Measles is on the Rise - UCLA is Vulnerable
BY OMAR SAID
ART BY EMILY DEMBINSKI
Five cases of measles broke out in Los Angeles County in April.
Urgent messages were sent to 125 UCLA students, asking them to submit to being quarantined. Students were shuffled into a building with metal panels sealing the doors. In the middle of UCLA’s midterm exam season, students hunched over their computers, frantically searching for medical documents.
Measles isn’t like most diseases. It lingers in the air for up to two hours after a person who is infected leaves a room, potentially exposing anyone who breathes the same air, according to the Centers for Disease Control and Prevention. The symptoms start with a red blotchy rash and high fever, but can morph into pneumonia and brain swelling, both of which can be fatal. Add the fact that individuals are contagious for four days before the appearance of a rash, and it’s easy to understand why the disease is so dangerous.
April’s outbreak affected more than just UCLA. Of Los Angeles’ five measles cases, only one was a UCLA student. Ultimately, LA County had 20 measles cases in 2019, with 2,500 potentially exposed to the disease.
Ultimately, the spread of measles was quelled, but the outbreak showed cracks in UCLA’s immunization policies and emergency response to life-threatening outbreaks.
Officially, 843 students were potentially exposed to measles in April.
UCLA officials examined students’ schedules to find who would have been in the building on the days the student who was infected came to campus. While UCLA eventually determined that 718 of the 843 exposed students were vaccinated, the university didn’t have records for the rest.
But those numbers don’t account for casual passersby.
Boelter Hall, one of the buildings that was infected, is home to the popular SEAS Café, a coffeehouse that, given its cash-only nature, doesn’t keep records of its clientele. Any one of those customers could have been infected, becoming an unofficial and unlogged host for the disease to continue spreading throughout UCLA’s population.
Franz Hall, the other building that was infected, is home to UCLA’s psychology department, where volunteer test subjects frequently come to participate in studies. Any one of those subjects – many of whom aren’t necessarily students and don’t have vaccination requirements – could have been unvaccinated against measles.
(Emily Dembinski)
The students who lived in the dorms and were exposed to the virus were quarantined in Bradley Hall, and separated into two groups based only on gender, but not sequestered individually – potentially exposing students to measles a second time.
Additionally, while student accommodations included mattresses, food and televisions, the university sent proctors to the quarantined area so students could continue to take exams – because the only thing better than being thrown into a room with lingering measles virus is getting to take a midterm while it happens.
For the remaining students who lived off campus, Dean of Students Maria Blandizzi sent out a cryptic text message. It was vague and rife with contradictions – it told students they couldn’t leave their apartments, but also requested they make the trek to the Arthur Ashe Student Health and Wellness Center for a blood test.
Students were forced to choose their own interpretation of the message – either isolating themselves or leaving their apartments to walk through one of the busiest parts of campus to reach the Ashe Center. The cherry on top? The Ashe Center was closed when the message was sent.
Blandizzi’s original text message was additionally unclear regarding what students with roommates should do. The text told students they couldn’t stay in their apartments if they had roommates, but that was all. There was no clarification whether sharing an apartment but not a room with someone qualified, nor did the message indicate how long the quarantine would last. More importantly, it didn’t tell those students who felt they couldn’t isolate themselves in their apartments where to go, what to do or who to call for answers.
A student who misunderstood the order could have spread the disease further if they had just walked into their kitchen for water or answered the door to accept a package.
Ricardo Vazquez, a UCLA spokesperson, said at the time, off-campus students were directed to isolate themselves and if they couldn’t, they were invited to come to the official campus quarantine facility.
But Blandizzi’s original message contained no such invitation, and the order to isolate was a directive no one was enforcing. Students’ apartments weren’t sealed, and they could come and go as they pleased.
The university ultimately required only 39 of the 125 students – those who were living in the dorms – to quarantine themselves in UCLA’s designated isolation center.
(Emily Dembinski)
It turns out the vaccination forms UCLA students once meticulously filled out aren’t as binding as they seemed.
The university made it clear through emails and explanations on its website that students who didn’t submit their vaccination records may be subject to enrollment holds, preventing them from registering for classes. But the university didn’t actually place any holds – the vaccination requirement wasn’t being enforced.
The University of California passed new systemwide vaccination requirements in 2015, following a series of measles outbreaks throughout the country. The policies themselves make sense. By requiring vaccination of all students except those with medical exceptions, the UC could guarantee herd immunity – stopping a disease’s spread by decreasing the number of vulnerable potential hosts – at each of its 10 campuses.
