One percent of Johnson County’s public school students aren’t vaccinated against highly contagious diseases, such as the measles, and that rate could be enough to prompt an outbreak, the county’s health officer said.

Right now, nearly 300 students out of more than 25,700 students haven’t received all of the shots required by the state. About 23 percent of those students have exemptions because they have allergies, low immune systems or other medical conditions that make getting the shots dangerous.

The rest have exemptions for religious reasons, according to school health officials.

“We’re in good position to have a nice outbreak with that many people unimmunized,” Johnson County Health Officer Dr. Craig Moorman said.

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After news reports of measles outbreaks in California and other states, the county health department started getting calls from concerned parents who wanted to know if their kids’ vaccination records were up to date.

The news hasn’t sent a rush of people to the health department to get shots, however, because many of the families with questions already had gotten the necessary vaccinations for their children, Johnson County Health Department director of nursing Lisa Brown said.

By the beginning of this week, at least 150 cases of measles had been reported in at least 17 states since the start of the year. So far no cases have been reported in Indiana, but that could change quickly, Brown said.

“It spreads quickly. We’re talking a little over a month,” Brown said. “Fortunately, we are still one of the states that is at zero. But that could change today, tomorrow.”

For families who choose not to vaccinate their children — either for medical or religious reasons — the decision has implications.

If there’s an outbreak of measles or another vaccine-preventable disease, students who don’t have all of the recommended shots will be sent home for about three weeks to help ensure they don’t get sick.

And some doctors, including Moorman, a Franklin pediatrician, have opted not to accept unvaccinated children as patients.

Moorman said he doesn’t want to turn any prospective patients away but can’t give children the complete medical care they need without vaccines. He also could be held liable if a child became sick or died from an illness that a vaccine could have prevented, he said.

“It’s their choice, as a parent, to do whatever,” Moorman said. “But as a physician, I can’t be part of their medical care knowing they’re not immunized.”

Moorman said he thinks one reason some families opt not to vaccinate their kids is because it’s been decades since measles and other preventable diseases were at their peak.

“One hundred years ago or 50 years ago, everybody knew someone who lost a child due to one of these vaccine-preventable diseases,” he said. “We’ve lost our memory of how bad they are.”

If 10 unvaccinated people are in a room with the measles, chances are nine of them will get sick, which is why one case equals an outbreak, Indiana State Department of Health chief medical consultant Joan Duwve said.

The state requires children to have two measles, mumps and rubella shots by the time they start kindergarten, and parents can choose not to vaccinate their children for religious or medical reasons.

To receive a medical exemption, students need to provide a note from a doctor detailing what condition they have and why they cannot be vaccinated. Parents who want a religious exemption for their child have to write and sign a note specifying which shots they object to, and no additional proof is required.

Families have to resubmit their notes for medical and religious objections each year.

But if there’s even one case of measles or another contagious disease that breaks out at a Johnson County school, students who haven’t received the recommended vaccines will be sent home for at least 21 days, health officials said.

That step is necessary to protect students without vaccines from potentially deadly illnesses, Duwve said.

“We hope the unvaccinated children don’t end up coming down with a preventable disease,” Brown said.

Along with class, students also would miss any school-related activities during that time: dances, sporting events and graduation. The only way to reduce that window is if students who are healthy enough receive a measles vaccine within 72 hours of being exposed to the disease, health officials said.

Locally, the Johnson County Health Department doesn’t do a lot of instruction about the benefits of vaccines. That’s partly because news reports have been renewing conversations about preventable diseases and because pediatricians regularly talk with parents about the importance of the shots.

“I don’t know really what more we could do,” Brown said. “They know the options that are available to them, and they know from the time they have that baby that vaccines are important.”

Statewide, groups including the Indiana Immunization Coalition also try to create campaigns encouraging parents to get their kids vaccinated, Duwve said.

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“One hundred years ago or 50 years ago, everybody knew someone who lost a child due to one of these vaccine-preventable diseases. We’ve lost our memory of how bad they are.”

Johnson County Health Officer Dr. Craig Moorman