Northeast Ohio's total immunization rates are low, according to the latest data from a statewide database.
And that has Cuyahoga County's Vaccine Supervisor Cindy Modie worried.
"It is too low to prevent disease," Modie says.
In Cuyahoga County, 77 percent of public school kindergartners reported being fully immunized during the 2012-2013 school year. Eighty-five percent of children in first through 12th grade at those same schools report being fully vaccinated.
Not being fully vaccinated means children are lacking one or more of the series of shots that are recommended during the first years of life. That includes the combined MMR shot for Measles, Mumps and Rubella.
And Modie says the rates are not high enough to protect against highly contagious diseases like measles.
"If we're going to limit the conversation to measles, which is what is making headlines right now, we would need vaccine rates to be between 92 and 94 percent to prevent outbreaks," Modie says.
The rates are low, she says, because "parents are slack."
But she doesn't necessarily blame the parents. After all, she parents don't understand the ramifications of the diseases.
"They do not know what the disease looks like, they do not know someone who has had the disease, they do not know how bad it can be. They don't understand what the ramifications are of my child getting the measles," Modie says. "It's that simple."
Measles spreads rapidly through the air. Currently, there are outbreaks in nearby Chicago, Illinois as well as Pennsylvania. Since January 1, more than 140 individuals have reported measles in 17 states, according to the CDC.
Ohio had the biggest US measles outbreak in decades last year largely among the Amish communities living in the central part of the state. A total of 644 cases were reported.
As the outbreak grew last year, Amish families who suffered the measles or so others suffer reported in large numbers to emergency vaccination clinics arranged by county officials and the U.S. Centers for Disease Control and Prevention.
Modie says parents who know the disease would want their children vaccinated.
"They do not understand that there can be death," Modie says. "They do not understand that there can be brain death. They do not understand that there can be inflammations of the spinal cord and the brain. They do not understand that there can be pneumonia. They do not fear the disease because they don't know the disease.
In Cuyahoga County, vaccination rates are lowest among public school children. The private schools report kindergarten vaccination rates of 91.5 percent and first through 12th grade rates at 91.48 percent. The data shows full vaccination rates as well as the rates of those who requested medical as well as religious and philosophical exemptions.
"Measles is always your marker," Modie says. "If we outbreaks of measles that's telling us that our community is not well enough vaccinated."
Ohio is also currently the only state in the nationwide without minimum vaccination requirements for attending a preschool or day care.
That will soon change, however, House Bill 394 was signed on December 19, 2014. It will require licensed daycare centers and preschools to require vaccination records.
The bill goes into effect 90 days from when it was signed, according to the Ohio Department of Health.