Exemption Redemption

Background: Washington State has the highest school vaccine exemption rates in the country. High exemption rates may contribute to community outbreaks of communicable diseases. Rural communities are at increased risk of outbreaks. Our project targeted the rural school district that had the highest exemption rates in our county and was aimed at increasing the number of children in school who were fully immunized.

Objectives: Accurately determine the number of exempt/noncompliant students in the district Determine number of students with true exemptions/vaccine resistance Evaluate the role of lack of education and services on exemption rates Plan with the county to incorporate our data to increase vaccine compliance in schools

Methods: Phase one: Determine accurate number of exempt/non compliant students. Phase two: Contact parents to discuss vaccines and educate. Phase  three: Provide in school free vaccination clinics Phase four: Meet with school/county leaders to discuss results and plan intervention Phase five: Provide immunization clinics on the day of school registration Phase six: Evaluate 2010 numbers of exempt/non compliant students and plan future options

Results: Data clean up revealed issues with data entry into the school computer system, lack of education of school staff providing information to parents, use of outdated forms, and under use of the state immunization registry contributed to incorrect assessment of exempt/noncompliant rates. Most parents of underimmunized students were not vaccine resistant. Free school based vaccine clinics were utilized by many parents and increased the number of compliant students. Cooperation from principals in enforcing state policy increased immunized students.

Conclusions: State data on exemptions in this school district did not reflect true exemption rates. Providing no cost convenient vaccination increased vaccine rates. Support in following school state school policies resulted in decreased exemption rates. Use of the state immunization registry information increased data accuracy and reduced staff time.