State health officials are looking for new ways to boost Arizona’s sagging rate of vaccination of children after scrapping a pilot program aimed at parents who opted their youngsters out.
That program, started more than a year ago in 16 Phoenix-area schools, asked parents in half of them to view a video about the need for widespread immunization, both for their own children and others who for various medical and religious reasons cannot get vaccinated. But as state health officials were reviewing the results, some parents complained to the Governor’s Regulatory Review Council that they feared what was, for now, an option to view the videos could be made a requirement for parents who oppose vaccinations.
But Colby Bower, the department’s assistant director, told Capitol Media Services Tuesday that the now-abandoned pilot program was not part of the rules under review – or even under the purview of the council. And he said the decision to scrap the pilot program – and not try to take it statewide — has nothing to do with those rules which the council ended up approving anyway.
Put simply, he said, the program 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, in half of those schools there actually was a slight increase in the number of exemptions requested. Conversely, in 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,” Bower said.
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 just youngsters in kindergarten would mean about 5,000 statewide would be at risk for just measles, one of the diseases now in the list of mandatory vaccinations. Other in the immunization list include polio, chickenpox, hepatitis B and diphtheria.
Under the pilot program, any parent seeking an exemption viewed an “introductory” online module about vaccinations. Then, depending on which of the multiple vaccines on the mandatory list they did not want, there were separate modules.
After viewing the applicable modules parents were able to print the forms seeking each vaccination exemption to return to the school.
But department spokeswoman Melissa Blasius-Nuanez said the program was voluntary: Parents who did not want to view the videos were still given access to the exemption forms.
In her blog post Tuesday, Christ said alternatives are being planned. But she indicated the changes proposed are not based on any concerns that the pilot program was being targeted solely on parents who choose not to immunize their children, whether for personal or religious reasons.
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.