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Sun, Sept. 15

Pilot program to increase vaccinations for children goes awry

The test in 16 Phoenix area schools was aimed at parents who said they wanted to exercise their legal right under state law to exempt their children from the battery of immunizations required to attend schools. (Adobe Images)

The test in 16 Phoenix area schools was aimed at parents who said they wanted to exercise their legal right under state law to exempt their children from the battery of immunizations required to attend schools. (Adobe Images)

PHOENIX – A pilot program designed to increase vaccination rates among Arizona youngsters actually ended up having the opposite effect.

The test in 16 Phoenix area schools was aimed at parents who said they wanted to exercise their legal right under state law to exempt their children from the battery of immunizations required to attend school. The parents in eight of the schools were shown one or more video “modules’’ detailing the effects of failing to vaccinate; parents in the other eight schools got the opt-out forms without the videos.

It didn’t work. In fact, it’s worse than that.

In a blog post Tuesday, Health Director Cara Christ said in the elementary schools where the video was shown to parents who did not want immunizations for their children, there actually was a slight increase in the number of exemptions sought in more than half of those schools. Conversely, in more than half of the schools where there was no video, there actually was a slight decrease in exemptions.

“Unfortunately, these weren’t the results we were hoping to see,’’ she said.

So what’s next?

“It’s time to reevaluate and readjust and figure out how we can move the needle,’’ said Colby Bower, the agency’s assistant director.

That “needle’’ is the percent of children who start school with the legally required vaccinations. The reason that compliance is not 100 percent is Arizona law allows parents to refuse to go along, whether for religious or personal reasons.

What has caused concern is that in the 2016-2017 school year 4.9 percent of parents of students entering kindergarten opted out of immunization for personal reasons. That is on top of 0.3 percent seeking a medical exemption.

The most recent data available for the 2017-2018 school year found that personal noncompliance rate hit 5.4 percent, with a 0.7 percent medical exemption. And among those in child care, non-immunization for personal reasons went from 3.9 percent to 4.3 percent.

All that is significant because, in general, state health officials say it takes about a 95 percent vaccination rate to create “herd immunity.’’ That’s where enough people are immunized against the disease to prevent it from spreading widely into those who cannot be vaccinated for things like medical and religious reasons.

State health officials figure that the failure to achieve herd immunity for youngsters in kindergarten would mean about 5,000 statewide would be at risk for measles, one of the diseases now in the list of mandatory vaccinations. Others in the immunization list include polio, chickenpox, hepatitis B and diphtheria.

Bower acknowledged that the pilot program drew objections from parents who are opposed to vaccinations. They complained to the Governor’s Regulatory Review Council they feared what was being billed as a voluntary program would become mandatory for all anti-vaccine parents as the program was expanded.

He said, though, that the council has no purview over the program and that the decision to pull the plug was based largely on the failure of the test to produce the desired results.

Still, Christ indicated she is sensitive to concerns by parents who oppose vaccinations that they are being singled out.

One option, she said, is making the course into educational videos available to all and not specifically targeting parents who want to opt out of vaccinations. There is also the idea to have the program target all parents at schools with the highest percentage of children who are granted personal exemptions from immunization.

As it turns out, a 2013 University of Arizona study cited by the health department found that the highest opt-out rates tended to occur in schools with mostly Anglo students – and, in particular, those in more affluent areas.

The health department also has found a much higher rate of rejection in some areas in the northern part of the state, with the highest percentages of refusal – above 14 percent – in and around Prescott, Sedona and Page. Conversely, some of the lowest rates – below 2 percent – were in and around Tucson, Bisbee, Douglas, Yuma and Santa Cruz County.

Separately, the health department’s own data has found that, geography aside, the parents who send their children to charter schools are more than twice as likely to keep their children from getting immunized as those going to traditional public schools.

The reasons, according to the UA study, included concerns about side effects, notably a perceived link to autism despite repeated assurances by the Centers for Disease Control that there is no link. Other fears expressed by parents ranged from perceived contaminants to a lack of trust of manufacturers, pharmaceutical companies, government and physicians.

Bower said the reaction from parents to the pilot program was in some ways expected.

“Whenever we do anything with vaccines there’s always pushback,’’ he said.

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