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Thousands of US kindergartners unvaccinated without waivers

COLUMBUS, Ohio (AP) – States are heatedly debating whether to make it more difficult for students to avoid vaccinations for religious or philosophical reasons amid the worst measles outbreak in decades, but schoolchildren using such waivers are outnumbered in many states by those who give no excuse at all for lacking their shots.

A majority of unvaccinated or undervaccinated kindergartners in at least 10 states were allowed to enroll provisionally for the last school year, without any formal exemption, according to data reported to the Centers for Disease Control and Prevention. Only 27 states submitted information about the group, so the true size of the problem is unknown.

Poor access to health care keeps some of those children from getting inoculated against some of the most preventable contagious diseases, but for others the reasons are more mundane.

“It really could just be, ‘I didn’t have time to go to the doctor,’ or ‘I just don’t want to do this,’” said Melissa Arnold, CEO of the American Academy of Pediatrics’ Ohio chapter. “From a public health standpoint, we really don’t know.”

Experts say it’s likely that many or even most of those children ultimately get all their vaccinations, as state laws require, but no one knows for sure. It’s neither tracked nor required to be.



That leaves officials with a maddening lack of information as vaccination rates inch downward and diseases like measles, once declared eradicated, reemerge.

The CDC has called on education officials to do more to ensure that those children get vaccinated, and state health and education departments routinely issue reminders. But for school officials, complying with state mandates that require children be vaccinated in order to attend class can sometimes require choosing between educating students and safeguarding public health.

“At the heart of our purpose is to have children in school; that’s our role as school nurses,” said Kate King, a board member at the Ohio Association of School Nursing. “We don’t want to exclude them. So that’s our dilemma.”

All 50 states allow students to receive exemptions from vaccinations for medical reasons. But formal vaccine exemptions for religious or philosophical reasons have recently come under fire as the CDC has confirmed 880 measles cases in 24 states since January, the greatest number since 1994.

But children whose vaccinations are incomplete for other reasons can’t be ignored.

Of the 27 states that reported data on that group for the 2017-2018 school year, Arkansas had the highest percentage of kindergarten students enrolled without complete vaccinations and without invoking a medical, religious or philosophical exemption, according to the CDC . In Ohio, that figure was 5.3%, the second highest. Georgia and Hawaii were lowest, at 0.2%.

Neither Ohio nor Arkansas has any measles cases yet this year, but health officials say the percentages of unvaccinated children are a worry. A 95% immunization rate is considered necessary to achieve group resistance to the spread of a contagious disease, officials said.

“If it gets here, it will be bad,” King said of Ohio.

In the 10 states where unvaccinated kindergartners lacking exemptions outnumbered unvaccinated kindergartners who invoked them, the figures were striking: Only about 15,000 children were using exemptions compared to almost 27,000 who weren’t. Overall, the 27 states reported about 60,000 kindergartners who were unvaccinated without exemptions and about 70,000 who used them.

States provide anywhere from a few days to many months for students to get vaccinated, but officials in charge of the vaccination data for several different states said no system is in place to go back and check whether children ever get caught up.

Once a grace period expires, barring a student from attending school can be a tough call, risking the child’s educational outcomes and, in some urban districts, their safety.

In Pennsylvania, officials recently shrank the state’s eight-month grace period to just five days, said Cindy Findley, the state’s acting deputy secretary for health promotion and disease prevention. The shorter window brings more focus and resources to the issue at the busy start of school.

“What we’d find is children would go through the entire school year and not be up-to-date with their vaccinations and basically carry on to the next age group,” she said.

Other states, including Arkansas and Indiana, now require public reporting of kindergarten immunization rates by schools, and Colorado has made the information easier to access. Dr. Jennifer Dillaha, medical director for immunizations at the Arkansas Department of Health, said the idea is to draw attention to the issue and to provide parents with information that might affect their choice of school.

The CDC theorizes that “vaccine hesitancy” – fueled by a vocal anti-vaccination movement that contends some shots are unsafe despite overwhelming evidence to the contrary – has contributed to rising levels of unvaccinated schoolchildren in the U.S. But in Arkansas, Dillaha said, the issue is access.

