The number of students opting out of the state’s mandatory vaccination requirements has been on the rise in recent years in Plano ISD and other school districts across the state. During the 2018-19 school year, nearly 2.2% of PISD students received exemptions for reasons of conscience from the state’s vaccine requirements, according to the Texas Department of State Health Services. These conscientious exemptions are granted when a parent objects to the requirement based on their personal beliefs, religious or otherwise. In this case, a parent or guardian has the legal right to exclude their children from otherwise required immunizations. While the number of unvaccinated students is low compared to the number of vaccinated children, the risk for an outbreak of some vaccine-preventable diseases is higher when more than 5% of students are unvaccinated, according to the Texas Department of State Health Services. “You want to build as much protection into the community as you possibly can to protect everybody,” said Chris Van Deusen, the director of media relations for the DSHS. “If it’s one [unvaccinated]  person and everybody else is immunized, it’s not going to be [a problem], but when you see immunization rates falling under 95%, you start to get concerned.” Several Plano ISD schools have exemption rates that are double the districtwide rate, according to numbers provided by the district. Shepard Elementary School and Pearson Early Childhood School top the list with the number of exemptions granted at more than 5% of enrollment. Eight more elementary schools in the Plano district reported exemption rates higher than 4%. “School immunization requirements are set by the Texas Department of State Health Services,” PISD Director of Health Services Staci Antelo said in response to a question about the Plano schools at or nearing the 5% threshold. “Exclusions from compliance are allowable on an individual basis for medical contraindications, reasons of conscience, including a religious belief, and active duty with the armed forces of the United States.” As vaccination rates have declined in some communities, the U.S. has seen a spike this year in the number of cases of measles. The disease was considered eliminated in the U.S. in 2000, but 1,022 cases were reported nationwide from Jan. 1 through June 6—more than the previous four years combined, according to the Centers for Disease Control and Prevention. Plano ISD reported a single case of the measles in August at Plano West Senior High School. The district advised parents at the time that there was a three-day window in which their children could have been exposed to the disease. No additional measles cases were reported. Plano West had a 1.8% exemption rate this year, the highest of the district’s senior high schools, but still below the 5% threshold. “Getting immunized is really the best way … the easiest, the least expensive, [and]  it’s the most straightforward way to protect yourself, protect your family and really anybody else around you,” Van Deusen said.

Requirements and exemptions

In accordance with Texas law, public and private schools require students to receive six mandatory vaccines before they can enroll in kindergarten. Requirements are set by the state health department and the Texas Education Agency. A seventh vaccine that prevents meningitis is also required for students to enroll in seventh grade. A medical exemption is granted when a child is unable to receive a certain vaccine due to a health condition. This exemption requires a letter from a doctor. Conscientious exemptions, on the other hand, require a notarized letter from a child’s guardian and require renewal every two years. The state began allowing exemptions for reasons of conscience in 2003.

Risk of outbreaks

Following the recommended vaccination schedule is important to prevent an outbreak of diseases, said Dr. Jawaid Asghar, the chief epidemiologist with Collin County Health Care Services. According to the DSHS, the measles cases in Texas so far this year have not resulted in any outbreaks, as of this paper’s print deadline of June 14. In the event of an outbreak in Plano ISD, the district has a policy that prohibits unvaccinated students from attending class. “Plano ISD works very closely with the Health Department to manage communicable disease occurrences,” Antelo said. “In a case such as measles, the Health Department takes the lead investigating the illness and enforcing exclusion requirements.” Part of the reason public health officials aim for high vaccination rates is because of a concept called herd immunity. Herd immunity exists when enough people in a community are immunized that even a highly infectious disease has trouble spreading, said Zachary Simoni, an expert in medical sociology at The University of Texas at Dallas. This reduces the chances of a disease spreading, especially to those who cannot be immunized or those who choose not to be immunized. “Vaccines aren’t meant to be perfect for every single person; they rely on herd immunity,” he said. Richardson Editor Olivia Lueckemeyer and McKinney Editor Cassidy Ritter contributed to this report.

Conscientious exemption rate by Plano ISD campus

Campus Conscientious exemption rate
Pearson Early Childhood School 5.2%
Shepard Elementary 5.0%
Carlisle Elementary 4.8%
Beverly Elementary 4.8%
Hedgcoxe Elementary 4.8%
Haggar Elementary 4.5%
Harrington Elementary 4.4%
Aldridge Elementary 4.3%
Davis Elementary 4.2%
Sigler Elementary 4.2%
Boggess Elementary 3.9%
Skaggs Elementary 3.8%
Haggard Middle 3.7%
Plano ISD Academy High School 3.7%
Hendrick Middle 3.6%
Miller Elementary 3.6%
Head Start 3.4%
Hughston Elementary 3.4%
Wells Elementary 3.2%
Barksdale Elementary 3.0%
McCall Elementary 2.9%
Beaty Early Childhood School 2.8%
Dooley Elementary 2.8%
Hightower Elementary 2.6%
Robinson Middle 2.6%
Schell Elementary 2.6%
Andrews Elementary 2.4%
Vines High 2.3%
Hunt Elementary 2.3%
Isaacs ECS 2.3%
Renner Middle 2.3%
Mitchell Elementary 2.2%
Rice Middle 2.2%
Haun Elementary 2.1%
Frankford Middle 2.1%
Carpenter Middle 2.1%
Jackson Elementary 2.1%
Shepton High 2.0%
Schimelpfenig Middle 2.0%
Otto Middle 1.8%
Plano West Senior High 1.8%
Daffron Elementary 1.8%
Wyatt Elementary 1.7%
Gulledge Elementary 1.7%
Mathews Elementary 1.6%
Christie Elementary 1.6%
Murphy Middle 1.6%
Memorial Elementary 1.6%
Thomas Elementary 1.6%
Huffman Elementary 1.6%
Wilson Middle 1.6%
Centennial Elementary 1.6%
Mendenhall Elementary 1.6%
Hickey Elementary 1.5%
Barron Elementary 1.4%
Jasper High 1.4%
Williams High 1.4%
Bethany Elementary 1.4%
Clark High 1.4%
Stinson Elementary 1.3%
Brinker Elementary 1.3%
Saigling Elementary 1.2%
Bowman Middle 1.2%
Meadows Elementary 1.2%
McMillen High School 1.1%
Rasor Elementary 1.1%
Weatherford Elementary 1.1%
Plano East Senior High 0.9%
Forman Elementary 0.9%
Armstrong Middle 0.7%
Plano Senior High 0.2%