Thousands of unvaccinated American mothers without waivers

COLUMBUS, Ohio (AP) – States are hotly debating whether it is harder for students to avoid religious or philosophical immunizations in the most serious measles outbreak in decades. apologize for missing their shots.

According to data reported to the Centers for Disease Control and Prevention, a majority of unimmunized or under-vaccinated kindergarten children in at least 10 states have been allowed to enter provisionally for the last year school, without any formal derogation. Only 27 states submitted information on the group. Therefore, the actual magnitude of the problem is unknown.

Poor access to health care prevents some of these children from being vaccinated against some of the most preventable infectious diseases, but for others, the reasons are more mundane.

"It could just be" I did not have time to go to the doctor "or" I just do not want to do that, "said Melissa Arnold, CEO of the chapter of the Canadian Medical Association. Ohio from the American Academy of Pediatrics. "From a public health point of view, we do not really know."

According to experts, it is likely that most, if not most, children will eventually receive all the vaccinations required by law, but no one knows it. This is neither followed nor required to be.

This leaves managers with an infuriating lack of information, as vaccination rates fall and diseases like measles, once declared eradicated, reappear.

The CDC has called on education officials to do more to ensure that these children are vaccinated, and state health and education departments regularly issue recalls. But for school officials, respecting state mandates to vaccinate children to attend clbades can sometimes force students to choose between educating students and protecting public health.

"Our goal is to have kids in school – it's our role as a school nurse," said Kate King, a board member of the School Board of Trustees. Ohio Association of School Nursing. "We do not want to exclude them, so it's our dilemma."

The 50 states allow students to benefit from immunization exemptions for medical reasons. But official exemptions for vaccines for religious or philosophical reasons have recently been criticized, as the CDC has confirmed 880 cases of measles in 24 states since January, the highest number since 1994.

But children whose vaccinations are incomplete for other reasons can not be ignored.

According to the CDC, among the 27 states that reported data on this group for the 2017-2018 school year, Arkansas posted the highest percentage of children 's garden students. registered without full vaccination and without invocation of medical, religious or philosophical exemption. In Ohio, this figure was 5.3%, the second highest. Georgia and Hawaii were the lowest at 0.2%.

Neither Ohio nor Arkansas still have measles cases this year, but health officials say the percentages of unvaccinated children are a source of worry . A vaccination rate of 95% is deemed necessary to achieve group resistance to the spread of a contagious disease, officials said.

"If that happens, it will be bad," said King about Ohio.

In the 10 states where unvaccinated children did not have more exemptions than unvaccinated children who invoked them, the figures were striking: only around 15,000 children were exempted 27,000 others. Overall, the 27 states reported that about 60,000 children from unvaccinated maternal schools without exemptions and about 70,000 used them.

States expect students to be vaccinated from a few days to several months, but immunization data officials from several states said there was no system in place to check if children were trapped.

Once the grace period expires, prohibiting a student from going to school can be difficult, compromising the child's academic performance and, in some urban districts, its safety.

In Pennsylvania, officials recently reduced the grace period from eight months to just five days, said Cindy Findley, Acting Assistant Secretary of Health Promotion and Disease Prevention. The shorter window brings more attention and resources to the question at the beginning of the school.

"What we would find is that children would spend the entire school year without being aware of their immunizations and would continue to move on to the next age group," she said.

Other states, including Arkansas and Indiana, now require schools to publish reports on vaccination rates of infants, and Colorado has facilitated access to these informations. Dr. Jennifer Dillaha, Medical Director of Immunizations at the Arkansas Department of Health, said the idea was to draw attention to this problem and provide parents with information likely to affect their choice of school.

According to CDC theory, the "reluctance to vaccine", fueled by an anti-vaccination movement that claims some vaccines are dangerous, despite compelling evidence to the contrary, has contributed to the increase in the number of students not vaccinated in the United States. But in Arkansas, said Dillaha, the problem is access.

Most of Arkansas's children are enrolled in Medicaid, a health insurance for low-income residents, and 16 of Arkansas's 75 counties have only the local health department to which they are affiliated. Address to be vaccinated, she said. This means that there are no doctor's offices, clinics or corner pharmacies to facilitate the procedure.

"We have a weak immunization infrastructure," she said. "Therefore, due to access problems, the degree of strict application of attendance criteria for vaccinations varies from one school to the next."

In Ohio, state data show that the number of unvaccinated students remains high as students enter the school system, with 10% of grade 7 students being under-vaccinated without invoke exemption.

The last measles outbreak in Ohio occurred in 2014 in Knox County and was attributed to the local Amish community, where vaccination rates are lower than those of the general population because their traditional way of life tends to avoid any essential medical treatment, said Pam Palm, spokesman for Knox County Department of Health.

But even with this story, managers are trying to be flexible. Steve Larcomb, director of Knox County's East Knox Local Schools, is reminded to have hosted a new relative in the district, busy moving and waiting for the child's doctor appointment five weeks later. .

"We try not to draw too many lines in the sand and not be too hard because we understand family situations," said Larcomb.