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An epidemic of the non-vaccinated

Districts around the country are facing a growing trend of children attending school without vaccinations for contagious diseases such as measles, chicken pox, rubella, hepatitis A and B, and whooping cough.

In a 2012 study, the Centers for Disease Control and Prevention found that almost 5 percent of kindergarten students around the country were not fully vaccinated. Colorado had the lowest rate of vaccinations nationwide, which was 87 percent.

Parents are choosing to forego vaccinations based on what school nurses say is misinformation about vaccine dangers. Also, parents in 19 states can claim personal or philosophical objections. Forty-eight states grant exemptions on religious grounds.

“Access to vaccinations also remains a concern,” says Stephanie Wasserman, the executive director of the Colorado Children’s Immunization Coalition—which seeks to increase the number of vaccinated students. Although vaccines are covered without copayments for health insurance under the Affordable Care Act, not all families needing that coverage have enrolled.

In rural areas, Wasserman adds, access to vaccinations faces another hurdle. Private medical practices in rural areas of Colorado typically have lower numbers of patients (and less business) than in cities, she explains.

“The cost of stocking vaccines (before being reimbursed by insurance companies) has become cost-prohibitive, and 50 percent of those practices have stopped giving vaccines or are considering stopping,” she says.

Wasserman stresses that unvaccinated students pose a risk not only to themselves and others without vaccinations, but to children whose immune systems are compromised by other illnesses.

“The immune systems of kids undergoing cancer treatments, for example, are not working very well,” Wasserman says. “Chicken pox can be deadly for a kid having chemo.”

As the primary response to that threat, the Brevard County Public Schools and many other districts around the country, including Beaverton and Seaman USD 345 in Topeka, Kansas follow a standard procedure if a student contracts diseases such as chicken pox, whooping cough and measles.

“We pull out any students who are not immunized (and those who are immuno-compromised), send them home, and tell their parents, ‘We’ll let you know when it’s safe to come back,’” explains Pamelia Hamilton, health coordinator for the Brevard County schools. The time away from school can extend to 21 days, she adds.

In June, a federal judge upheld the same policy in New York City schools after several families claiming religious exemptions sued because their non-vaccinated children were kept out of school during outbreaks.

Some school districts and vaccination advocates are taking more proactive approaches. Wasserman has lobbied Colorado legislators not to allow parents to cite just philosophical reasons for refusing vaccinations and succeeded. And she adds that Oregon, California and Washington also now require a doctor’s note before granting philosophical exemptions.

Wasserman also points out that some districts in Colorado and other states offer immunization clinics at the start of the school year. Students whose parents have forgotten or put off their vaccinations can get them at the clinics, Wasserman says. Medical staff also can reach out to those parents who have chosen not to vaccinate their children.

Carolyn Duff, president of the National Association of School Nurses, says it is possible to change the minds of unwilling parents. “School nurses can sit down with families and educate them about how the missing vaccinations can affect not only their own children,” she says, “but the whole school community.”