Despite being considered safe by the medical community, “reason of conscience” vaccination exemptions are on the rise in Hays County and throughout the state.
The state average of children exempted from immunization for reasons of conscience increased by more than half from 2011 to 2017, according to statistics from the Texas Department of State Health Services.
In Hays and San Marcos CISDs, the increase has been more rapid. According to data released June 8 by the Texas Department of State Health Services covering the 2016-17 school year, SMCISD’s conscientious exemption rate has nearly doubled for the second year in a row and exceeded the state average for the first time. For the fifth consecutive year, Hays CISD reported an exemption rate double the state average, with 1.92 percent opting out of vaccines.
The case for vaccines
Vaccinations contain small traces of the disease it prevents to prepare the body to strengthen its response to a future exposure, said Stephen Richardson, a primary care doctor at Live Oak Health Partners in San Marcos. A few of the diseases the state requires to be vaccinated for include Hepatitis A and B, polio and the measles.
“When your body is exposed to a bacteria or a virus, your immune system eats it up and puts out markers to the rest of your body to recognize how to fight it next time it comes around,” Richardson said. “Your body will recognize the piece [because of the vaccine] if you ever do get exposed to the virus. It gives your immune system a chance to fight it pre-emptively.”
Even if someone who has been immunized is exposed to the disease and still catches it, being vaccinated can help speed along the healing process, said Macie Walker, Hays CISD director of student health services.
“Even with vaccine preventable diseases, a child may still contract the virus, but the actual presentation of the disease may be less than what it would be if they weren’t vaccinated,” Walker said. “Their immunity would protect them so they have a lesser response. They have a minimal reaction, versus what it could have if they hadn’t been vaccinated.”
Exemptions increase
However, some parents are still concerned about the safety of immunizing their children, sometimes because of medical issues, or for reasons the state calls reasons of conscience.
According to the Texas Department of State Health Services, state law allows guardians to file for exemption from immunizations for reasons of conscience, including religious beliefs. A student's legal guardian must request, sign and submit to the child's school an official DSHS affidavit form, which is then valid for two years.
Walker said school districts often have “pockets” of students whose parents file for exemptions. Certain campuses tend to have more exempt students than others. Negley and Carpenter Hill elementary schools in particular have had a higher rate of conscientious exemptions for the past few years, according to district data. Trends of exemptions are not uncommon, both in Hays CISD and other districts, Walker said, often because the parents of children attending those campuses tend to spread anti-vaccine information with each other.
“Medically, we believe vaccines in general are good for students and supportive of the immunity of the community as a whole. We encourage [vaccines],” Walker said. “But we certainly understand for a multitude of reasons, parents may not want to have their child vaccinated and there are allowances for that. We honor those allowances and give them guidance for what that looks like.”
Immunizations are made available to Hays CISD students through the WELL Clinic, which serves Hays CISD students and their siblings. Uninsured HCISD children may be eligible for a discount with proof of income.
Possible consequences
San Marcos CISD has also experienced a striking rise in exemptions. From 2011 to 2017, the number of children exempt for that reason rose from 0.31 percent to 1.08 percent.
SMCISD Lead Nurse Dyanna Eastwood said the district has had a re-emergence of diseases treatable by vaccines as a result of the increase in exemptions.
“My opinion, as the nurse, is that vaccinations are safe and important to the community,” she said.
Children in San Marcos CISD schools can visit Live Oak Health Partners in San Marcos, who offer free immunization programs, Richardson said.
“Vaccines are considered safe by the medical community,” Seton Internal Medicine Specialist Fausto Meza said. “I wish everyone knew more about how safe they were.”
Fact vs. fiction
The widely spread idea that vaccines are linked to autism is a myth with no scientific basis, Meza said.
“From the standpoint of the medical community, it’s been well-refuted,” Richardson said. “There’s never been a causal link of [vaccination] shots to autism. I think the media hypes it up and plays into that.”
That is not to say all vaccines are perfect, Richardson said. More common reactions are irritation or swelling at the injection site, and the occasional fever. Medically fragile children, like those who have received an organ transplant, are often exempt from immunization, Walker said.
The success of vaccinations, such as the virtual eradication of polio in the United States, may ironically be one reason parents are becoming increasingly likely to not immunize their children, Richardson said. Nowadays, most parents have never seen anyone, much less a child, affected by a disease like polio.
“I think not being afraid of what the drug has reduced is very small to them. So the risk, the very rare risk, seems to be more concerning,” Richardson said. “When the vaccine for polio was made, no one refused it because everyone was scared to death of their child getting polio.”