AURORA | The proportion of U.S. kindergartners exempted from school vaccination requirements has hit its highest level ever, 3%, according to U.S. health officials.
Colorado school vaccination rates, notoriously low among states, have also been trending down.
“The bad news is that it’s gone down since the pandemic and still hasn’t rebounded,” said Dr. Sean O’Leary, a University of Colorado pediatric infectious diseases specialist. “The good news is that the vast majority of parents are still vaccinating their kids according to the recommended schedule.”
More parents are questioning routine childhood vaccinations that they used to automatically accept, an effect of the political schism that emerged during the pandemic around COVID-19 vaccines, experts say.
Aurora schools are echoing national trends in vaccinations and are seeing fewer students fully vaccinated this school year.
State records show that 85% of all Aurora Public School District students are fully immunized this school year, according to data from the state. The district’s vaccination compliance rate has been decreasing since the 2019-20 school year.
And 82% of district kindergarteners are fully vaccinated, the lowest vaccination rate in the last six years. An average of 1% of APS kindergarteners received exemptions for all vaccinations this school year.
Also, 89% of all Cherry Creek students are fully immunized this school year.The district’s vaccination compliance rate has been decreasing slightly every year since the 2019-20 school year.
However, 87% of district kindergarteners are fully vaccinated this school year. An average of 2% of Cherry Creek kindergarteners received exemptions for all vaccinations this school year.
Cherry Creek has registered nurses at every school who provides resources to families. They are unable to administer vaccinations, but refer families to health care providers such as STRIDE Clinics, Shots for Tots and Teens and the students’ own provider, according to district spokesperson Lauren Snell.
In APS, their health staff refer families to community immunization events and to the district’s four school-based health clinics. APS spokesperson Corey Christiansen also said that the district’s Medicaid Department also “helps families connect with community resources and apply for federal funding. There is also limited funding available to support uninsured students with health services.”
Herd immunity, which is when a large portion of the community is immune to a disease making it difficult for it to spread, varies for each disease, according to a report from the Mayo Clinic.
For measles, a highly contagious viral respiratory disease, approximately 94% of the population must be immune in order to prevent it from spreading.
In APS, 85% of kindergarten students are vaccinated against measles this school year. In Cherry Creek, 91% are vaccinated against it.
Only three school districts in the state saw a 100% immunization rate against measles: Campo School District, located near the Colorado – Oklahoma border; Creede School District, located in southwest Colorado; and Edison School District, located southeast of Colorado Springs.
Moffat 2 School District, in southern Colorado, had the lowest immunization rate against measles this school year. Only 59.6% of their students were fully immunized.
According to the Colorado Department of Public Health and Environment, children entering child care are required to have the following vaccinations:
Hepatitis B (HepB)
Diphtheria, tetanus, pertussis (DTaP)
Haemophilus influenza type b (Hib)
Inactivated poliovirus (IPV)
Pneumococcal conjugate (PCV)
Measles, mumps, rubella (MMR)
Varicella (chickenpox)
Children in K-12 are required to have
the following vaccinations:
Hepatitis B (HepB)
Diphtheria, tetanus, pertussis (DTaP)
Inactivated poliovirus (IPV)
Measles, mumps, rubella (MMR)
Varicella (chickenpox)
Tetanus, diphtheria, pertussis (Tdap)
According to state spokesperson Annemarie Harper, “students with an exemption from one or more school-required vaccines may be kept out of a school or child care during a disease outbreak” to protect unvaccinated children.
The state defines “non-medical exemptions” as a parent or guardian having a personal belief or following a religious teaching that is opposed to immunizations.
There are two ways to receive a non-medical exemption. A parent must submit a certificate with a signature from a Colorado doctor, doctor of osteopathic medicine, advanced practice nurse, physician assistant/associate, registered nurse, or pharmacist.
Or, a parent must complete an education module provided on the state website at cdphe.colorado.gov. An exemption will be granted after participation, without having to provide a supporting explanation.
Even though more kids were given exemptions, the national vaccination rate held steady: 93% of kindergartners got their required shots for the 2022-2023 school year, the same as the year before, the Centers for Disease Control and Prevention said in a report Thursday. The rate was 95% in the years before the COVID-19 pandemic.
All U.S. states and territories require that children attending child care centers and schools be vaccinated against a number of diseases, including, measles, mumps, polio, tetanus, whooping cough and chickenpox.
All states allow exemptions for children with medical conditions that prevents them from receiving certain vaccines. And most also permit exemptions for religious or other nonmedical reasons.
In the last decade, the percentage of kindergartners with medical exemptions has held steady, at about 0.2%. But the percentage with nonmedical exemptions has inched up, lifting the overall exemption rate from 1.6% in the 2011-2012 school year to 3% last year.
Last year, more than 115,000 kindergartners were exempt from at least one vaccine, the CDC estimated.
The rates vary across the country.
Ten states — all in the West or Midwest — reported that more than 5% of kindergartners were exempted from at least one kind of required vaccine. Idaho had the highest percentage, with 12% of kindergartners receiving at least one exemption. In contrast, 0.1% had exemptions in New York.
The rates can be influenced by state laws or policies can make it harder or easier to obtain exemptions, and by local attitudes among families and doctors about the need to get children vaccinated.
“Sometimes these jumps in exemptions can be very local, and it may not reflect a whole state,” said O’Leary, who chairs an American Academy of Pediatrics committee on infectious diseases.
Hawaii saw the largest jump, with the exemption rate rising to 6.4%, nearly double the year before.
Officials there said it’s not due to any law or policy change. Rather, “we have observed that there has been misinformation/disinformation impacting people’s decision to vaccinate or not via social media platforms,” officials at the state’s health department said in a statement.
Connecticut and Maine saw significant declines, which CDC officials attributed to recent policy changes that made it harder to get exemptions.
Health officials say attaining 95% vaccination coverage is important to prevent outbreaks of preventable diseases, especially of measles, which is extremely contagious.
The U.S. has seen measles outbreaks begin when travelers infected elsewhere came to communities with low vaccination rates. That happened in 2019 when about 1,300 measles cases were reported — the most in the U.S. in nearly 30 years. Most of the cases were in Orthodox Jewish communities with low vaccination rates.
One apparent paradox in the report: The national vaccination rate held steady even as exemptions increased. How could that be?
CDC officials say it’s because there are actually three groups of children in the vaccination statistics. One is those who get all the shots. A second is those who get exemptions. The third are children who didn’t seek exemptions but also didn’t get all their shots and paperwork completed at the time the data was collected.
“Last year, those kids in that third group probably decreased,” offsetting the increase in the exemption group, the CDC’s Shannon Stokley said.