Washtenaw County Schools Working to Reduce Elevated Vaccine Waiver Rates

Parents of children in Washtenaw County schools excuse their children from being vaccinated at a rate that is troubling local public health officials.

Washtenaw’s immunization waiver rate was the 20th highest out of 83 Michigan counties.

Database: See vaccination rates at Washtenaw County public and charter schools

Requiring that students at public and charter schools submit vaccination reports or waivers at the beginning of certain school years is one of the primary methods states use to ensure child immunization.

Students entering kindergarten, seventh grade, or changing school districts are required to submit report their vaccination records no later than the first day of school.

If the record is incomplete, parents can either ensure their children to receive the required vaccinations or sign a waiver form.

“Reporting means we need to know the status of at least 90 percent of the school by November 1 and that increases to 95 percent in February,” Washtenaw County Public Health immunization nurse coordinator Christina Karpinski said.

“The school secretaries are constantly working on getting this information from parents to make sure the kids are reported.”

Vaccination is tied to districts’ state school aid funding. The Michigan State School Aid Act of 1979 mandated that districts failing to meet the reporting deadlines would lose 5 percent of their state funding.

“What we work on as a health department is making sure that students are not just reported, but complete,” Karpinski said.

“People sometimes just sign the waiver because they think ‘I don’t have to get my kid vaccinated because everyone else did.’”

Karpinksi said that attitude can be dangerous, as lower levels of vaccination in a population can put everyone at risk.

Lower Vaccination Numbers, Higher Infection Numbers

Nationwide, public health officials are becoming increasingly concerned with low vaccination rates as measles infections are at their highest levels since the early 1990s. A number of cases of the potentially fatal respiratory infection have been documented in Ohio, but none have been reported in Michigan in the last 10 years.

“We need to keep our kids in school so they can optimize their educational opportunities,” vaccination policy expert Matt Davis, with the Child Health Evaluation and Research Unit at the University of Michigan, said.

“When kids get sick with vaccine preventable diseases that is an avoidable problem. We know how to keep kids healthy and in school and that’s by giving the recommended vaccines on the recommended schedule.”

Washtenaw County is in the midst of a second straight year with high pertussis, or whooping cough, levels in its schools. Public health officials said the outbreak was preventable and was caused by lower vaccination rates. Pertussis is characterized by the “whooping” cough that can make it extremely difficult for those with the infection to breath.

Washtenaw County vaccination rates fall behind state averages

One case of mumps, which can cause fever, headache and swelling of the brain and spinal cord has also been reported in the county in 2014.

School districts are responsible for notifying parents about the vaccination requirements and following up to ensure that records or waivers are completed.

“You let them know up front what the expectations are, what the due dates are, when we need the forms by and that they have to be inoculated by a certain date,” Teresa Cornelison, administrative assistant to the superintendent and secretarial supervisor at Ypsilanti Community Schools.

“We always let parents know up front what we need as part of our registration process and we train our people in the building what to look for in those immunization records so they can help parents on the spot.”

Most of the large school districts in the county had between seven and 12 percent of their students on waivers, with fully vaccinated students making up between 88 and 92 of the student population. The data is kept by the Washtenaw County Public Health Department and was obtained by The Ann Arbor News through a Freedom of Information Act request.

Manchester Community Schools had a higher waiver rate than most of the county at 17 percent, while Ypsilanti Community Schools had a waiver rate of just 1 percent across the district.

What the Districts Are Doing

The new Ypsilanti School district had a lower level of reporting than other districts in the county, with just 88 percent of students reporting as fully vaccinated or turning in the waiver form. However, all but 1 percent of those who did report were fully vaccinated.

Cornelison attributes those numbers to an emphasis at the secretarial level that vaccination is important.

“The waiver is not really something we offer up front,” she said.

“We say ‘your child needs to be inoculated’ and then we stay firm with it. It seems to work. If a person has a real objection they can of course fill out the waiver, but they may say ‘I don’t have a doctor here,’ so we help them with that. We help them get to the clinic through the county or direct them to a doctors office.”

Ann Arbor Public Schools has 88 percent of its students reporting as fully vaccinated and 9 percent have submitted waivers. District spokeswoman Liz Margolis said schools in the city work hard to get students either immunized or to fill out waiver forms.

“We aren’t making judgment calls,” she said. “Some schools will have a higher number of waivers than others and that’s just how it is. I think we can safely say we do see the impacts sometimes though.”

Saline Area Schools district nurse Karan Hervey said she has been very concerned about immunization rates dropping across the country and that she is leading a team effort to increase the rates in her district.

She said there will always be a small percentage of waivers that will never change but that she has focused on the cases that she can “turn around.”

“We try to be proactive instead of reactive here, and anticipate the needs of families and help them connect with the resources they need,” she said.

“In the past we might have said ‘we have a deadline to meet with the health department so just sign the waiver if you’re not vaccinated.’ But now we’ve reduced our waiver rate and we’ll continue to work on that.”

Saline Area Schools had an 8 percent waiver rate and 92 percent of students reported as fully vaccinated in 2014. Waiver rates at the district’s elementary and middle schools were all below 10 percent.

Waiver percentages varied widely in charter schools across the county. Ann Arbor Learning Community had 21 percent of its students on waivers and Honey Creek Community School had 32 percent, while New Beginnings Academy had just a 3 percent waiver rate.

Higher waiver rates were seen at high schools, where the only students reporting were ones who were new to the district. Karpinski said that the higher rates could in large part be attributed to foreign exchange students and other international students coming into the schools who had either different or incomplete immunization records and did not want further vaccination.

Six schools across the county had full immunization rates of 99 or 100 percent: Bryant Elementary School and the Roberto Clemente Center in Ann Arbor, the Central Academy Kindergarten, South Meadows Elementary in Chelsea, Saline Alternative High School and the Washtenaw County Juvenile Detention and Young Adult Programs.

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