SPOKANE, Wash. — Spokane is one of 14 "anti-vaccine hotspots” around the United States, according to a June 2018 study from the Public Library of Science (PLOS).

The PLOS is a science and medicine publisher and advocacy organization. Its examination of so-called "hotspots" breaks down data by counties, including Spokane County and King County in western Washington.

Seattle and Portland, Oregon, also made the list of “anti-vaccine hotspots." Other cities listed include Salt Lake City, Utah; Provo, Utah; Phoenix, Arizona; Troy, Michigan; Warren, Michigan; Detroit, Michigan; Kansas City, Missouri; and Fort Worth, Houston and Plano, Texas.

“Several US ‘hotspot’ metropolitan areas stand out for their very large numbers of nonmedical exemptions (NMEs),” the PLOS writes. “Additional smaller counties – especially in ID, WI, and UT – also stand out for their high exemption rates.”

The PLOS examined total numbers of kindergartners with NMEs per county to identify areas with large numbers of “potentially vulnerable pediatric populations.” These totals were also provided by state health departments.

“The high numbers of NMEs in these densely populated urban centers suggest that outbreaks of vaccine-preventable diseases could either originate from or spread rapidly throughout these populations of unimmunized, unprotected children,” the PLOS writes.

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According to the PLOS, the number of “philosophical-belief” NMEs has risen since 2009 in 12 of the 18 states that allow the policy, including Idaho and Oregon.

Idaho had an abundance of counties with the highest NME rates from 2015 to 2016, according to the PLOS. The NME rate was nearly 15 percent in Kootenai and Boundary Counties and nearly 20 percent in Bonner County.  

The state of Washington had a 90.5 percent measles, mumps and rubella (MMR) vaccination rate from 2016-2017, according to the PLOS. Nonmedical exemptions for that time frame sat at 4 percent. These numbers are out of 87,142 children enrolled in kindergarten.

The PLOS also analyzed the relationship between NME rates and vaccine coverage and found an inverse relationship between NME rate and MMR vaccine coverage in kindergartners. This indicates that states with higher overall NME rates have lower MMR vaccine coverage, according to the PLOS.

Vaccination data for Spokane Public Schools 

There are more than 2,500 students in Spokane Public Schools that have not been vaccinated against measles, according to spokesperson Brian Coddington. For reference, there are 31,904 students enrolled in Spokane public schools, meaning that about 8 percent of students have not received the vaccine.

RELATED: More than 2,500 Spokane students have not received measles vaccine

In addition to the number of students who haven’t received the MMR vaccine, there are currently 1,338 non-compliant students, meaning they have not provided record of their vaccinations and have not applied for an accepted religious or personal exemption, Coddington said.

This is up from Sept. 2017 where the number of non-compliant individuals sat much lower at 884 students or 3 percent of the total student body, according to numbers provided to KREM by Coddington.

At last check, there were more than 41 cases of measles western Washington and Oregon. There are at least 15 additional suspected cases.

Spokane Regional Health District is already preparing for the possibility that the outbreak could spread beyond the Cascades and into eastern Washington. Gov. Jay Inslee recently declared a state of emergency in all counties in response to the outbreak.

RELATED: WA measles outbreak could spread; Spokane health district warns of 'recipe for disaster'

SRHD spokesperson Kim Papich said the health district has both outbreak management and risk assessment plans in place. If cases begin to cross the Cascades, the health district would activate its incident command in the area. This allows the health district to place individuals in different roles, begin epidemiology investigations, and send documents to parents and schools.

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