In the fall of 2022, 209 kindergartners showed up for the first day of school at Horizon Elementary School in Jerome. Only 65 had the full battery of immunizations recommended by the state, for diseases ranging from whooping cough to measles, hepatitis B to polio.
Many parents weren’t current on their kids’ wellness exams. Some just didn’t know the state’s vaccination guidelines. Jerome officials tried to improve Horizon’s meager 31% immunization rate — with popup clinics at parent-teacher night, which didn’t do much good, and with a series of four reminder notes to parents, which helped a bit.
Horizon’s immunization rates look better this year, said Jennifer Vergara, a Jerome School District nurse. “There’s still a lot of work that needs to be done, though.”
And, she says, the Legislature could make her job even tougher.
One bill, which passed the House on a party-line vote, would require parents to opt in to the state’s voluntary immunization registry. Another bill — headed to the House floor, after a party-line committee vote — would highlight Idaho’s lenient vaccination opt-out law.
Regardless of what the Legislature does this year, vaccination rates have been declining, in schools across the state.
Crunching the numbers
Idaho has long had one of the nation’s lowest immunization rates — partly because Idaho has one of the nation’s highest opt-out rates. Idaho law makes opting out easy; parents can request an exemption, for any reason or no reason, simply by turning in a note to their child’s school.
Since the pandemic, Idaho’s immunization rates have steadily dropped across the board.
In 2022-23, the kindergarten immunization rate came in at 78%, declining for the third straight year. The 2019-20 rate was 86%, which still isn’t high enough to provide “herd immunity” from diseases such as measles.
At the local level, some numbers are even worse.
The state Department of Health and Welfare provided Idaho Education News school-by-school data for 2022-23 — including detailed and largely unredacted spreadsheets covering 435 grade schools across the state.
Twenty-nine of these schools had kindergarten immunization rates of 50% or less, and they represent Idaho’s varied education landscape.
The list includes 16 private schools, mostly in the Panhandle and the Treasure Valley; a pair of Treasure Valley charter schools, Peace Valley Charter School in Boise and Victory Charter School in Nampa; and a smattering of virtual schools, such as the Oneida School District’s sprawling, statewide Idaho Home Learning Academy.
Also on the list: eight traditional public schools, offering face-to-face instruction in rural communities from Sagle to Driggs. Horizon is by far the largest school in this group.
For kids beyond kindergarten, the numbers are mixed, but never good. First-grade immunization rates climbed to 82%, but plummeted to 73% in seventh grade and a dismal 54% in 12th grade.
What’s happening at the local level?
Immunization numbers vary widely from community to community. The explanations for the low immunization rates are just as diverse.
In the north-central Idaho community of Cottonwood, nine of Prairie School’s 36 kindergartners were in school on a religious exemption last year — and nine kindergartners are attending on a similar exemption this year, said Jon Rehder, Cottonwood’s superintendent and elementary school principal. Religion is a factor but it doesn’t tell the whole story. Last year, 25 kindergartners showed up with incomplete immunizations or incomplete records, driving a worst-in-the-state 6% immunization rate.
In Fairfield, Janet Williamson blames the aftershocks of the pandemic. “There is a real apprehension with any kind of government documentation and fears of losing control of personal information,” said Williamson, Camas County’s superintendent, principal, federal programs director and Title IX coordinator. Last year, Camas County’s kindergarten immunization rate came in at 50%; this year, every kindergartner showed up fully immunized, and Williamson isn’t exactly sure what changed.
In Jerome, Vergara sees no signs of post-pandemic vaccine hesitancy — to her relief. “It would be a bigger battle.” But Vergara is fighting an information and awareness battle, and that’s why she is worried about the bills working their way through the Legislature.
What’s happening at the Statehouse?
Three immunization bills are in the pipeline.
House Bill 397. This would again make the state’s Immunization Reminder Information System an opt-in program. That’s how it worked when Health and Welfare started IRIS in 1999, but a 2010 law turned it into an opt-out program.
The bill’s sponsor, Rep. Megan Blanksma, R-Hammett, says she immunized her children and kept copious records. She said her problem instead is with IRIS. Opting out is cumbersome. The current system allows the government to more readily gather personal data, but it hasn’t delivered on its promise of improving immunization rates.
“It’s tough to make an argument for any government program that, upon review, is not having the effect that was expected,” Blanksma said in an interview last week.
The House passed HB 397 on Feb. 9. The Senate has taken no action on it yet.
House Bill 438. This addresses the immunization notices schools send to parents. If a school refers to one piece of state law — a section that says, erroneously, that immunizations are required — the school must also refer to the section of law that allows parents to ask for an exemption. These easy-to-get exemptions basically make immunizations voluntary, no matter what the law says.
“This is a mixed message being sent to parents, guardians and students,” said the bill’s sponsor, Rep. Dori Healey, R-Boise, a registered nurse who describes herself as pro-vaccine. “They’re providing half the story.”
The House Health and Welfare Committee passed HB 438 Monday, and it awaits a floor vote.
House Bill 597. This bill addresses students who turn 18, saying young adults can opt out of immunizations for high school, college or career-technical school. House Health and Welfare introduced this bill Monday, setting the stage for a possible hearing.
A relatively low-key issue
Vaccinations are a hot-button political issue — but not necessarily at the Statehouse.
The House’s party-line vote on HB 397 came after a brief floor debate. House Health and Welfare spent only a few minutes on HB 438 Monday before dispatching it to the floor.
Opposition has been sparse. The Idaho Association of School Administrators is taking no position on the bills. The Idaho School Boards Association opposes HB 438 but did not testify on it in committee Monday. The Department of Health and Welfare is not commenting on any of the three bills.
Away from the Statehouse, some school administrators are worried.
Rehder, the Cottonwood superintendent, is particularly concerned about HB 438, which would highlight the voluntary nature of immunizations. “I think that’s just backwards.”
Jerome schools already inform parents about exemptions, so Vergara isn’t too worried about HB 438. The registry bill, HB 397, is a bigger concern. Vergara uses IRIS to doublecheck on students’ vaccination status, and says it’s an important resource.
“Opting out of IRIS is just a simple click away,” she said, “Instead of having thousands of parents have to opt in.”
Blanksma maintains that IRIS has no bearing on childhood immunization rates — and hasn’t for years. And after serving on the Central District Health board during the onset of the COVID-19 pandemic, she says policymakers should focus on the underlying causes of a low immunization rate — such as vaccine hesitancy and, perhaps, a need to better promote vaccines.
“It’s probably better to look into those factors that are causing the decline, rather than the data reporting,” she said.
