A vial containing the MMR vaccine is loaded into a syringe before being given to a baby at the Medical Arts Pediatric Med Group in Los Angeles. (Mel Melcon/Los Angeles Times)
More Clark County students were reportedly up to date with their vaccines in the 2018-19 school year, but Clark County Public Health Officer Dr. Alan Melnick isn’t taking the data at face value.
According to data compiled and recently released by the Washington State Department of Health, 80.3 percent of students from kindergarten through 12th grade had completed their recommended vaccinations, compared with 77.6 percent in 2017-18.
However, the data were collected before an outbreak of measles earlier this year resulted in 71 confirmed cases.
That’s a reason why the data don’t give the best picture of how the outbreak affected local vaccination rates. The data also precede the passage of House Bill 1638, which eliminated personal and philosophical exemptions to the measles, mumps and rubella vaccine for children in public and private schools as well as licensed day-care centers.
The data, collected almost a year ago, indicated Clark County kindergartners saw the biggest increase in completed vaccinations, jumping from 76.5 percent of kindergartners in 2017-18 to 82.4 percent in 2018-19. During the same time period, sixth-grade vaccination rates rose from 65.1 percent to 77.7 percent.
“I can’t verify the reason for that” increase in vaccination, Melnick said, adding, “It’s fluctuated before.”
While exemption statistics fluctuated marginally from 2017-18 to 2018-19, out-of-compliance rates took large dips. The sixth-grade out-of-compliance rate in Clark County fell from 27.6 percent in 2017-18 to 14.3 percent. And for Clark County kindergartners, the out-of-compliance rate fell from 13.5 percent to 6.9 percent. That might be a sign that schools are tightening their record-keeping around vaccination.
Being declared out of compliance doesn’t necessarily mean that a student hasn’t received immunizations. It can also mean there isn’t proof on file that a student has received a vaccine, or they aren’t up-to-date on their vaccination schedule.
Evergreen Public Schools has cracked down on its high out-of-compliance rate, which was around 40 percent at the start of the last school year. Clark County Public Health was working on a pilot project with Evergreen to improve its out-of-compliance rates, but in an email Evergreen spokeswoman Gail Spolar said the project was delayed because of the measles outbreak and has yet to resume.
She said students are currently turning in vaccination forms for this school year, and data haven’t been compiled yet, so it’s hard to decipher how Evergreen’s out-of-compliance rates have changed this year.
According to the Department of Health data, Evergreen’s out-of-compliance rates were already decreasing before the measles outbreak. For sixth-graders, it fell from 76.5 percent in 2017-18 to 28.3 percent in 2018-19. Kindergarten rates dropped from 31.1 percent to 9.9 percent.
Melnick said the school immunization data aren’t quite as accurate and reliable as the Washington State Immunization Information System, which is compiled from data sent in by health care providers. Melnick said he will be looking at that data in the coming months to see how vaccination rates have changed after the outbreak.
One area in particular that interests Melnick is if medical exemptions will begin to rise. Since personal and philosophical exemptions for MMR have been restricted through HB 1638, Melnick said some providers might hand out illegitimate medical exemptions. After California passed a similar vaccine bill to Washington’s that targeted personal exemptions, the state saw an increase in medical exemptions.
“Medical exemptions are really rare,” Melnick said. “That’s going to be something we need to look at. Is there a small handful of health care providers who are handing these exemptions out? It’ll be interesting to look at the data to see if those numbers go up and to see if they are concentrated in an area or with certain medical providers.”
Melnick explained that if there are any problems that arise with medical exemptions, it could mean more policy changes are needed.
“Do we need to tweak another statute or Washington Administrative Code to tie this up?” he asked. “It could be. We’ll have to see what happens. Maybe everything will be great. That’s my hope. We’re a long way from that. We just got this bill passed, and we need to see how it works.”
Clark County K-12 vaccine type incomplete, 2018-19 Diphtheria, tetanus
5.6% Pertussis
5.3% MMR
6% Polio
6.4% Hep B
6.1% Varicella
6.9% — Clark County Public Health
