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Friday, December 8, 2023
Dec. 8, 2023

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Fall is on its way: What to know about back-to-school vaccines in WA


Did summer just end?

After a pair of particularly smoky and warm weekends, gray skies and rainy forecasts might have prompted similar questions throughout the region this week, a reminder we could be nearing further seasonal changes.

Meanwhile, another sign that fall is on its way: Schools and public health teams are rolling out their annual push to vaccinate kids against upcoming respiratory illnesses.

Local pediatricians and public health experts have said they’re particularly scarred this year from last winter’s “tripledemic” — which overwhelmed pediatric emergency departments in Washington and throughout the U.S. with patients sick with the flu, COVID-19, RSV, or sometimes all three. Seattle Children’s ER, for example, was often filled with twice as many patients than usual, sometimes running at 200% capacity last October, the hospital said.

At the same time, the state’s vaccination rates for school-required shots among K-12 students have seen a slight dip in recent years, particularly among kindergartners. Pandemic-related school closures likely played a role, state health officials said last week, but so have fluctuating sentiments about vaccines.

“If we continue to see the erosion of people taking vaccines or parents taking their kids to get vaccinated, we’re concerned about worsening protection for all of us,” state Secretary of Health Dr. Umair A. Shah said in a recent interview.

During the 2022-2023 school year, about 90.9% of Washington’s K-12 students were up-to-date on their school-required vaccinations — about 10 shots for certain diseases, including chickenpox, measles, mumps, rubella, polio and tetanus, among others. The rate is high compared to many other states in the U.S., but it’s down from about 91.7% the year before, and 92.6% in the 2020-2021 school year, according to the state’s school immunization data dashboard.

Still, childhood vaccine compliance is higher than it was in the years preceding the pandemic. Between 2015 and 2019, an average of about 88.4% of K-12 students in the state received their required shots each year, according to the state.

Another noticeable trend: While vaccine exemptions for medical and personal reasons have dropped slightly in the past two years, more families have been opting out of school-required vaccines for religious reasons, state data show.

Last year, about 1.6% of students were granted religious exemptions, up from 1.2% — or more than 5,700 additional kids — during the 2020-2021 school year. The rate of increase was even sharper among kindergartners, about 2.9% of which are vaccine-exempt for religious reasons.

In general, the state’s childhood vaccine exemption rate has settled at about 3.5% the last several years, after falling 8% between the 2019-2020 and 2020-2021 school years.

Despite the drop in immunization rates in the past few years, Washington still “does pretty well” in terms of childhood vaccinations, Dr. Mandy Cohen, new director of the Centers for Disease Control and Prevention, said during a visit to Seattle last week.

“I see Washington as being leaders, but I want them to run even faster and really show what the strongest public health system in our country could be,” Cohen said in an interview, after meeting with state health leaders and touring a Department of Health microbiology laboratory in Shoreline. “I think that could be here.”

She referenced Washington’s “great investment” in public health, particularly in our genome sequencing network, which helped quickly identify new COVID variants and track disease spread throughout the worst of the pandemic.

“That’s exactly why I’m here in Washington, to understand how our dollars are working and what else the state needs in terms of support,” Cohen said.

Get ready for fall

At a free Sodo vaccine clinic for Seattle Public Schools families last week, part-time pediatrician Dr. Melanie Ito’s bright energy and firm hand kept the stream of kids and teens moving smoothly.

“What kind of McDonald’s are you going to get after?” Ito cheerily asked one tearful 3-year-old, Maleia, hoping for a quick distraction. Howls still ensued, but a glow-in-the-dark sticker brought a smile to the toddler’s face afterward.

The recent SPS clinics have gotten busier as the school year approaches, distributing both required shots, like flu vaccines, and recommended ones, like COVID vaccines, said Ito, who worked for King County for years before her first retirement in 2011.

Public Health — Seattle & King County and the state Department of Health will also continue to host vaccine clinics this fall.

Measles, in particular, has been worrying public health leaders more than usual this year, sparked by nearly 20 outbreaks throughout the country as of early August. In Washington, at least three King County residents, including a child, have been diagnosed with the highly contagious disease this year.

In King County, there were notable declines in MMR (measles, mumps and rubella) vaccines especially in the Kent and Seattle school districts this past year, said Sharon Bogan, spokesperson for the county’s public health department. Fewer Kent and Bellevue students also got their polio shots last year compared to the 2019-2020 school year.

In addition to required vaccines, doctors also recommend children seek protection against RSV, or respiratory syncytial virus. This is not required by schools, but is now an option for the first time.

The Food and Drug Administration approved the new monoclonal antibody drug for infants and children up to 2 years old in July, hoping to limit severe RSV infections, hospitalizations and deaths that disproportionately impact babies and older adults. The CDC recommends the one-shot dose for all infants under 8 months, as well as some older, immunocompromised babies.

A vaccine for babies — different than an antibody treatment — is not yet available, though one for those 60 and older was approved by the FDA earlier this year.

“RSV is one of the leading causes of hospitalization for young children not only at Seattle Children’s, but nationally as well,” said Dr. Janet Englund, an infectious disease expert at the hospital. “Families who live with older members — grandparents who are very involved in the care of kids, for example — should consider vaccinations for those who can be protected to help shield the entire household.”

The RSV shots should become available in Washington pharmacies by mid-September, Cohen said. Flu shots are also available at pharmacies and primary care clinics, and are recommended for those over 6 months old.

“This fall and winter, we know we’re going to see more COVID, we’re going to see more flu and we’re going to see more RSV,” Cohen said. “And we want to make sure we’re protecting our kids from those and [other infectious diseases]. These are things that can be crippling to our children.”

Washington kids under 18 can get vaccinated for free if they live in South King County, are un- or under-insured, are experiencing homelessness, or recently moved to the U.S., according to Public Health — Seattle & King County.

For the next several weeks, more clinics are scheduled at schools or YMCA centers in South King County, or after the Seattle Storm’s final home game of the season.

Ito plans to help staff some of these, knowing many clinics will likely get busier as the season of respiratory infections gets underway.

On a recent Friday afternoon, Alejandra Salas brought her soon-to-be second grader, Santiago, to the Sodo clinic to satisfy district vaccine requirements, but also because she remembers a brutal flu season last year.

“I hope the same doesn’t happen this winter,” she said.

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