The proportion of U.S. kindergartners exempted from school vaccination requirements has hit its highest level ever, 3%, according to a recent report from the U.S. Centers for Disease Control and Prevention.
Hawaiʻi saw the largest jump in the 2022-2023 school year, with the exemption rate rising to 6.4%, nearly double the year before. The rate was 3.4% for the 2021-2022 school year and 3.7% the year prior.
The Conversation talked to Ron Balajadia, head of the state Health Department’s immunization branch, about Hawaiʻi's vulnerability to disease outbreaks.
"We definitely are aware of the exemption rates having gone up, and it's something that we've always been concerned about," he said.
Experts like Balajadia say more parents are questioning public health interventions and routine childhood vaccinations that they used to automatically accept, an effect of the political schism that emerged during the pandemic around COVID-19 vaccines.
The department plans to host a vaccination summit early next year to understand why families opt out of mandatory vaccines and to discuss how to raise the vaccination rate.
Hawaiʻi has not seen more cases of preventable diseases like polio but "that's knocking on wood," Balajadia said.
"But that doesn't mean it can't happen, and this is the whole reason why we're concerned," he added. "When rates go down, it's ripe for introduction of disease."
People who can be vaccinated but choose not to are not the only ones that health officials worry about. Those who cannot be vaccinated include children who are too young and older adults who do not have robust immune systems, Balajadia said.
"We have vulnerable populations within our community and when we do have disease that's introduced, it could potentially spread to others. And then, again, we've had outbreaks in the past — mumps, hepatitis A, measles — and so we don't want that to be repeated."
In the last decade, the percentage of kindergartners nationwide with medical exemptions has held steady, at about 0.2%. But the percentage with nonmedical exemptions has inched up, lifting the overall exemption rate from 1.6% in the 2011-2012 school year to 3% last year. In Hawaiʻi, the nonmedical exemption rate was 5.8% last year.
More than 115,000 U.S. kindergartners were exempt from at least one vaccine last year, the CDC estimated.
This story aired on The Conversation on Nov. 30, 2023. The Conversation airs weekdays at 11 a.m. on HPR-1.
The Associated Press reporter Mike Stobbe contributed to this report. Sophia McCullough adapted this story for the web.
