TIP Talk!

Thursday September 14, 2017

Texas Vaccine Exemptions Continue to Creep Up


The number of Texas parents who file non-medical exemptions to avoid vaccinating their school-age children continues to inch upward disturbingly, the latest figures from the state show.

In the 2015-16 school year, 0.84 percent of parents filed for non-medical exemptions, which under Texas law are called exemptions of conscience. This past school year, the number was up to 0.97 percent, or nearly 1 percent.

Of course, that isn’t much of an increase, a rise of a little more than a tenth of a percentage point. But added through the years, those tenths start totaling up. The exemption rate has grown a bit each year since the 2010-11 school year, and now is twice the rate it was then.

The staff at The Immunization Partnership has analyzed the new data from the state and found some signs of areas where the exemption rate is rising to worrisome levels—and a few spots to celebrate, where exemption rates have dropped substantially, or where they are at or near zero.

Sad to say, the Austin Waldorf School isn’t one of them, with a non-medical exemption rate of 49 percent in 2016-17. That’s up by a scary 8.5 percentage points from where it was the year before. Keep in mind that the Healthy People 2020 goal calls for 95 percent vaccination rates across all populations, which is what’s needed overall for community immunity--the point at which enough people are vaccinated to keep a disease out of the community.

Or look at it this way: The measles outbreak that sickened nearly 80 people in Minnesota in recent months, sending dozens of children to the hospital, occurred largely among the Somali community, among whom the childhood vaccination rate had fallen to 40 percent. And now, the Austin Waldorf School, a private school, isn’t far from that point.

It’s important to remember that the non-medical exemption rates don’t necessarily indicate how many students aren’t vaccinated. The numbers might be higher, because some kids have medical conditions that make vaccines dangerous for them. These include students who are undergoing chemotherapy treatment or who must take drugs that suppress the immune system. In addition, some parents don’t file for exemptions but also don’t vaccinate their children unless their schools carefully enforce the law.

Conversely, parents who file exemptions sometimes have their children vaccinated against some diseases but not all of them.

The Austin Waldorf School has the highest reported non-medical exemption rate of any school reporting, but it’s not the only one with exemption rates that set off warning signs. Some 44 others, almost all of them private schools but a few charter schools, have non-medical exemption rates of more than 10 percent.

That doesn’t necessarily mean traditional public schools are doing better. Texas reports the vaccine exemption rates for counties and school districts, but not for individual public schools. There could be pockets of very low vaccination rates in some schools, but it’s hard for parents to find out. TTIP supported legislation this year, House Bill 2249, that would have required the state health department to publish immunization data at the school level. Students’ identities would have remained completely confidential; only the aggregate numbers for each school would have been posted. Schools collect campus level information, but those numbers are not publicly reported. However, the bill never made it out of committee and parents can find out vaccination rates at their children’s schools only through a formal open-records request.

What do the county and school district figures show? Higher exemption rates, of 2 percent to 2.5 percent, show up in several metro counties: Williamson, Travis, Hays, Kendall, Bandera, Denton, Collin and Hood. Some smaller, rural counties have even higher percentages, including the disturbing 6.3 percent in Gaines County, the highest in the state.

Within counties, a troubling number of pockets of vaccine resistance appear among individual school districts. Of the state’s 1,788 school districts, 142 or 7.9 percent reported non-medical exemption rates of more than 5 percent. The Seminole Independent School District, for example, reports that 7.5 percent of its 2,800 students have non-medical exemptions on file.

In Rains County, the rate was much lower, 1.96 percent. But in 2010-11, only .06 percent of students had non-medical exemptions. That means in increased more than 32-fold in a few short years.

Let’s not forget the many bright spots among Texas’ public schools, though. The small, rural Trinidad Independent School District has a non-medical exemption rate of zero. Others reporting that same sterling number are Zapata, La Pryor, San Perlita, Lyford, Lasana and many others. And three counties—Ken, Kimble and Roberts – had previously had students with non-medical exemptions but saw those rates fall to zero over the past several years.

If only the wisdom of parents in those school districts were contagious!



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