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As his mother Wenyi Zhang holds him, one-year-old Abel Zhang looks at the book being given him by Dr. Lauren Lawler, right, as his grandmother Ding Hong helps with his clothes moments after the child received the last of three inoculations, including a vaccine for measles, mumps, and rubella (MMR), at the International Community Health Services in Feb. 13, 2019, in Seattle.Elaine Thompson/The Associated Press

Certain pockets of British Columbia fall far short of the immunization coverage public health officials say ensures the best defence against serious diseases, and an outbreak across the border in Washington State should be a wake-up call.

There have been 54 measles cases reported in reported in Washington State this month, and on Wednesday B.C. health officials confirmed three cases of measles.

The B.C. cases are unrelated to those in Washington, but Monika Naus, medical director of communicable disease and immunization service at the B.C. Centre for Disease Control (BCCDC) said there’s a vulnerability in certain pockets of this province.

“I think we have geographic parts of this province where if we had the introduction of measles, we could easily have the kind of outcome that they are seeing in Clark County,” said Dr. Naus said in an interview on Thursday.

Measles are highly contagious and unvaccinated, young children are at highest risk. Complications from measles can include pneumonia and encephalitis, or inflammation of the brain. However, the Measles, Mumps and Rubella (MMR) vaccine is almost 100-per-cent effective if people are vaccinated properly, according to the BCCDC website. Children should typically be vaccinated at 12 months and for a second time between the ages of four to six.

To make it difficult for the disease to spread, MMR immunization coverage ­– the percentage of people who receive one or more vaccines in relation to the overall population – should be at 95 per cent.

However, vaccination data from 2017 data shows that 87.3 per cent of two-year olds received the first MMR vaccine in the province.

In Clark County – where 53 of the 54 measles outbreaks occurred – only 67.7 to 79.3 per cent of kindergartners completed their required immunizations in the 2017-2018 school year.

In 2014, a measles outbreak with over 400 cases occurred in the Fraser Valley, B.C. The area is one of several pockets in the province that have lower vaccination rates. Other under-vaccinated areas include the Gulf Islands and some communities in the Northern Health district, Sunshine Coast and Interior Health district, Dr. Naus said.

“When immunization rates drop as they have in some geographic areas, it’s easy for these things to transmit.” Dr. Naus said.

Tiffany Akins, communications leader at Vancouver Coastal Health (VCH), said the health authority has confirmed two cases and one of them was contracted locally. The other was infected abroad. A third case, reported by BCCDC, involved an adult traveller returning from the Philippines.

“What we would be more concerned about rather than the outbreak in Washington is the fact the illness has spread locally,” Ms. Akins said.

VCH has notified people who were in contact with the locally acquired case. The health authority is urging under-vaccinated or unvaccinated individuals among them to be immunized.

In Maple Ridge, mother of two Katie Clunn is petitioning for mandatory vaccinations (with medical exemptions) in public schools.

Parents who do not vaccinate their children would still have the choice to home-school them, she said.

“A few of my kids’ friends are immunocompromised, so they are at risk,” Ms. Clunn said. “That concerns me because I don’t just care about my own children, I care about other people as well."

The petition has nearly 2,000 signatures and Ms. Clunn says nearly all feedback she’s received is encouraging.

“We keep peanuts, dairy, eggs and wheat out of the kids’ classrooms to keep kids safe – why are we allowed to bring in measles and chicken pox and whooping cough?”