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By Howard Fisher
Capitol Media Services
PHOENIX – A growing number of vaccine deniers, combined with one of the easiest opt-out regulations in the nation, has left Arizona with nearly one in 10 kindergartners unprotected against key childhood diseases.
And that’s causing concern from the state’s top health officials.
“The MMR measles vaccine is very effective,” said Don Herrington, interim director of the state Department of Health Services.
The same vaccine, given correctly, also protects against mumps and rubella. And he said high vaccination rates are the best way to prevent an outbreak among those who cannot be vaccinated for medical or religious reasons or simply because they are too young.
Yet in the most recent school year, according to the most recent data available, only 90.6 percent of Arizona kindergartners actually received the MMR vaccine, Herrington said, “far short of the 95 percent threshold considered necessary to prevent localized outbreaks’.
Those outbreaks have resulted, like three new measles cases earlier this month in Maricopa County, including an adult and two minors, all unvaccinated. One had to be hospitalized.
And Herrington said these are not harmless ailments
“With measles, in particular, you can have hearing loss,” he told Capitol Media Services.
“It can affect their intellectual development,” Herrington continued. “You could have brain swelling. It killed people.”
But of particular concern is the growing number of parents claiming a “personal exemption” from requiring school-going children to be vaccinated against not only measles, mumps and rubella, but a host of other diseases. Specifically, they need not provide any reason.
The result is that 6.6 percent of school-based kindergarteners in the state have a personal exemption for one or more vaccines.
And that only paints part of the picture.
The refusal rate exceeded 10% in Mojave County and 11% in Gila County. And nearly one in seven children in Yavapai County has a personal exemption for one or more required vaccines.
“It’s insidious,” said Will Humble, executive director of the Arizona Public Health Association, of the decline in childhood immunizations in the state, with rates declining by about half a percent a year over the past decade.
“That might not sound like much,” he said. “But if you start looking at a 10-year period, you’re now looking at a 5% loss.”
Hence the coverage rate of 90.6% – and this trend line is moving further down.
Herrington said he could only do so much.
According to the National Conference of State Legislatures, Arizona is one of only 14 states that has a personal exemption. And Gov. Doug Ducey, who has seen the rate of personal refusals of kindergarten-required vaccinations rise from 1.4 percent in 2000 to 6.6 percent now, has shown no interest in asking lawmakers to remove this privilege.
This is not a new attitude for the lame-duck governor.
“At the end of the day, the decisions will be left to the parents,” he said in 2019, when the opt-out rate reached 5.4 percent.
That was after California, faced with a measles outbreak at Disneyland, removed the personal exemption. And the same week that Ducey announced his support for giving up parental rights, Washington Gov. Jay Inslee signed a law that says parents can’t use personal or philosophical exemptions and still send their kids to school.
Press Contributor to Ducey CJ. Karamargin said Wednesday that the governor’s attitude has not changed since then.
But Humble said Herrington’s agency isn’t completely powerless, even if Arizona keeps it a personal exception.
He pointed out that the department actually worked with state Sen. Heather Carter to create a pilot program in 2018 to provide educational materials to parents who want to opt out of one or more vaccines. The idea was to show that the benefits outweighed any risks.
But the effort was scrapped after complaints from some parents who feared they would have to take the course to get a personal exemption, something that was not true.
Humble, who was health director before Ducey took over, said the agency should review the plan.
All of this is based on his opinion that there is a direct link between vaccine uptake and the education and related income problem, which he says is confirmed by a study done by the University of Arizona for the health department a year ago.
“Lower-income families, when their pediatrician says something, they believe it. It’s ‘the doctor recommended this, so this is what I’m going to do,'” Humble said.
And those with higher incomes and higher education?
“You get people who think they know more than the doctor does,” he said. “So I guess it’s hubris when you think you’re smarter than you really are about things and question the doctor’s advice and therefore decide not to vaccinate yourself, or based on what your friends say in the group of friends, or what you read on Facebook, or whatever those sources of bad information are.’
However, Herrington said he is not ready to have that fight again.
