Many students said not vaccinated at Waldorf school because of religious exemptions.
The Centers for Disease Control and Prevention lists for parents "14 Disease You Almost Forgot About (Thanks to Vaccines)," but a real-time scenario this week may be a better reminder or introduction.
Three dozen chickenpox cases have been diagnosed at a private school in North Carolina where religious exemptions from mandated vaccinations are said to be high.
The CDC has long reiterated the country's vaccines are the safest in world and the best prevention against diseases that once killed millions, but an anti-science skepticism rooted in a long-debunk association with autism continues to motivate some parents not to have their children vaccinated.
Massachusetts law requires children be immunized in accordance with current Department of Public Health recommended schedules against vaccine preventable diseases.
These means students in kindergarten through 12th grade are required to be immunized with diphtheria, tetanus and whooping cough (DTaP/Tdap), polio, measles, mumps, rubella (MMR), hepatitis B and varicella vaccines.
Children who are not immunized in Massachusetts may be admitted to school on the basis of either a medical or religious exemption and religious exemptions in a state where philosophical or personal exemptions are not allowed have been on the increase in recent years.
How a school district enforces excluding students not vaccinated is up to each district in Massachusetts.
The importance of herd immunity - rates of vaccination between 90 to 95 percent - is highlighted by the recent reported 36 cases of chickenpox at North Carolina's Asheville Waldorf School where many families of the nursery-school to sixth-grade students are said to claim religious exemptions from school immunization requirements.
Individuals infected with such a preventable disease as chickenpox not only infect others not vaccinated but put at risk individuals who may not be able to be vaccinated because of a compromised immune system that makes them especially vulnerable to any disease in the first place.
While Massachusetts has a 1.3 percent average exemption rate for vaccines, one of the lowest in the country, the percentage rates of students with one or more exemptions are uneven across the state.
Medical exemptions come from a student's doctor and document a contraindication to getting immunized. Religious exemptions come from the parent/guardian and state in writing that a vaccine conflicts with his/her sincerely held religious belief.
Children not immunized may be excluded from school during outbreaks of vaccine preventable diseases.
Franklin County continues to have the highest percentage of medical and religious exemptions of kindergarten students with a medical or religious exemption to one or more vaccines at 5.3 percent, according to state data for 2017.
Hampshire County is second at 3.7 percent, Cape Cod's Barnstable County, second at 3.1 percent and Berkshire County, third at 3.0 percent.
The remaining counties in the state are under 2 percent, including Hampden County at 1.8 percent and Worcester County, at 1.2 percent, with Boston and Suffolk County, 0.3 percent.
Franklin County also has the highest percentage at 3.2 percent of kindergarten students in 2017 with an exemption and no documented vaccines on file.
The state average for the rate of kindergarten students with an exemption and no vaccines is 0.6 percent.
According to the state, students who are "completely unimmunized pose a greater risk to the community as they are unprotected from multiple infectious diseases."
Berkshire County has the highest rate of kindergarten students - some 5.3 percent - who began the 2017 school year not meeting school requirements, something that can change as, for example, homeless children not vaccinated are allowed in school where officials are mandated to help them get up-to-date on immunizations.
Franklin County was second for the rate of kindergarten students beginning the 2017 school year not meeting vaccination requirements at 4.9 percent, followed by Hampden County at 4.3 percent.
The state average for kindergartens entering school without meeting school vaccination requirements in 2017 was 4.1 percent.
According to the Massachusetts Childcare/Preschool Immunization Survey Results for the 2016-2017 school year, two of the schools with the highest percentages for vaccine exemptions were in Western Massachusetts counties.
These were the Hartsbrook School, a Waldorf school in the Hampshire County town of Hadley, with a 34 percent exemption rate and Sanderson Academy, a public school, in the Franklin County town of Ashfield with a 22 percent exemption rate.
There have been three recent measles cases in the commonwealth.
Two in the Lowell area of Middlesex County and one in the Boston area.
The Centers for Disease Control and Prevention said there has been a total of 15 outbreaks - defined as 3 or more linked cases - of measles so far in the country in 2018.
It says the outbreaks in countries to which Americans often travel - a number of European countries have had an increase in measles cases related to a drop in immunization rates - can directly contribute to an increase in measles cases in the U.S. and has warned travelers to be up-to-date on their vaccinations.
All 50 states have legislation requiring specified vaccines for students and all school immunization laws grant exemptions to children for medical reasons.
Forty-seven states permit vaccine exemptions on religious grounds, and 18 states allow exemptions on personal or philosophical grounds.
The two-dose varicella vaccine for chickenpox is made from a live but weakened virus and has helped eliminate the disease, which can be deadly, in the U.S. during the last 20 years.
Prior to the development of vaccines, the CDC notes:
- Nearly everyone in the U.S. got measles before there was a vaccine, and hundreds died from it each year. Today, most doctors have never seen a case of measles.
- More than 15,000 Americans died from diphtheria in 1921, before there was a vaccine. Only two cases of diphtheria have been reported to CDC between 2004 and 2014.
- An epidemic of rubella (German measles) in 1964-65 infected 121/2 million Americans, killed 2,000 babies, and caused 11,000 miscarriages. Since 2012, 15 cases of rubella were reported to CDC.