Health leaders push for vaccines as student vaccination rates drop

The number of Granite State students up to date on the various vaccinations the state requires for school attendance is going in the wrong direction, health experts say. The trend is also playing out nationally, the Centers for Disease Control and Prevention reported earlier this month.

Experts say that even a small decline in vaccination rates, which New Hampshire has seen, increases the chance of communicable diseases spreading through the school and beyond. Specifically for measles, the CDC said the 93.5% vaccination rate among the nation’s kindergarten students still puts 250,000 of their peers at risk of becoming infected.

Vaccine skepticism, which has hampered acceptance of the COVID-19 vaccine, plays a role but is hardly the driver, health experts said. Neither did religious exemptions, which so dominated legislative debates last session that lawmakers made it easier for parents to get one.

Religious exemptions for all students have dropped from the 2019-2020 school year, when 2.5% of parents requested one, to 1% this year, according to the Department of Health and Human Services. (The COVID-19 vaccine fueled the shift in exemption claims, but it’s not required to attend schools and daycare centers.)

Dr. Erik Shessler, president of general pediatrics and associate medical director at Dartmouth Health Children’s and vice president of the New Hampshire Chapter of the American Academy of Pediatrics, says two other culprits are responsible for the drop in vaccination rates: staff shortages and the The pandemic has made it more difficult for children to have their annual physicals, where providers update vaccinations and check the child’s overall mental and physical health. And some families are not making it a priority to reschedule those missed visits.

“One of the things we’ve had to do across the state and across the country is a little bit of that cheerleading again, being like, ‘No, not getting your regular physical is a big deal,’” Shessler said. “Like any kind of pandemic or catastrophe, people expected the sky to have fallen, and when the sky didn’t fall, it was, ‘Well, I’ll get back to that, but not right away. I’ll get there when I get there. ”

Shessler and other public health experts are urging parents to reschedule missed appointments as soon as possible. But they caution that won’t reverse the drop in vaccination rates immediately because providers are grappling with a rise in flu and RSV cases as they try to reschedule adults and children who have delayed care during the pandemic.

“We are behind schedule and you add their delay plus our delay and you end up falling behind on vaccines,” Shessler said.

State law requires children to have several vaccinations to attend public or private schools or day care centers: diphtheria, mumps, whooping cough, polio, rubella, rubella, and tetanus. The Department of Health and Human Services, which may also require vaccinations, requires vaccines against hepatitis B and chickenpox and a vaccine that protects against meningitis, epiglottitis, and pneumonia.

The department would lose its authority to mandate vaccines under House Bill 557, which would only allow lawmakers to make changes. Wilton Sponsor Representative Jim Kofalt said that while the department has been “very restrained” in adding new vaccines, he is concerned that a future Commissioner of Health and Human Services would add all CDC-recommended vaccines or the COVID-19 vaccine. .

“That should be something the legislature decides and not the individual who runs the agency,” he said.

Laura Montenegro, spokeswoman for Health and Human Services, said the percentage of students in public and private schools who are current on mandatory immunizations has dropped from 95 to 93 percent. Vaccination rates tend to be lower among private school students by 2 to 4 percent, according to department records. Private school students also have higher rates of religious exemptions. Last school year, the most recent period available, 4% of students were exempt from mandatory vaccinations for religious reasons, twice the number of public school students.

Outside the world of public health, a two percentage point drop might seem small, especially when rates remain above 90%. But for some vaccines, a drop below an 80-year rate risks the herd immunity that public health experts say is needed to prevent an outbreak.

“We don’t want to lose our fantastic immunization rates in the state and now all of a sudden we have to deal with outbreaks of measles or pertussis and have lots of babies admitted to the hospital,” said Shessler.

Measles was declared “eliminated” in the United States in 2000 thanks to high vaccination rates, according to the CDC. This is no longer true.

In 2019, there were 1,274 reported cases. The number dropped during the pandemic, when people wore a mask and social distancing, but rose again, from 49 in 2021 to 121 cases last year. A November measles outbreak in Ohio infected 85 students, 72 of whom had not received the combined mumps, measles and rubella vaccine.

“It’s about putting the community in perspective,” said Ryan Tannian, chief of the Department of Health and Human Services at the Bureau of Infectious Disease Control. “We’ve seen examples across the country where there have been outbreaks of vaccine-preventable diseases. And, you know, our goal is to keep kids in school and not have to close a school because of a vaccine-preventable disease.”

Tannian said schools across the state have had to close due to outbreaks of the flu, an unvaccinated disease in New Hampshire. It has not reported disease outbreaks with mandatory vaccines, he said.

Like Shessler, Tannian said the drop in childhood vaccination rates has expanded the department’s vaccination reach beyond helping communities by making vaccines easily available at local schools or clinics.

“We are trying to make sure that people choose to have their children vaccinated,” Tannian said. “And so, in the meantime, we want to make sure that anyone who missed, or didn’t have access to, or couldn’t get their routine vaccines, is caught and updated.”

Hali Wilkins of Henniker is not among those who missed the chance to get her 3-year-old daughter, Jovie, vaccinated. She and her husband chose not to vaccinate her.

Wilkins’ opposition to all vaccines started with a miscarriage that had nothing to do with vaccines. Instead, Wilkins began questioning all medical recommendations, including vaccinations, after concluding that an internal ultrasound had killed her baby several weeks into the pregnancy.

Before her second pregnancy with Jovie, Wilkins and her husband, Cody, discussed delaying recommended childhood vaccinations. They finally decided to forgo all vaccinations. She shared her research with others through Facebook groups and her company, Jovial Birth and Postpartum Services, which focuses on natural childbirth and care.

“The day I had (my daughter), I just looked at her and thought, ‘Wow, I could never let anyone inject her with anything if I risked hurting or killing her,’” Wilkins said. “So I thought, let’s sit down and look at each photo and what it should, quote, protect against.”

None of them, they decided, were worth the risk for Jovie and her second baby on the way.

Shessler and Tannian said it’s impossible to know how many parents are choosing not to vaccinate their children because of health concerns about the vaccine or religious objection.

“There is a large population that takes all the vaccines we can give. There’s a small, active population that doesn’t get any of the vaccines,” Shessler said. “And then there’s a big chunk in the middle where you’ll hear the term ‘vaccine hesitancy.’ We’re trying to move people from one side of that spectrum to the other to improve their confidence in vaccines. And having a reliable source for that information is extremely important.”

Health leaders push for vaccines as student vaccination rates drop

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