Louisiana isn’t last — or near last — in everything.

As public health experts grapple with the vaccine animus that has led to measles outbreaks in states like California, Arizona and Oregon, some are noticing states that normally sink to the bottom of ranking lists are coming out on top in terms of immunization rates. Among the states most successful in achieving high vaccine rates for children entering kindergarten are Louisiana, Mississippi and Alabama, states with deep pockets of poverty that often result in poor outcomes in measurements of school proficiency and health insurance coverage.

Mississippi, often appreciated in Louisiana for taking 50th place in child welfare rankings, boasts the nation’s best rate of immunizing children. Key to this record, experts have said in recent weeks, is a tough legal stand that only allows parents to opt out of vaccines for medical reasons.

However, Louisiana also does well when comparing its rate of students immunized, despite a state law that allows parents to declare a philosophical objection to vaccines and still be able to enroll their children in public schools.

Louisiana ranked No. 10 in the U.S. for vaccination rates among kindergarten students during the past school year, according to the Centers for Disease Control and Prevention.

“We have parents and schools here who really understand the importance of vaccinations,” said Dr. Frank Welch, the medical director for the state’s immunization program.

Widespread vaccinations have been a key safeguard in the state against the measles flare ups that have clustered in communities with strong anti-vaccine sentiments, Louisiana public health experts said.

Measles, a once-eliminated respiratory illness, has infected more than 100 people in at least 14 different states during the current outbreak, according to the CDC. Thus far, there are no reported cases of measles in Louisiana, Welch said.

Measles is a highly contagious disease, spread through coughing and sneezing and even lingering in the air for two hours.

“We use it as the standard-bearer for infectious disease,” Welch said. “If there are 99 people vaccinated against the virus, it’ll find the one who’s not.”

The current measles outbreak has largely happened in well-off communities where parents en masse have developed fears of immunization, Welch said.

One of the myths that has permeated through some of these communities, he said, is that small children have immune systems ill-equipped to handle trace levels of viruses found in vaccines.

Another stems from a longed-debunked study linking vaccines to autism.

While anti-vaccination clusters are common in other states, such opposition in Louisiana is sporadic and the incidents are mostly limited to one family at a time rather than a neighborhood cluster, Welch said.

“I attribute it to parents partnering with schools on the importance of vaccinations,” Welch said. “There are hoops you have to jump through at schools and daycares if you don’t want your children immunized.”

Every state requires vaccinations for children in kindergarten, according to the CDC. But most states also allow certain exemptions, based on medical, religious and personal beliefs. Louisiana state law allows opt-outs based on medical reasons or personal beliefs, with the law only requiring “written dissent from the student or his parent or guardian.”

But most parents don’t take advantage of this. The opt-outs are hardly ever used in the East Baton Rouge Parish School System, spokesman Keith Bromery said.

Only about a dozen of more than 42,000 students systemwide have opted out of the immunization requirements, he said.

A greater number of parents seem to be taking advantage of the exemption in Lafayette, but vaccination rates are still high. More than 94 percent of students in the parish school system are up-to-date with their vaccinations, spokesman Bradley Cruice said.

He said the parents of students not vaccinated may just be unaware of the requirements.

“We don’t have a mass problem of parents refusing,” Cruice said.

During the 2013-14 school year, the most recent available data, 96.8 percent of 63,976 Louisiana kindergarten students were immunized for measles, according to the CDC. Of the 505 kindergarten students with reported exemptions: 394 had a religious exemption, 28 had a philosophical exemption and 83 had a medical exemption, the agency said.

If measles ever shows up in East Baton Rouge public schools, Bromery said, the district’s response will be the same as with any other infectious disease: Send the students home and readmit them once they return with a doctor’s note certifying their health.

“We’re used to those kinds of things,” Bromery said. “That’s how you eliminate the situation.”

New Orleans pediatrician Dr. Stephen Weimer said he last saw a case of measles during his residency at LSU in 1995.

He was examining a young patient for a bad cold, he said, when he noticed the child had a head-to-toe rash and white lesions in his mouth — the telltale sign of measles.

“It’s just something you hardly ever see here and I attribute that to the vaccination rates,” he said.

Weimer, who practices at the Tulane Medical Center, said most of his patients’ parents choose to vaccinate.

Welch said, in his experience, the most common reason parents opt out of vaccinations is a fear their child’s immune systems might be overwhelmed.

“I tell them, ‘That doctor went to school and has nothing but your family’s best interests at heart,’ ” he said.

The most recent measles outbreak comes amid a wave of anti-vaccination advocacy, Welch said, many of whom cite the long-debunked study by a British doctor in 1998 linking the measles, mumps and rubella vaccine to autism. Since then, Jenny McCarthy, a former television host and Playboy Playmate, has publicly linked her son’s autism to his vaccination.

“To that I say: If you’re building a bridge, would you rather have advice from a celebrity or a civil engineer?” Welch said.

Follow Matt McKinney on Twitter, @Mmckinne17.