Most Arkansas children are on Medicaid, health insurance for low-income residents, and 16 of 75 Arkansas counties have only the local health department to turn to for vaccinations, she said. That means no doctor’s offices, clinics or corner pharmacies to make the procedure convenient.

“We have a weak immunization infrastructure,” she said. “Consequently, because there are access issues, it varies from school to school how rigidly they enforce attendance requirements for vaccinations.”

In Ohio, state data show the number of unvaccinated students remains high as students go through the school system, with 10% of seventh graders last year undervaccinated without invoking an exemption.

Ohio’s last measles outbreak occurred in 2014 Knox County and was traced to the local Amish community, where vaccination rates trail the general population’s because their traditional lifestyle tends to eschew anything but the most vital medical care, said Pam Palm, a spokeswoman for the Knox County Health Department.

But even with that history, officials try to be flexible. Steve Larcomb, superintendent of the East Knox Local Schools in Knox County, recalled accommodating a parent who was new to the district, busy moving and awaiting a child’s doctor’s appointment five weeks in the future.

“We try not to draw too many lines in the sand and be too hard core, because we understand family situations,” Larcomb said.

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After a gorgeous Friday it may be difficult to believe that severe weather is expected for parts of the state on Saturday.

First is important to note that there will be a sharp cut-off on where the severe weather is possible and it is all dependent of the track of the low pressure and position of the warm front. No severe weather is expected to the northwest of Little Rock.

Check out the map below for which parts of the state could see severe weather starting early as 1 p.m. Saturday for south Arkansas and expanding north through the day until as late as 11 p.m.

Severe wx threat

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RED ZONE: (Camden, Monticello, Warren, El Dorado)  Severe Weather Likely, with storms in the afternoon and evening possibly producing large hail, damaging winds, and tornadoes (including strong and long-tracked).

ORANGE ZONE: (Pine Bluff, Arkadelphia, Stuttgart)  Severe Weather Possible with storms in the afternoon and evening capable of producing damaging winds, large hail and a weak spin-up tornado.

YELLOW ZONE: ( Hot Springs, Little Rock) Low risk of severe weather but some storms in the evening could produce damaging winds and large hail. Tornado threat low.

WHAT YOU NEED TO KNOW:

Stay weather aware.

Download the THV11 app and make sure you have settings to allow weather alerts.

Make sure your NOAA radio is good to go.

If you live in a mobile or manufactured home have a place to go that is much safer, a shelter, another home that is well constructed and anchored to the ground with interior rooms that do not have windows.

Below is some advice from the National Weather Service on tornado safety.

Wx safety

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EXPECTED SCENARIO:

A low pressure system will develop in east Texas and swing across central Arkansas through the day on Saturday dragging a cold front through the area Saturday evening. As the low develops it will pull in warm and moist air from Louisiana into southern parts of the state. This will set the stage for the potential of severe weather in this area.

The tornado risk is high in southeast Arkansas because there are high winds about 5,000 feet that will cause the storms to rotate in this region.

Wx graph 1

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Wx graph 2

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FLASH FLOODING:

Heavy rain through the day could cause smaller creeks and streams to rise out of their banks. Water could also pond in low lying or poor drainage areas. Rainfall totals from this event will range from 1 to 3”. Isolated locations could see more if heavy rain falls in a location for a long period of time.

Rain

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FUTURE RADAR: The time could be off a couple of hours.

Below shows what the radar is expected to look like through the day. We will be watching the potential of supercells developing in the RED ZONE ahead of the cold front as it charges through Saturday afternoon and evening. The threat of severe weather should be done for Arkansas by 11 p.m.

If there is sunshine in southeast or south Arkansas, the threat of severe weather will increase. Sunshine in this set-up is like adding fuel to the fire.

8 a.m. wx

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12 p.m. wx

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3 p.m. wx

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5 p.m. wx

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8 p.m. wx

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