“I think it was really like a line in the sand for some people,” he said of the response to the 2018 pilot program. “
But he said it wasn’t.
“I think some people felt we were trying to scare people, which of course we weren’t,” Herrington said. So instead of moving forward, he said, “we just rethought it and ended it.”
What’s left in his toolkit, he said, are press releases, blog posts and media interviews, all aimed at explaining to people the benefits of the MMR vaccine — and why it’s not like others that some see no reason to. to accept.
“People are reading that the COVID vaccines can prevent half of the cases,” Herrington said. “Flu is 60% preventable”.
“But this measles, mumps and rubella vaccine, if you get both doses in the right sequence, the timing, I mean, it’s 97 percent effective,” he said. “And I think that’s going to have to be a big part of our messaging that doesn’t associate all vaccines with that of the flu shot or the COVID vaccine.”
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On Twitter: @azcapmedia
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Kindergarten Personal Exemption Levels:
District / 2013-14 / 14-15 / 15-16 / 16-17 / 17-18 / 18-19 / 19-20 / 20-21 / 21-22
Apache / 1.6% / 2.2% / 1.0% / 2.3% / 2.5% / 6.1% / 4.9% / 4.3% / 9.8%
Cochise / 3.1% / 1.8% / 2.6% / 1.9% / 2.7% / 2.8% / 2.6% / 2.7% / 6.3%
Coconino / 6.4% / 5.1% / 7.1% / 7.4% / 10.3% / 5.9% / 6.4% / 5.2% / 6.0%
Gila / 2.3% / 4.2% / 4.4% / 3.2% / 4.7% / 5.9% / 4.1% / 10.1% / 11.2%
Graham / 4.3% / 3.8% / 4.2% / 3.1% / 2.7% / 5.8% / 4.1% / 3.1% / 3.4%
Greenlee / 1.6% / 3.4% / 1.9% / 0.7% / 2.5% / 1.3% / 1.1% / 0.1% / 2.0%
La Paz / 2.2% / 2.8% / 0.5% / 1.7% / 1.3% / 1.9% / 2.6% / 0% / 3.5%
Maricopa / 5.1% / 5.1% / 4.9% / 5.4% / 5.9% / 6.5% / 5.9% / 5.9% / 7.0%
Mohave / 6.5% / 5.1% / 5.2% / 5.2% / 6.8% / 10.3% / 8.3% / 8.0% / 10.6%
Navajo / 7.9% / 4.5% / 4.3% / 5.2% / 5.1% / 7.8% / 5.8% / 6.0% / 6.7%
Pima / 2.6% / 2.8% / 2.6% / 2.6% / 2.7% / 3.2% / 3.1% / 2.6% / 3.3%
Pinal / 4.9% / 5.6% / 4.1% / 6.1% / 5.0% / 5.5% / 4.8% / 7.0% / 6.4%
Santa Cruz / 1.5% / 1.2% / 1.1% / 0.8% / 1.3% / 1.7% /1.5% / 1.4% / 0.9%
Yavapai / 11.6% / 10.0% / 13.5% / 11.5% / 14.0% / 12.5% / 12.3% / 11.5% / 15.1%
Yuma / 0.7% / 0.7% / 1.1% / 1.0% / 1.2% / 1.3% / 1.3% / 2.0% / 2.5%
Total / 4.7% / 4.6% / 4.5% / 4.9% / 5.4% / 5.9% / 5.4% / 5.4% / 6.6%
— Source: Arizona Department of Health Services
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Current MMR vaccination rate for those entering kindergarten, counting all exemptions.
Apache – 88.5%
Cochise – 90.1%
Coconino – 89.2%
Gila – 85.8%
Graham – 92.2%
Greenlee – 89.5%
La Paz – 90.3%
Maricopa – 90.6%
Mojave – 84.3%
Navajo – 87.0%
Pima – 93.8%
Pinal – 89.4%
Santa Cruz – 96.6%
Yavapai – 77.3%
Yuma – 95.4%
Nationwide – 90.6%
— Source: Arizona Department of Health Services
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