In the 2021-22 school year, only one county in Washington reached the federal target of 95% or more children receiving all required vaccinations before entering kindergarten.
No, it wasn’t King.
The sole county was Franklin in Eastern Washington, where Pasco is located. About 1,550 of the county’s 1,600 kindergartners — around 96% — had completed all required immunizations in fall 2021, according to new data from the Washington State Department of Health.
The immunization rate for kindergarten students is down in Washington, dipping below 90% for the first time in two years. According to new data from the Department of Health, around 75,600 of Washington’s 85,000 kindergartners — that’s 89% — had completed all required immunizations in fall 2021.
Washington state provides all recommended childhood vaccinations at no cost to children through the age of 18.
The kindergarten immunization rates fell in 36 of the state’s 39 counties from the 2020-21 school year. The only three where the rates increased were Ferry, Grays Harbor and Franklin.
Washington has never been among the top states for child vaccination rates. But when state law changed in 2019 to tighten vaccine-exemption requirements, the rates increased. After years of kindergarten immunization levels around 85% to 86%, the rate jumped to 90% in fall 2019.
Even after the pandemic took hold, and with schools closed, the rate still increased to 91% in fall 2020. During that school year, kindergarten immunizations exceeded the federal target of 95% in seven counties.
So you might think in fall 2021, with schools open again, the percentage of kindergarten students with complete immunizations would continue to rise.
But that's not what happened.
The vaccination rate fell statewide in the 2021-22 school year, and in a few counties, the rates plummeted. For example, in Jefferson County, where Port Townsend is located, only around 69% of kindergartners completed all required immunizations, down from 88% the year before.
The dip in immunization rates is not unique to Washington. It's part of a national trend. During the 2020-21 school year, the rate of kindergarten students with all state-required vaccines declined from 95% to approximately 94% in the U.S., according to the Centers for Disease Control and Prevention. And in 2021-22, the rate fell another percentage point to 93%.
Disruptions to schooling, child care and in-person health care made it difficult for some families to keep up with shots.
Another possible explanation: Like everything else, public health became politicized during the pandemic. Controversy swirled around the COVID-19 vaccines, with heated debate around the efficacy and potential side effects, as well as the implementation of vaccine mandates.
For some parents of school-age kids, this may have lowered their trust of government directives and of vaccines in general. In December, a Kaiser Family Foundation survey showed 28% of respondents felt parents should have the right to opt out of vaccinating their children, even if it increases health risks for others.
To be clear, the immunizations required of school kids in Washington do not include the COVID-19 vaccine. Rather, they are for vaccines to prevent various childhood diseases like measles, mumps, rubella, chickenpox, tetanus, diphtheria, polio and so on — diseases that had all but been eradicated. Now, with declining immunization rates, there is concern that these disease could reemerge.
Across the U.S., children are required to be vaccinated for childhood diseases before entering kindergarten, whether at public or private schools. But every state allows medical exceptions, and most, including Washington, allow exemptions for religious or personal/philosophical reasons.
But in 2019, Washington law was changed to stop families from using personal or philosophical reasons to excuse their kids from the measles-mumps-rubella (MMR) vaccine. That cut the rate of these types of exemptions to less than half their 2018-19 level of 4.2%, and it's also surely the primary reason why the rate of completed vaccinations for kindergarten students increased in fall 2019.
But with personal/philosophical exemptions off the table for the MMR vaccine, religious exemptions have increased dramatically since 2019 — from fewer than a couple of hundred kids to more than 1,000. Indeed, that was the biggest change in the 2021-22 school year. More than 1,900 kindergartners, or 2.2%, received an exemption on religious grounds, up from 1.8% the year before.
The counties with the highest immunization rates were all in Eastern and Central Washington. In addition to Franklin County, Yakima, Douglas, Adams, Garfield and Chelan counties were all at 93% or higher.
The lowest rate was also in Eastern Washington. In sparsely populated Pend Oreille County, only 58 of its 86 kindergarten students had completed their required immunizations, for a rate of just 67%.
In King County, about 90% of kindergarten students had completed their immunizations in fall 2021, down nearly 2 percentage points from the year before.