A recent chickenpox (or “varicella”) outbreak in the Yale Public Schools dstrict illustrates several important issues. Chickenpox is a vaccine-preventable disease that was quite common, but most people are unaware there can be severe and life-threatening consequences. Susceptible women entering child-bearing years are very worrisome because of the risk for congenital varicella syndrome.
In Yale, one child had a prolonged hospitalization, one adult was infected and (at least) one pregnant woman was exposed. In five weeks, 27 cases were reported in the Yale outbreak compared to 24 reported cases in all of St. Clair County in 2011. When a large percentage of a population is vaccinated, the entire community — vaccinated and unvaccinated — receives additional protection. “Herd immunity” is a primary justification for mandatory vaccination policy in the United States. Schools are a prime venue for the transmission of vaccine-preventable disease. Active school-age children can further spread disease to their families and others with whom they interact. State governments are solely responsible for school vaccination requirements — not the federal government. The allowance of exemptions to required immunizations is provided in connection to school or day-care enrollment; an exemption does not pertain to the circumstance of an outbreak and outbreak control measures. Public Health Code Act 368 of 1978, section 333. 5115 gives local health officers the authority to enforce these decisions, including the exclusion of unimmunized and immune susceptible students from school in the event of communicable disease outbreaks.
The current MDCH immunization waiver form explicitly states that in the event of disease occurrence, exclusion of unimmunized individuals may be undertaken as a disease control measure. In the Yale outbreak, 57 of 519 students (greater than 10 percent) initially were excluded from Yale Junior High School. Although cases appeared in other schools, the junior high experienced the highest number of cases. Those who could prove immunity or received a vaccine were allowed to return. Ultimately, 11 have remained excluded. The time of exclusion is 21 days from the last case reported because of the prolonged lag time the infection can take to appear.
We are aware and concerned that some parents are signing waivers to required immunizations as a matter of expediency in the school registration process without truly careful consideration of the importance of vaccines and the benefits in preventing these important illnesses. The waiver rates for St. Clair County are higher than the state average (seven percent) and have been increasing in the past several years. We urge each school district to re-evaluate its waiver policies to ensure “personal bias” and convenience are not creating a dangerous situation for its students and staff.
Vaccine Exemption Forms