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LIHUE, Kauai — Nearly a quarter of public, charter and private schools on Kauai have extremely high rates of unvaccinated children — a far higher proportion than elsewhere in Hawaii — according to newly released data from the state Department of Health.
Pockets of extremely high numbers of unvaccinated children dot all of Hawaii, with Maui and Hawaii counties, along with Kauai, far outstripping Oahu in terms of percentages of children without necessary shots.
The statewide rate of unvaccinated children for 2018-19, with some schools not yet reporting, is roughly 2 percent — about 3,900 unvaccinated students. In 2013-14, a school year that had more complete data, it was roughly 1 percent of all students, according to a Civil Beat analysis of the data.
Roughly 5.7 percent of students on Kauai had a waiver, 4.3 percent of students on Hawaii Island, 3.3 percent on Maui and less than 1 percent on Oahu, our analysis showed.
About 8 percent of charter school students, 2.6 percent of private school students, and 1.39 percent of public school students had waivers.
The new data were released by the Health Department under a public records request filed by Civil Beat. Prior to release of the data — which are expected to be posted on the Department of Health website soon — Hawaii had no centralized source of information for parents concerned about the dangers their children may face by attending schools with high rates of unvaccinated students.
Hawaii parents who are unwilling to have their children vaccinated can claim a religious exemption, though there is no definition of the term. Children can also be exempted for medical reasons if their doctors certify that vaccination would create undue risk.
Schools are important locations in which infectious diseases can take root because, even when a large majority of students are vaccinated and the school achieves what public health experts call “herd immunity,” outbreaks of diseases like measles and pertussis can take root and gain momentum quickly if even only 10 or 15 percent of students are unvaccinated.
The Hawaii Department of Education declined an interview request to discuss the vaccination rate. Directors and principals at six religious, private and charter schools did not return calls seeking comment on high exemption rates on their campuses.
Civil Beat obtained data for the current school year and five previous school years to allow for trend comparisons.
On Kauai during the current school year, six of 27 schools reported rates exceeding 15 percent of parents claiming a religious exemption to legally justify their children attending school without receiving vaccines.
A public health expert contacted Thursday night described the Kauai rates as extraordinary. The schools in question are, overwhelmingly, on the North Shore or East Side.
• Alakai O Kauai Charter School, with 130 students, 40 percent of whom are unvaccinated as a result of religious exemptions. The relatively new school had the same rate in 2017-18.
• Hanalei Elementary; 252 students; 29 percent religious exemptions. The rate is only slightly higher than the 27.6 percent it recorded six years ago.
• Kanuikapono Charter School; 207 students; 32.9 percent, which is actually 4 percentage points lower than six years ago.
• Kauai Christian Academy; 73 students; 21.9 percent. In 2013-14, the school reported no religious exemptions from vaccinations.
• Kilauea Elementary; 312 students; 33 percent, up more than 10 percentage points from the 2013-14 school year.
• St. Catherine School; 116 students; 15.5 percent. The schools’ rate was unchanged in the six years reviewed.
Statewide, only 10 other schools had religious exemption rates of 15 percent or higher. In Hawaii County they include:
• Malamalama Waldorf School/Kinderhale, 95 students, 46.3 percent. The rate declined from 54.9 percent six years ago.
• Kona Pacific public charter school, 222 students, 37.4 percent. The rate more than tripled from the 10 percent it reported in 2013-14.
• Waimea Country School, 35 students, 16.1 percent.
• Innovations public charter school, 237 students, 16.9 percent.
• West Hawaii Exploration Academy, 259 students, 16.6 percent.
In Maui County, schools include:
• Haleakala Waldorf School, 245 students, 52.7 percent. The rate 1 percentage point lower than six years ago.
• Roots School, 53 students, 41.5 percent. Its rate was up slightly more than 10 percentage points from six years ago.
• Montessori Maui, 181 students, 35.4 percent. Its rate was up sharply from 27.7 percent six years ago.
In Honolulu City and County, schools above 15 percent include:
• Sunset Beach Elementary, 403 students, 18.9 percent.
• Myron B. Thompson Academy public charter school, 519 students, 17.5 percent.
The vast majority of schools in counties other than Kauai show low rates of unvaccinated children, though some range as high as 10 percent or more. On Oahu, many schools record unvaccinated rates of zero or close to zero.
“It will be useful for parents to have access to these data and see for themselves what the vaccination picture is in any particular school,” said Dr. Sarah Park, head of immunology for the Health Department.
Dr. Lee Evslin, a prominent pediatrician on Kauai who said he has spent hundreds of hours working on vaccination issues, said he was “alarmed to see how much higher these rates of unimmunized are in the North Shore schools.”
Evslin cited whooping cough and measles as two examples of diseases that are still around in significant numbers and highly contagious.
“If a person with measles just passes through a room of people, everyone in that room is at risk,” he said. “When the percentage of unimmunized in a close environment is high, the chances of rapid spread are greatly magnified.”
At risk are children who are not completely immunized because their shots are not completed, or even a fully immunized patient because “neither the measles shot nor the whooping cough are 100 percent effective,” Evslin said.
The Health Department initially told Civil Beat that staffing shortages had resulted in data being incomplete. Last month, after repeated inquiries, the department gave schools two weeks to report their vaccination data.
Some of them have still not done so.
“Public release of this information is an opportunity to move forward with improving vaccination rates,” said Dr. Janet Berreman, the department’s district health officer for Kauai.
Kauai experienced the consequences of under-vaccination during a 2017-18 statewide mumps outbreak, Berreman said, adding that mumps primarily affected elementary school students on Kauai, while elsewhere in Hawaii it tended to affect young adults.
In dozens of jurisdictions around the country, state, county and city health departments routinely post vaccination exemption data on websites so parents can understand the comparative risks their children may face if they attend schools with high counts of unvaccinated children.
Here are the figures for 2018-19, with some schools not yet reporting:
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