Gov. Josh Green on Tuesday urged the public to get vaccinated against measles after the discovery of a case Monday in a child under 5 on Oahu.
The governor also shared that his office has updated the rules regarding a religious exemption many people utilize to avoid vaccinations that contradict their religious or spiritual beliefs. Under the new rules, a person who has religious exemption from certain medical procedures may choose to receive the MMR (measles, mumps, and rubella) vaccine without losing their religious exemption status.
“Please, humbly, get the MMR vaccine,” Green said at the very beginning of his address and several times throughout the hearing. “That’s the way to stop the spread of measles, and that’s the way to avoid getting measles.”
Though measles was determined to be eradicated from the U.S. in 2000 through vaccinations, outbreaks on the mainland have been growing increasingly common every year since 2023, when four outbreaks were confirmed with 59 cases that year, followed by 16 outbreaks and 284 cases last year, according to the U.S. Centers for Disease Control and Prevention.
So far this year, the Oahu case joins 607 cases of the measles that have been found in 22 states, Green said. Two children in Texas have died from a measles outbreak in Gaines County, which has an 82% vaccination rate.
The case of measles discovered on Oahu on Monday night occurred in an unvaccinated child who had returned from international travel with their family. The DOH is doing a contact-tracing investigation to find any children or adults who night have been exposed to measles, and several locations and times were shared to alert the public of possible exposure.
The DOH said anyone who might have been at the C gates, customs and baggage claim area of Honolulu’s Daniel K. Inouye International Airport on March 30 between 10:50 a.m. and 2 p.m. could have been exposed to measles.
Another window of possible exposure at the Honolulu airport is from 1 p.m. to 7 p.m. on April 4 at Terminal 2 departure gates, TSA checkpoints, and the gate area from Delta flight 309 to Atlanta.
The MMR vaccine has proven to be 97% effective in preventing measles in infants, children and adults who receive the two-dose immunization. A community with a 95% average vaccination rate is determined to have herd immunity, but the current rate for the entire state is about 90%, the DOH said.
Big Island schools have vaccination rates between 70% to 81%, the department said, and schools on Maui and Kauai have vaccination rates between 42% to 81%.
“I’m not judging, but some communities vaccinate less, some people are more isolated,” Green said. “But the measles doesn’t discern whether you’re from a Mennonite community or a community in a rural part of Hawaii, or if you’re on a plane and you’re traveling to an international destination. If you’re not vaccinated, you will catch the measles.”
Statistically, 1 in 5 patients who are infected with measles will require hospitalization, and Green said it is urgent to control the spread of measles because, “if you had 5,000 cases … you would then have 1,000 hospitalizations, which cannot be accommodated for … statewide. Yes, vaccination is a personal choice, but it’s also a choice to protect your neighbors and your community.
“We also only have one children’s hospital in our state, so we’re being very, very mindful about how fast this can take over a community if we’re not careful,” Green said.
Dr. Nadine Tenn Salle, the clinical chief of pediatrics for The Queen’s Health Systems, also was at Tuesday’s press conference and said medical transport planes from the neighbor islands are already often full, meaning patients needing specialty care to treat measles would not be able to access the bigger hospitals as quickly as needed.
Green — a Big Island physician who helped perform emergency vaccinations of 37,000 people in two days during a deadly 2019 measles outbreak in Samoa that caused 5,000 cases and 83 deaths — spoke from experience about the high level of risk in under-vaccinated communities like the one he served in Ka‘u.
“If there’s an outbreak, it can overwhelm a community hospital very quickly,” Green said, adding that during his tenure as a doctor in Ka‘u, “as much as we tried, people were vaccine-hesitant.”
“I know this has been a big debate,” Green continued. “I know there are people who feel passionately about getting the vaccine … and other people who feel passionately about not getting vaccinated, and they have reasons, whether medical or religious. If someone asked for religious exemption and now wants to be vaccinated against the measles, you will be able to get it and maintain your religious exemption. We’re trying to be inclusive.”
People are encouraged to contact their health care providers if they were possibly exposed, and immediately upon feeling any of the symptoms of a measles infection. Though most infected patients show symptoms within seven to 14 days, it can take up to three weeks for them to present.
Symptoms include fever over 101 degrees, runny nose, watery red eyes, a cough and malaise. Spots also might be visible inside the mouth of an infected person, and three to five days after symptoms begin, the person likely will experience a rash on their face that then spreads to the body.
According to the DOH, people experiencing any symptoms should immediately isolate themselves and contact a health care provider. Sick individuals should not to go to clinic to determine if they have the measles, but instead are urged to discuss their condition with a professional over the phone.
Email Kyveli Diener at kdiener@hawaiitribune-herald.com.
