A few weeks ago, a child was diagnosed with measles in Clark County, Washington, just over the river from where my family and I live in Portland. I was hoping it was nothing more than an isolated incident—but the disease spread. Soon there was a full-on measles outbreak, complete with a long list of schools, restaurants, churches, and doctors offices that could be contaminated with the virus. Portland’s airport, NBA arena, science museum, even Ikea, are all on the list. Now the total number of confirmed measles cases in Washington and Oregon is hovering around 40—most of them in kids—with at least a dozen more under investigation.

It’s no coincidence that Clark County, the epicenter of the measles outbreak, is an anti-vaccination hotspot. The area has the lowest measles vaccination rates in the entire state of Washington—just 84.5 percent of Clark Country kindergarteners were current on their measles vaccination in the 2016–2017 school year (down from 96.4 percent in 2004–2005). “Measles was considered eliminated thanks to vaccination,” says Jennifer Vines, M.D., deputy health officer for Multnomah County Health in Portland. “Now we are backsliding.”

Thankfully, I’m the mother of a fully vaccinated seven-year-old. I feel very confident that she is protected, and I am not concerned that she will contract the virus. But if this had happened two years ago, it would have been a different story.

Two years ago, my little girl was battling childhood kidney cancer. Her cancer was eradicated, but months of chemotherapy and radiation ransacked her immune system. While her body bounced back, she was still at risk of contracting any number of infections—especially highly contagious ones like measles. Compromised kids, like my daughter then, can’t get vaccinations; their immune systems are too weak to develop the response that is so protective (and some vaccines contain traces of a live virus, which could lead to infections in people with weak immune systems). She was vulnerable. Unprotected. Had there been a measles outbreak two years ago, my daughter would have been a sitting duck.

For healthy kids, measles is serious but rarely fatal (less than one in 1,000 healthy children who contract measles die, according to the Centers for Disease Control and Prevention). But for immunocompromised kids, it’s a big deal—pneumonia, encephalitis, and permanent hearing loss are very real concerns. And even more terrifying, the death rate among immunocompromised kids skyrockets. “In this group, death has been reported in 20 to 70 percent of measles cases,” says Dawn Nolt, M.D., associate professor of pediatric infectious disease at Doernbecher Children’s Hospital in Portland.

If measles had been allowed to spread when my daughter was unable to get vaccinated, scared doesn’t even begin to describe how I would have felt. She would have been forced to wear a mask out in public, and trips to places like the science museum would have been off limits. School and dance class might not have been safe. Our family would likely have been quarantined.

I’m sure scared doesn’t begin to describe how parents of immunocompromised kids are feeling in the face of the outbreak happening right now.

My daughter, luckily, is no longer at risk. As soon as her immune system was strong enough, she got the vaccinations she needed (to protect both her and the kids around her). Still, every time I hear of another diagnosis or read about another exposure site, I can’t help but worry for the children who are going through cancer treatment right now. Or for their parents, who are faced with yet another threat to their kids’ lives.

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