- Associated Press - Sunday, June 28, 2015

BILLINGS, Mont. (AP) - Vaccination rates at one in eight elementary schools in Montana are too low to ensure immunity from outbreaks of measles or whooping cough, new state data shows.

The Montana Department of Health and Human Services released immunization and exemption rates of 347 elementary schools for the first time this month in response to a records request by The Billings Gazette, joining at least 13 other states that have publicized such data.

The agency has declined to release grade-level rates, citing patient privacy concerns in rural areas. The agency instead agreed to provide schoolwide rates for public and private elementary schools with enrollments over 20 students.

Schools are required to report immunization data to the state annually. About 95 percent did so in 2013-14, according to a DPHHS summary report.

Though information for small schools and non-reporting schools isn’t available, the data released this month lends new detail about vaccination trends in Montana, a state with historically poor immunization rates

In recent years, Montana kindergartners have been required to get vaccine series for measles, mumps and rubella (MMR), polio (IPV), and tetanus, diphtheria and whooping cough (tdap) before entering school. Children who have started but not completed their vaccine series may be conditionally enrolled, and those with certain medical conditions are exempt.

About 3.6 percent of Montana kindergartners had parents who choose to file religious exemption paperwork in 2012-13, according to the Centers for Disease Control and Prevention, ranking it in the upper fourth of states.

However, Montana hasn’t seen as sharp a spike in vaccine objections as some states. Neighboring Idaho, for instance, had almost 6 percent of kindergartners exempted for nonmedical reasons.

“For the most part our coverage levels are pretty good,” Jim Murphy, Communicable Disease Control and Prevention bureau chief for the Montana Department of Health and Human Services, said.

Religious objections tend to be concentrated in northwestern Montana and in private parochial schools, school data shows.

Health experts say at least 92 percent of individuals must be immunized in a setting to protect against diseases such as measles or whooping cough. One in eight schools included in a Gazette analysis (http://bit.ly/1edbwTZ ) didn’t meet that baseline.

Murphy said health officials get nervous wherever the immunization rate dips below 95 percent, the CDC’s target for measles vaccines. A quarter of Montana elementary schools had at least 5 percent of students who were not immunized.

Many schools have high immunization rates; one in six schools had 100 percent. Among the state’s large school districts, no single elementary school had immunization rates below 93 percent. Most were much higher.

But small isolated groups of underimmunized people still exist in Montana cities. In Missoula, for example, six public schools had exemption rates of only 1 or 2 percent, but one had 6 percent of its students exempt.

Kalispell had the most schools among AA districts with above-average religious exemption rates.

Exemptions in Billings were heavily clustered in private Christian schools, data indicates.

The state tracks school numbers in case of outbreaks, but local city and county health departments are asked to more regularly monitor for pockets of underimmunization and check the data for errors, Murphy said.

An amendment introduced by a Polson lawmaker last spring would have extended exemptions to parents whose personal beliefs run contrary to immunization. The measure was killed, and instead the Montana Legislature approved two new required vaccinations for school-aged children, a step lauded by health officials.

Beginning this fall, all students will need to show proof that they’ve received two doses of the chickenpox vaccine, and seventh-graders must get a pertussis booster shot. Students entering eighth through 12th grade who have not had the whooping cough vaccine will also need a single dose.

Concern about childhood immunizations has been renewed nationally since a measles outbreak earlier this year infecting more than 100 people in several states.

Though measles hasn’t been documented in Montana, the state has the highest rate of whooping cough, another vaccine-preventable infection, with 478 cases reported to the CDC last year. And its immunization rates among individuals particularly susceptible to the diseases - infants and toddlers - are historically poor.

Blame for the re-emergence of measles has been laid upon the increasing number of parents refusing to vaccinate their children for philosophical reasons or health concerns.

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Information from: The Billings Gazette, http://www.billingsgazette.com

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