Who is in charge of Vermont vaccine compliance, enforcement?

Published: May. 15, 2019 at 9:07 AM EDT
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Kids in Vermont are required to get vaccinated to attend school, or to fill out the appropriate paperwork that lets them opt out. Schools have until January 1 to send the health department the number of vaccinated and unvaccinated children. The large majority of Vermont students are vaccinated, with 94.5 percent for the 2018/2019 school year. But it's up to your child's school to follow through on the legal requirements, and we found some schools have low vaccination rates.

In the Colchester School District, it's district nursing supervisor Deb Deschamps job to keep track of who is vaccinated and who isn't. According to the latest reports from the Vermont Health Department, nearly 96 percent of kids were up-to-date at Colchester High School, and nearly 98 percent in the middle school.

"We keep a list of students who need to get their vaccinations, so it's very hard for them to slip through the cracks," Deschamps said.

For students who don't get the legally required vaccines and don't have an exemption form, they eventually can be forced to stay home from school. But Deschamps says her school takes steps so that doesn't happen, like contacting the parents to figure out how to get the children to a doctor.

"Fortunately, in almost every case -- every case -- we definitely work on it. Parents recognize that they have to sign an exemption or take the child to get that vaccination," Deschamps said.

The lowest fully-vaccinated schools in Vermont are independent schools. For example, none of the kids at the Twelve Tribes Community Schools in Bellows Falls, Rutland and Island Pond are reported to be up to date on vaccines. In the latest report, the lowest fully vaccinated public school is Windham Elementary at 62.5 percent.

You can't tell from the state statistics why those students, or students at dozens of other low-reporting schools aren't up to date.

We asked Vermont Health Commissioner Dr. Mark Levine if it's possible kids across the state are slipping through the cracks and not being tracked properly by their schools and still showing up for class.

"I don't think it's an epidemic of that happening, but at the same time I'm sure it's happening," Levine said.

When, and if, it does, state agencies aren't enforcing the vaccine law. The Vermont Health Department doesn't follow up to make sure specific schools are in compliance for all students. "We can say, 'This is your rates.' We can't point at a kid and say, 'This one needs to be immunized, this one needs to be immunized,'" Levine said.

The Agency of Education doesn't enforce the law either. It's up to local school administrators to do the job.

We found certain schools report low vaccination rates year after year, but Dr. Levine says he only has enforcement power when there's a health problem. "When there's a public health crisis and there's an issue with not exposing general population to potentially infected people, we have complete responsibility there," he said.

With 94.5 percent of Vermont students fully vaccinated, that means about 4,600 of the nearly 84,500 kids children aren't up-to-date.

We asked Dr. Levine if he felt comfortable with the rates. "Not during a measles outbreak, which is why we're doing what we're doing now -- trying to be more activist about this, because we don't have the enforcement mandate as a health department," he said.

About 114 schools reported vaccination levels below the 95 percent, the threshold the health department says keeps kids safe from measles, the highly-contagious disease that used to be eradicated.

Dr. Levine says the measles used to kill hundreds every year and hospitalize tens-of-thousands.

Reporter Alexandra Montgomery: Do you want the health department to legally have more power to say to these schools specifically -- you need to do better?

Dr. Mark Levine: I think the campaign we're embarked on right now with awareness across the board in the midst of a national crisis, I think that can be as effective.

So far the there have been no reported cases of the disease in Vermont.


Vermont health officials say compliance rates for vaccines have been fairly good since the state removed philosophical exemptions, but they have noticed a slight increase in religious exemptions.

"We're doing pretty well. The vast majority of kids in Vermont are fully up to date on all their vaccines," said Patsy Kelso of the Vermont Department of Health.

The kids who aren't up to date have two options. The first is to hand in proof as soon as possible. In the meantime, they are admitted to school on a provisional basis and have six months to get the appropriate shots. About 2.3 percent of nearly 84,500 students across the state were admitted provisionally in the latest report. That's down slightly from last year.

The second option is to submit a medical or religious exemption form, making it so they do not have to get a shot.

Medical exemptions would have to be pretty serious, like chemotherapy. Just 0.2 percent of students were admitted with a medical exemption in the latest report, which is on par with other years.

For the religious exemption forms, they just need to be filled out and signed. No proof is required like with the medical exemption. Religious exemptions were reported at about 3 percent in the latest numbers.

"We saw a slight bump in the religious exemption in the last year, with the absence of the philosophical exemption," Levine said.

Lawmakers got rid of the philosophical exemption for the 2016-2017 school year to combat falling vaccination numbers, but it seems the number of religious exemptions is now creeping up.

From the 2012-2013 school year to the 2015-2016 school year, the percentage of those with philosophical exemptions hovered around 4 percent.

In the same time frame, religious exemptions were near 0 to 0.5 percent. Since the philosophical exemption was removed, religious exemptions jumped to 3 percent across K-12. And just last year, the number of kindergartners filing religious exemptions was up to 4.4 percent.

Levine says misinformation is what is causing parents to choose not to get their kids vaccinated. We asked if he would support getting rid of the religious exemption and he said as a public health measure, he definitely would.

So what is the health department doing to help stop a measles outbreak? Watch that story Thursday on Channel 3 News at 6.

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