Good afternoon, everyone.

Uh this is Councilmember Tue with the community health and safety council committee meeting, kind of making some echo there.

Uh I have council members Weir and Bader this evening for our meeting.

And tonight we have one main agenda item, which is the Snohomish County Health Department.

We have a guest presentation tonight.

And so I'd like to introduce James Lewis, a Snahomish County Health Officer, uh, with the presentation.

So, James, thank you very much for being here.

Yes, thanks for having me.

Let me get the is this a good distance from the microphone here.

Okay, great.

Let me get the slides shared.

One minute.

Get it to presentation mode.

Okay.

All right, that looks right.

So uh I know the request was to talk about uh vaccines in general, but I thought since we've recently had a measles outbreak, which is one of the more prominent vaccine preventable diseases uh that has actually gotten national attention is directly connected to the large outbreak that's been, you know, in the national news for weeks now in South Carolina, that that would be a good way to highlight this issue uh and the potential impacts and real impacts that have already happened here.

So that's uh the approach I'm gonna take, but happy to talk about you know vaccine preventable diseases and immunizations more broadly with any questions if if folks want to at the end.

So uh let's just talk a little bit about measles.

It's one of the most contagious diseases on the planet.

Uh its presence spreads through respiratory droplets.

So kind of like COVID, we learned a lot during COVID about that, but also tuberculosis, you may have heard uh these these diseases are airborne and they're really small droplets, so they can hang around in the air for a really long period of time.

They like to float and they take a really long time to settle.

So that means they can remain up in the air for two hours.

So if I was infected with measles right now, and I come in here and I'm coughing or heavy breathing, sneezing, whatever in the room, uh, anybody who comes in this room two hours after I left is potentially at risk of being exposed.

Uh, and and it's also because of how infectious it is.

So you can see this this figure we have up on the table.

Uh, nine out of 10 people that would be in this room with me at that point would, if they were susceptible, meaning not immune previously or had not been infected previously, uh, would end up getting infected with measles.

So it's very infectious.

Um and uh typical symptoms are cough, runny nose, high fever, red and watery eyes, and then there's a characteristic rash that comes.

That's kind of the classic illness, but there can be severe complications, including uh meningitis, encephalitis, uh, severe pneumonia and uh and and death can occur.

So uh one out of every thousand people will develop that brain swelling or encephalitis symptom, which can cause permanent damage subsequently, and then one uh to three of every 1,000 people with measles will end up dying.

And we did see our numbers consistent with that last year with three deaths nationally and uh just over 2,000 uh cases uh in 2025.

Um then roughly one in five people will get hospitalized, even if they don't have these severe subsequent comp complications.

But that does take up a hospital bed and and um pediatric hospital beds in particular are our precious resource.

Uh and that's the group that's mostly been impacted, which we'll talk more about in a little bit.

So uh I don't know how much I need to explain this to the group here, but uh why are vaccines so important?

So in the case of MMR vaccine, two shots of MMR vaccine are 97% effective.

So that essentially means if you have an MMR, we you don't need to worry about measles, uh, even if there's an outbreak, you know, in your town, uh, it's not going to impact you.

But you may have members in your household who uh are not yet able to be immunized or have chosen not to be immunized for some reason.

And those people are at very real risk, no matter what age they are.

You know, we think about children often uh being most characteristically impacted by measles, but uh, we've seen uh adult cases here.

In fact, in early 2025, we had a secondary case related to a case uh that came in from King County at a clinic.

Person got infected there and they were an adult.

And they got pretty sick.

Luckily, you know, they uh they were hospitalized briefly, but luckily they they didn't have severe outcomes after that.

But but anybody at any age can get significant illness from from measles.

So uh over the last half century, it's estimated 154 million deaths, uh, which is what's stated here on the slide, have been prevented across the globe thanks to vaccines.

And that's all vaccines, including polio measles, hepatitis B, uh, and about two-thirds of the lives saved were under five years old.

So we're talking about, you know, extremely premature deaths that would have otherwise occurred if it hadn't been for us administering vaccines.

Uh, but unfortunately, even though you know that that statistic is pretty staggering in my opinion, uh, vaccine preventable diseases like measles are on the rise as vaccination rates decline.

And uh you might not think that we in Washington would be at risk for this, but we'll show you some data in a minute showing that even though we're still doing okay, unfortunately, there's a real steady trend towards decreasing immunization uptake, even here in Washington.

So uh, and the this is just illustrating what I mentioned about the increasing incidence of measles.

So this slide goes all the way back to about the year 2000.

Uh, and you can see here in the in the further right part of the graph, uh, we're seeing almost a doubling of measles cases every you know five years or so here in this country, uh, with 2025 being a banner year and in the most cases this country had seen since the 90s, uh since we attained elimination status.

And in 2026, we're almost halfway to as many cases as, in fact, we we are halfway to as many cases now.

Uh the state is lagging behind uh that we had all year last year, and you know, we're barely through February at this point.

So we will almost certainly surpass the number of cases we saw uh in 2025 this year.

So this is the slide I was mentioning that shows our kind of steadily, slowly but steadily declining immunization uptake.

And this this talks about you know all of the major childhood immunizations, routine childhood immunizations with the different colors.

But since we're talking about measles, if you take a look at this um uh dark green line, it's kind of covered up here by this brown line.