Doctors, schools urge parents to get children vaccinated as families face barriers

Because of the risk of outbreaks, doctors are urging families to make sure their children are vaccinated before they run the risk of catching or spreading vaccine-preventable disease, which can cause serious illness or death.

“In the most recent reports from the state, local rates of routine vaccinations of school-age children declined this past school year,” said Dr. Becky Thomas, medical director for Public Health - Dayton and Montgomery County.

“That’s particularly concerning because we’re seeing increased incidence of diseases, which can be prevented by vaccines such as measles and looping cough,” she said.

A rate of least 94% is needed to reach herd immunity for highly contagious diseases in order to prevent the spread, according to the Mayo Clinic.

Only about 9% of the elementary schools in the region met the threshold of 94% or more of their kindergarten students having all of their required vaccinations for the 2023-2024 school year, the most recent year for which data is available, according to a Dayton Daily News analysis of ODH data.

Due to drops in vaccinations, communities are starting to experience outbreaks of diseases that haven’t been seen in 15 and 20 years. Dr. Jonathan Thackeray, associate chief medical officer at Dayton Children’s Hospital, used the example of pertussis, or whooping cough, which is a vaccine-preventable disease.

“We had a rate of children testing positive that’s higher for this time of year than it’s ever been in the time we’ve been tracking it,” Thackeray said.

“There are a lot of reasons that we see lower vaccination rates,” said Thomas. “One of them is access, and we think that could be the biggest one.”

Going to the doctor and keeping up to date on vaccines can be difficult for a number of reasons, Thomas said. Those reasons can include busy family schedules, limitations on locations where people can go and get vaccines and limited hours at those locations.

“Then the pandemic also brought up a couple of particular issues, including an increase in misinformation about vaccines that may be still shaping attitudes and behaviors,” Thomas said.

False information can spread quickly and take on a life of its own, she said.

Public charter schools miss the mark

Emerson Academy, a public charter school a part of the National Heritage Academies charter schools in Dayton, had one of the lowest rates of vaccination for the 2023-2024 school year. Emerson Academy reported only 13 out of 75 incoming kindergarten students, or about 17.3%, had all of their required immunizations, according to ODH data.

The majority, or 62, of Emerson’s kindergarten students were marked incomplete, according to state data, and eight of those students were marked as in-progress of getting immunizations.

Ensuring families understand the importance of completing their children’s immunization records when they enroll in school remains a priority, a spokesperson for National Heritage Academies said.

“This includes a focus on strong parent partnerships to decrease any barriers and connect them with the appropriate community resources, as needed,” the spokesperson for National Heritage Academies said.

Other public charter schools with low vaccination rates last school year included North Dayton School of Discovery at 55.62%, Montgomery Preparatory Academy at 33.87%, Klepinger Community School in Dayton at 49.15%, and Fairfield Preparatory and Fitness Academy in Hamilton at 36.92%.

Springfield Preparatory and Fitness Academy in Clark County broke that trend with having all 22 kindergarten students fully vaccinated last year.

Language is a growing challenge

One obstacle appearing more often is differences in language.

There are more than 80,000 students who are English learners in Ohio schools, according to the Ohio Department of Education.

Fairfield City Schools had the second lowest rate of kindergarten children fully vaccinated last year, after Fairfield Preparatory. At Fairfield South Elementary School, reporting 63 out of 106 kindergarten students, or 59.43%, having all of their immunizations, according to ODH.

“Our greatest barrier is language,” said Matthew Crapo, the director of student services at Fairfield City Schools.

If immigrant families or households that don’t speak English at home aren’t aware of the state’s vaccination requirements, schools say it can sometimes be difficult to communicate those requirements with them. While Spanish is the primary language of approximately one-third of the state’s English learners, there are more than 90 other languages are also spoken by Ohio’s English learners.

In all of Butler County, the enrollment of English learners has grown from 3,042 in the 2018-2019 school year to 4,803 in the 2022-2023 year, according to the Ohio Department of Education, which is an increase of about 57.9%.

