Colorado vaccination, exemption rates difficult to analyze
COLORADO SPRINGS, Colo. — A first-of-its-kind look at vaccination compliance and exemption rates at schools in Colorado’s 20 largest public school districts is drawing concerns about the accuracy of the data.
“We are collectively, at the local and state health level, intrigued by the report, but there are a number of problems with the methods. It’s not the kind of good, scientific methodology we’d like to see,” said Dr. Bill Letson, El Paso County Public Health’s medical director.
Chalkbeat Colorado, a nonprofit education news organization based in Denver, created the database and released it last week. A Colorado law enacted last July requires schools to disclose immunization and exemption rates upon request.
Three districts in the Pikes Peak region — Colorado Springs School District 11, Academy School District 20 and Falcon School District 49 — were among the 20 districts included in the examination.
No state agency collects or compiles this data, which Letson said is not for a lack of trying.
“It’s a difficult thing to do,” he said, “and it looks like they’ve run into the same problems we have had for years in getting the information.”
Schools don’t fall under the same privacy regulations as physicians, hospitals and other health care institutions; a separate law applies to students and their education records.
Thus, “things that govern public health are in conflict with the education standards, or at least perceived to be, which has made that difficult for public health,” Letson said.
The immunization information Chalkbeat collected was self-reported by schools and school districts, and Letson said the data appears to differ from district to district and even among schools within districts.
“There are variations in how they do their rules and how they supply the entry requirements,” he said.
Another issue is that the information available is “very limited,” Letson said. For example, the different types of vaccinations that students receive are not separated. Reporting of second doses of shots, such as the measles, mumps and rubella shot, also is not consistent.
Compared to previous trends in El Paso County, Letson said the Chalkbeat estimates are “either high or low — it goes in both directions.”
Non-compliance may mean parents are getting their children immunized but not turning in the shot record to the school or not filling out the paperwork to exempt their children from state laws governing immunizations.
On the other hand, a high compliance of students who have gotten all required immunizations, have signed exemption forms, or are “in process” of getting up to date on their immunizations, does not necessarily indicate high vaccination rates.
“That’s not to say it wasn’t worth the effort,” Letson said, “and we compliment the Chalkbeat folks for giving it a good try.”
As a result, Letson said he’s not really sure what the data mean and cannot provide interpretation or analysis.
Colorado ranks 45th in the nation for state immunization rates, and the Centers for Disease Control and Prevention recently ranked Colorado as having the lowest immunization rates in the nation of fully vaccinated children entering kindergarten.
Letson said variations occur for several reasons, including rural areas having less access to health care services.
That’s one reason Falcon School District 49 has a health center at Falcon Elementary School, in partnership with Peak Vista, said Matt Meister, D-49 spokesman. And it probably contributes to half of the district’s 26 schools listed on the Chalkbeat report having a 100 percent compliance rate for vaccinations, he said, as all D-49 students can get vaccinated at the center free of charge.
“Caring and high-performing school nurses and health assistants serve our students district-wide and work hard to inform families why immunizations are required and to ensure that our students are compliant with state immunization laws,” Meister said.
D-49 has four schools with what are considered high exemption rates of above 10 percent. Colorado allows immunization exemptions of all or some of the required shots for personal, religious and medical reasons.
In D-20, all seven campuses of The Classical Academy, a charter school system, have 100 percent compliance, but some have high exemption rates, including 27 percent at the high school.
Overall, D-11 had compliance rates in the 80s and 90s and low exemption rates. Only one school was above 10 percent in exemptions, Buena Vista Elementary School at 14 percent.
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