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A recent report from the state Department of Health shows that more and more local students are not up to date with their school-required immunizations.
According to statistics released earlier this year, about 39,583 or 21% of students from public, charter and private schools were reported as behind on their school-required immunizations last year.
The report comes among a nationwide trend of vaccine hesitancy since the COVID-19 pandemic. However, the school-required immunizations do not include the COVID-19 vaccine.
Currently, Hawaii has vaccination exemptions that include medical and religious reasons. The data show there has been a 25% increase overall in missing immunizations from the 2022-23 school year, demonstrating students are not up to par with required vaccines, and more schools are reporting an increase in the religious exemption rate.
The Centers for Disease Control and Prevention has also reported an upward trend in religious exemption rate for Hawai'i over the last few years. Medical exemptions have also increased from 0.07% in 2019-20 to 0.16% during the last school year.
On Maui, multiple schools reported missing immunizations for their students, and others did not report at all. Baldwin High School, Lihikai Elementary School, Lahainaluna High School, King Kamehameha III Elementary School and Moloka'i High School, were among the schools that did not report their data.
Other schools showed a trend of religious exemptions, including 58.46% of the 195 students at the Haleakala Waldorf School stating religious exemptions, as well as 28% of the 350 students at Haiku Elementary School.
Dr. Kenneth Fink, director of the Hawai'i Department of Health, said the statistics are concerning.
"High vaccination rates help protect those who are unable to receive certain vaccines due to medical reasons and those with a non-medical exemption," he said. "Low vaccination rates mean unvaccinated keiki are at increased risk of infection, especially at schools with a high rate of the student population not being up to date."
Fink also said more children in Hawai'i are getting sick.
"We are already seeing increased cases of pertussis and are at risk for a measles outbreak," he said. "Immunizations are necessary to protect infants, children and adults from potentially serious and contagious diseases."
Dr. Jannet Lee-Jayaram, an associate professor at the University of Hawai'i John A. Burns School of Medicine, said it's important to recognize there could be consequences if the trend continues.
"For the students themselves, they are vulnerable to potential diseases that are entirely preventable," she said. "The other issue is that it's a public health issue."
The public needs a certain level of vaccinated individuals to reach community immunity, she said, and when the levels drop below a certain percentage, people are at risk of spreading disease.
"Some people can't get vaccines. They may be immune compromised, or they have some major reaction to vaccines, so we need to protect them," she said. "Our duty is to protect the general public as well as ourselves."
Lee-Jayaram gave the example of what happened in Samoa in 2019 when a measles outbreak spread throughout the remote region. Thousands of cases were recorded and 83 people, mostly young children, died.
"Measles is super contagious," she said. "You have to have an immunization rate of more than 95% - it's that contagious. So when levels drop below that, it is a public health emergency."
The report also found the majority of the increase in those missing school-required immunizations is from the seventh-grade requirements implemented in 2020. For the 2023-24 school year, 16% of kindergarteners were not up to date with school-required vaccinations as compared to 55% of seventh-grade students.
The report included about 382 schools, in which 282 said more than 5% of their student populations were not up to date with the state's school immunization requirements, and 36 schools reported having more than 50% of their student body not current.
Lee-Jayaram said there may be a few reasons why immunizations are down, including barriers to healthcare access.
"They want them, but they can't get them because there may be some challenge to getting health care," she said. "The pandemic interrupted a lot of routine health care too, so regular childhood visits were interrupted."
She said there is a federally funded program called Vaccines for Children that includes all the routine immunizations for free. Insurance is not required.
"We all love our children, right? We care about our kids," she said. "We have to provide the right information and be willing to have a dialogue about it."
For more information on how to find access to immunizations, visit health.hawaii.gov/docd/vaccines-immunizations. Parents may also call (808) 586-8300 for more information.