While that population increased, state data shows the rest of the Butler County student population decreased from 56,747 in 2018-2019 to 54,561 in 2022-2023, a decrease of about 3.9%.

“A lot of families that come to us don’t know anything about the culture of American school, and so while it’s a challenge, we are adjusting the way we do things to meet the needs of those students,” Crapo said.

To help address access barriers, Fairfield City Schools has a school-based health center, Primary Health Solutions, which can provide immunizations to students with permission from parents or guardians.

“They’re on campus. We transport kids throughout the day, so that we eliminate that barrier of transportation,” Crapo said. “Then recently we’re also partnering with the county to provide immunization clinics.”

In Montgomery County, Public Health can help with translation services, and Public Health’s nurses can offer specific individual guidance. Anyone with questions regarding vaccinations may call 937-225-5700 to speak with members of Public Health’s Health Services staff.

Springfield seeing multiple hurdles

Clark County has similarly seen an increase in English learners, going from 531 in 2018-2019 to 838 in 2022-2023, state data shows, an increase of about 57.8%. The rest of the student population decreased from 20,688 to 19,401 in that same time frame, a decline of about 6.2%.

Springfield City School District’s Lincoln Elementary School had the lowest rate of vaccination in the 2023-2024 school, reporting 51 out of 78 kindergarten students, or 65.38%, as being fully vaccinated.

“There are several barriers that factor into the immunization rate, including the District’s high number of families living in poverty, the increased number of families choosing not to vaccinate their children, as well as the recent influx of non-English speaking students, which has increased exponentially in the last few years, said Jenna Leinasars, communications specialist for Springfield schools.

In December 2022, Clark County experienced its first measles case in more than 20 years, the health district said.

The district’s nursing staff try to engage with parents about vaccination, including communicating the need for vaccinations through email, letters sent via mail, backpack mail and hosting immunization clinics in conjunction with community partners.

Another barrier seen in Clark County is the number of vaccine providers is limited, the Clark County Combined Health District said.

Staffing shortages across all of health care have led to longer wait times, including with the health district’s immunization clinics. Language barriers, whether it’s Spanish or Haitian Creole, are a challenge, but the health district has interpreters on staff.

While the health district can provide immunizations, there is a high demand and appointments are booked full for the next few months, they said. The health district should be able to have some temporary increased capacity for vaccination at by the end of August as ODH is supplying some temporary staff to assist.

Primary care providers, health departments and pharmacies are additional places people can look for vaccinations, but they may be limited to a primary care provider or a public health clinic depending on their insurance coverage.

Community benefits from higher immunization, doctors say

The more children and people who are vaccinated, the more it helps protect vulnerable individuals who cannot be vaccinated, such as infants and individuals with compromised immune systems, according to Dr. Beejadi Mukunda, chief medical officer for CareSource Ohio.

“Vaccines help prevent serious diseases that used to seriously harm or even kill children,” Mukunda said.

Schools can be environments where diseases like measles, whooping cough, and others can spread easily among unvaccinated children, leading to outbreaks, Mukunda said. Cases of both measles and whooping cough have popped up in the region in recent years.

“When more people are vaccinated, the overall transmission of diseases decreases, making it less likely for outbreaks to occur,” Mukunda said.

If more children do not get vaccinated this coming school year, doctors are anticipating a difficult season, Thackeray said, when children return to school and are in close contact with each other again.

Since the measles vaccine came out in 1963, there have been a couple generations that have not had to deal with it to the scale it was prior. In the decade before the vaccine, 3 to 4 million people became infected in the U.S., an estimated 400 to 500 people died each year and 48,000 were hospitalized, according to the Centers for Disease Control.

“It causes infection of the lungs. It causes infection of the brain tissue, and those are things, even for children who survive it, it can affect them the rest of their lives,” Thackeray said.

Doctors are encouraging parents to make sure their children are vaccinated and up-to-date on their records, visiting the pediatrician, family health practitioner, or the public health department for resources.

If cost is a concern, the federal Vaccines for Children (VFC) Program provides vaccines to children whose parents or guardians may not be able to afford them.