhood immunization registry.

Luckily for Mississippi, this strong policy was put into place and implemented before the dubious “research” appeared linking vaccines to autism, which gave a big impetus to anti-vaxxer sentiment. And despite many efforts, mostly from the state’s powerful religious conservatives, to weaken the mandate, it stands. That’s very encouraging.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.