As school vaccinations dip, outbreak risks rise

Students at Crowley Kindergarten have been spending much of their recess time inside since school started just over a month ago. With temperatures regularly climbing over 90 degrees during school hours, parents have voiced concerns about their children being exposed to the heat.

“When it gets over 91 degrees, we just keep them inside. It’s too hot out there,” said Principal Angie Trahan, surrounded by children eagerly coloring and drawing in their air-conditioned classroom.

But there’s another risk of exposure Louisiana public health officials are concerned about. Since the pandemic, an increasing percentage of children have entered school unvaccinated, as more parents choose to file exemptions from commonly scheduled vaccines against mumps, measles and polio, among other communicable diseases. 

In the case of measles, the percentage of kindergarteners statewide who are vaccinated has now dropped below what has been scientifically accepted as the threshold for herd immunity, causing experts to worry about potential outbreaks.

“There are a lot of diseases that we have done very well effectively eradicating in this state,” said Louisiana’s top medical official, Dr. Joseph Kanter, who serves as the state health officer and medical director with the Louisiana Department of Health. “To the point that we take for granted the protections that we have built to them.”

Louisiana has historically had vaccination rates far above the national average, despite having some of the loosest exemption laws in the country, Kanter pointed out. And while the state’s percentage of kindergarteners exempted from mandatory vaccinations based on their parents’ request remains below the national average, increases on both the state and federal levels are cause for concern.

In the case of measles, vaccination rates among kindergarteners in Louisiana in the 2021-22 school year dipped just below the immunity threshold of 95%, causing Kanter to worry that the state might be at risk of an outbreak, similar to ones seen in other parts of the country in recent years. 

“Measles, when it’s severe, is such a devastating disease and we’ve done such a good job at eradicating it,” Kanter said, pointing to the efficacy of vaccine requirements. 

The disease, he noted, is “one of the most communicable diseases known to mankind.” One infected person, in an unprotected environment, will infect 12-18 other people, according to Kanter.

The consequences can be severe, he said. Out of 1,000 children infected, 1-2 are statistically going to die from the disease. 

An outbreak of a disease that has been largely eradicated due to high levels of vaccinations poses another challenge.

“There’s no healthcare system in the U.S. that is prepared for a mass outbreak of measles or polio. A lot of younger physicians have never seen a case,” Kanter said.

Health authorities contained a measles outbreak in Ohio, with federal assistance. While Kanter believes local healthcare systems could manage an outbreak, he warns it will nevertheless come at a human cost. 

“Do we have the tools to treat this and bring this under control? Yes. Will there be unnecessary sickness and loss of life? Probably,” he said.

So why are parents choosing not to vaccinate their children? Both Kanter and Acadia Parish School District Superintendent Scott Richard say increased vaccine hesitancy brought about by the pandemic and the rollout of the COVID-19 vaccine have likely played a role.

“There’s no question that the anti-vax movement is a larger entity now. It’s better funded, it’s better organized — and it’s been quite prolific at spreading its message,” Kanter said. “There’s a lot of families that have unfortunately fallen victim to that.”

Richard, whose district includes Crowley Kindergarten, said as vaccines have become more politicized, hesitancy has grown. The percentage of kindergarteners whose parents asked for them to be exempted from standard immunizations more than doubled in Acadia Parish over the past two years. 

“The entire concept of vaccinations has become controversial,” Richard said. While numbers for the current school year are not yet available on a parish-wide basis, Richard doubts that they’d show a rebound in vaccinations. “I would not be surprised if the numbers are static or even lower,” he said.

The school’s standard policy would require unvaccinated students to stay home in case of an outbreak, but Richard was reluctant to call for stricter regulations on exemptions in general. “At the end of the day, it’s the parents’ choice,” Richard said.  “If there’s any sort of issue that should arise with communicable diseases, we’ll definitely work with the medical community to address it.”

And despite his concerns, Kanter said Louisiana’s numbers were still strong, leaving him with the hope that things may improve again. 

“There’s not a lot of things that 94% of people in Louisiana agree on,” Kanter said, referring to the percentage of kindergarten students statewide who received the measles vaccine in the first school year post-pandemic.

“Vaccines retain widespread support,” he said. “The overwhelming majority of families take their physician’s advice to heart and take reasonable measures to protect their children.”

At Crowley Kindergarten, kids are encouraged to wash their hands, cover coughs and sneezes with their elbows, and take other precautions commonly advertised since the pandemic. 

Still, as the school year got rolling, students and staff have suffered head colds, stomach bugs and other commonly spread illnesses, which often occur when adults and large groups of children first convene, staff said. 

“A lot of students have never been anywhere, they’ve only been home with mom,” Trahan, the principal, said of her newly arrived flock.

Alena Maschke reports on health for The Current and the Acadiana Advocate. Her work is supported by the William C. Schumacher Foundation, Pugh Family Foundation, Pinhook Foundation and Blue Cross Blue Shield of Louisiana.