An increasing number of vaccine deniers, coupled with one of the nation’s easiest provisions for opting out of inoculations, have left Arizona with close to one out of every 10 kindergartners unprotected against key childhood diseases.
The state’s top health official is concerned.
During the last school year, the most recent data available, only 90.6% of Arizona kindergartners got the MMR vaccine against measles, mumps and rubella, said Don Herrington, interim director of the Arizona Department of Health Services.
That is “well short of the 95% threshold considered necessary to prevent localized outbreaks,’’ he said.
Three new cases of measles were confirmed earlier this month in Maricopa County, in an adult and two minors, all unvaccinated. One patient had to be hospitalized.
“The measles MMR vaccine is highly effective,’’ and a high vaccination rate is the best way to prevent an outbreak among those who can’t be vaccinated due to medical or religious reasons, or simply because they’re too young, Herrington said.
The 9.4% of kindergartners who didn’t get the MMR vaccine includes those who cited medical or religious reasons, as well as personal reasons that do not have to be specified.
These are not innocuous diseases, he said.
“Measles, in particular, you can have loss of hearing,’’ he said. “It can affect their intellectual development. You can have brain swelling. It’s killed people.’’
Of particular concern is the increasing number of parents who are claiming a “personal exemption’’ from the requirement that children attending school be vaccinated against not just measles, mumps and rubella, but a host of other diseases. They need not provide any reason, under state law.
The result is that 6.6% of kindergartners in school statewide have a personal exemption for one or more vaccines, which also include those for tetanus, pertussis, hepatitis, chickenpox and diphtheria, among others. The 6.6% figure only includes personal exemptions, not additional, specified medical or religious exemptions.
It only paints part of the picture.
The opt-out rate exceeds 10% in Mohave County and 11% in Gila County. Close to one child out of every seven in Yavapai County has a personal exemption for one or more mandated 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 the rate dropping about a half percentage point a year for the past decade.
“That might not sound like a lot,’’ he said. “But if you start looking at a 10-year period, now you’re looking at a loss of 5%.’’
Hence, the 90.6% coverage rate, the trend line moving ever lower.
Herrington said there’s only so much he can do.
According to the National Conference of State Legislatures, Arizona is one of only 14 states that allows a personal exemption.
Gov. Doug Ducey, who has seen the personal opt-out rate for kindergarten-required vaccinations rise from 1.4% in 2000 to 6.6% now, has shown no interest in asking lawmakers to eliminate that privilege.
“Ultimately, decisions are going to be left to parents,’’ he said in 2019 when the opt-out rate hit 5.4%.
That was after California, facing a measles outbreak at Disneyland, eliminated its personal exemption. The same week Ducey declared his support for parental opt out, Washington Gov. Jay Inslee signed legislation saying parents could not use personal or philosophical exemptions and still send their children to school.
Ducey’s attitudes have not changed since then, his press aide C.J. Karamargin said Wednesday.
But Humble said Herrington’s department is not entirely powerless even as Arizona keeps its personal exemption option.
He pointed out the department worked with state Sen. Heather Carter to create a pilot program in 2018 to provide educational materials to parents seeking to opt out of one or more vaccines. The idea was to show the benefits of vaccination outweigh any risks.
The effort was scrapped after complaints from some parents who feared they would have to take the course to get the personal exemption, something that was not true.
Humble, who was state health director before Ducey took office, said the department should revisit the plan.
That’s based on his view there’s a direct link between vaccine acceptance and education and the related issue of income, one he said was borne out by a study the University of Arizona did for the health department a year ago.
“The 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 among those with higher incomes and more education, “You get people who think they know more than the doctor knows,’’ he said. “So I guess it’s hubris when you think you’re smarter than you really are about things and question the physician’s recommendations and therefore decide on your own not to vaccinate, either based on what your friends are saying in the friend group or what you’re reading on Facebook or whatever those sources of bad information are.’’
Herrington, however, said he’s not prepared to have that fight again.
“I think it really was like a line in the sand for some people,’’ he said of the reaction to the 2018 pilot program. “We meant it to be very informative … so that we could inform people of the drastic consequences of not being vaccinated.’’
But he said that’s not the way it came across.
“I think some folks felt that we were trying to scare people, which, of course, we weren’t,’’ Herrington said. So rather than push ahead, he said, “we just rethought it and discontinued it.’’
What’s left in his toolbox, he said, are press releases, blog posts and media interviews, all with the goal of explaining to people the benefits of the MMR vaccine — and why the vaccine is not like others that some see no reason to take.
“People read that COVID vaccines might prevent half of cases,’’ Herrington said. “Flu might prevent 60%.
“But that measles, mumps and rubella vaccine, if you get both doses in the right sequence, timing I mean, it’s 97% effective,’’ he said. “And I think that’s going to have to be a lot of our messaging is that ‘don’t associate all vaccines with that of the flu vaccine or with the COVID vaccine.’”
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