Because vaccinating and collecting records from hundreds of thousands of students is such a large undertaking, the requirements were designed to be gradually implemented over three years, starting with education in 2015, then requiring students to upload vaccination records in 2016 before finally enforcing the regulation on students entering the UC in fall 2017. Amid backlash from those who felt the policy infringed their rights, UC delayed the enforcement for a year, to 2018.
Students who arrived at UCLA before fall 2018 didn’t have to fill out their vaccination records to attend. The policy encouraged students to upload those records, and students were made to think that uploading those records was mandatory.
Meanwhile, those who didn’t realize or ignored the requirements were allowed to remain as students and register for classes, without having holds placed on their accounts. According to Vazquez, this is because the policy took time to enact – a poor excuse for a university system boasting some of the country’s best health care systems.
As of fall 2018, incoming unvaccinated students have enrollment holds placed on their accounts, Vazquez said. But that still means that as it stands now, over half of UCLA’s undergraduates – effectively UCLA’s third and fourth years – may still be missing vaccinations.
To make matters worse, with the exception of a few types of staff, like health care and preschool workers, UCLA employees do not have any vaccination requirements, Vazquez said. An unvaccinated professor could easily have contracted measles by being in the same lecture hall as a student who was infected. That professor could go on to infect other students in each of their classes, who would go on to infect even more people.
That’s the problem with measles. It’s intensely contagious, and the tightly packed nature of a college campus only amplifies its ability to spread, given the shared use of so many spaces. UCLA’s campus is 419 acres – the smallest of any undergraduate-serving UC – and it is home to about 46,000 graduate and undergraduate students. Add UCLA’s approximately 36,000 nonstudent staff members, and the campus population is near 82,000 people – the largest of any UC.
Despite the high number of potential carriers, Vazquez said the majority of UCLA’s students are vaccinated, which is why the April outbreak didn’t spread past the original student.
But, unfortunately, it turns out that when it comes to vaccination, anything less than near perfection just isn’t enough. Timothy Brewer, a professor of medicine at the UCLA Fielding School of Public Health, said in order for a population to have herd immunity to measles, 95% of it must be vaccinated.
“Because measles is so contagious, it can spread so easily that you really need to consistently keep people vaccinated at rates higher than 95%,” Brewer said. “You fall much below that, you’re at risk for measles outbreak.”
Even vaccinating 80% of a population’s members is too low – no more than 5% can be unvaccinated at maximum, Brewer said.
Once those details are in the Ashe Center’s system, the university can sort students by vaccination status and produce reports. This should give UCLA the ability to determine how many students are currently unvaccinated against measles, but UCLA could not provide the exact number of students without their measles vaccines as of Oct. 25.
While UCLA still doesn’t have the exact numbers months later, about 7,500 students were missing vaccination records for measles in May after the outbreak.
These students who were missing vaccination records aren’t 5% of UCLA’s total population – they account for around 9%.
The real vaccination rates are likely even more drastic, considering UCLA employees’ lack of vaccination requirements. Looking only at undergraduate students, those 7,500 are about 24% of the population, an even more alarming statistic that shows UCLA’s herd immunity is basically nonexistent.
Despite what it might think, UCLA doesn’t qualify as a largely vaccinated campus.
Protecting a population from disease isn’t easy, especially when some members of that population feel like vaccines are inherently dangerous. Brewer said despite 10% to 15% of the population doubting vaccines’ safety, there are large amounts of evidence showing vaccines are safe, and that the consequences of getting a vaccine-preventable disease are far worse than the risks of vaccination.
Choosing not to get vaccinated decreases herd immunity and puts people who have medical exemptions – such as allergies to vaccines or conditions that prevent them from receiving it – at further risk of exposure than they already are.
This is an increasing issue, as infectious diseases might be back on the rise in America. Diseases are now stronger, with increased antibiotic resistance, and they persist for longer, such as in the case of the 2018 to 2019 flu season, which was the longest in a decade, according to the CDC’s annual report.
UCLA’s response may have been effective this time in keeping the disease from spreading past the first host. But if just a few more things had gone wrong, the outcome might have been completely different.
Perfection is undoubtedly difficult on such a large scale, but with the lives of around 80,000 people in its hands, UCLA should be up to the task.
