Fewer AZ Preschool Children Vaccinated ; Non-Medical Exemption Ratein Pima Is Lower but Growing

By Innes, Stephanie | AZ Daily Star, September 7, 2014 | Go to article overview

Fewer AZ Preschool Children Vaccinated ; Non-Medical Exemption Ratein Pima Is Lower but Growing


Innes, Stephanie, AZ Daily Star


More parents of local preschoolers are opting their children out of vaccines against infectious diseases like measles, meningitis and whooping cough.

The percentage of preschoolers statewide with non-medical vaccine exemptions has quadrupled since 2000, new state data shows. The higher the exemption rate, the more likely a disease can "wiggle its way into a group," says Dr. Karen Lewis, who is medical director of the state health department's Arizona Immunization Program.

The rise in exemption rates reflects the growth nationwide in parents who are more afraid of vaccines than of the serious diseases they prevent.

As with other age groups, the vaccine exemption rate of preschoolers in Arizona remains relatively small -- 4.1 percent. But it is a significant population because of its growth.

The new data says Pima County's rate of non-medical exemptions from preschool is 3.5 percent, which is lower than the state average but has also grown. Most Pima County preschools have what is considered a safe percentage of vaccinated children, but a handful are below what health experts say is required for "herd immunity."

Herd immunity is the level at which enough people are vaccinated that an isolated case of infectious disease will not morph into a full-blown outbreak. For most vaccines, herd immunity occurs when 90 percent or more of a particular group, such as a class of children, are vaccinated. For measles it's usually considered 95 percent since the disease is so contagious.

More than half of the children enrolled at the Waldorf preschool in Tucson last school year had non-medical exemptions from getting vaccinated, the state data shows. The state provided the Star with school-by-school vaccination rates for preschools, but withheld data from those with fewer than 20 children.

Having unimmunized children in preschool settings is particularly worrisome since they are at a high risk of spreading infection to one another and to the rest of the community. They have less control over their saliva and bowel movements, and they're more likely to put things in their mouths, thus increasing the possibility of disease transmission, Lewis said.

"I think the vast majority of parents are actually unaware of the fact that this is increasing," said Beth Jacobs, an associate professor of epidemiology at the Mel and Enid Zuckerman College of Public Health at the University of Arizona.

"It seems to keep going up and up and up. But is there a point where we have saturated the group of people who are inclined to do this (not vaccinate)? I don't know the answer to that," said Jacobs, who co-authored a 2012 study about vaccine exemption rates in Arizona kindergartners along with Kacey C. Ernst, also a UA assistant professor of epidemiology.

Rates declining

The UA study found that people who choose not to vaccinate their children were most often upper middle class, educated, and non- minorities. Based on their results, the state revamped its exemption forms and published a resource guide to vaccinations for schools and childcare centers.

Yet vaccination rates have continued to decline in Arizona, and non-medical exemption rates have continued to climb.

Children who can't be vaccinated because of illnesses like cancer, or whose immune systems are suppressed, depend on those around them to be protected. Public health officials say parents should feel some sense of responsibility to those children, not just to their own.

The Tucson Waldorf school, with an enrollment of 40 students, was among a handful of local preschools with vaccination rates low enough to put the children at risk for dangerous vaccine- preventable diseases during the 2013-14 school year.

"I wouldn't send my child to a school with 55 percent coverage of some of these vaccines," said Jacobs, who reviewed the Pima County preschool data at the Star's request. "Overall the rates (for Pima County) look pretty good, but it is worrisome that they are concentrated in specific preschools. …

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