As kids revel in the final days of summer break, Pennsylvania school nurses statewide are hustling to make sure students are vaccinated.
The mandatory recordkeeping is routine, and helps school officials to keep children safe from preventable diseases like tetanus and hepatitis B. But rising requests for exemptions to vaccinations are making this work fraught and revealing fears some parents have about caring for their children.
Under state law, parents who object to immunizations for philosophical or religious reasons can still send their children to school, though their kids can be barred from attending during an outbreak of a vaccine-preventable disease.
The growing use of exemptions is a concern in Pennsylvania and other parts of the U.S. During the COVID-19 pandemic, vaccination rates for childhood illnesses decreased, partly due to disruptions to the health care system and to increasing levels of vaccine hesitancy. Among the most alarming infectious diseases making a comeback due to these shifts is measles.
A measles infection can cause earache, fever, diarrhea, pneumonia, and swelling of the brain that can lead to deafness and intellectual disabilities. As of Aug. 15, there have been 219 confirmed cases in the U.S. in 2024, according to the CDC. Kids five and younger comprise 40% of these cases, and more than half of them were hospitalized.
Preventing the resurgence of measles and other childhood illnesses, like polio, requires nearly universal vaccinations, which isn’t the case in Pennsylvania. During the 2019-2020 school year, the kindergarten vaccination rate for measles was 96.4%, according to data analyzed by the state Department of Health. In 2022-2023, that rate dropped to 94%. If the number of unvaccinated kids creeps further upward, Pennsylvania could face a public health crisis that is entirely avoidable.
School nurses play a key role in prevention. They provide parents of unvaccinated children with resources on the importance of immunizations, said Eileen Wallace. A nurse for Bethel Park School District, Wallace told Spotlight PA she explains how skipping vaccines can be bad for community health. A virus that might pose little threat to one person, for instance, can have serious complications to another.
But parents ultimately decide what to do with this information.
“It’s something that we cannot question because it’s a given right,” Wallace, a board member for the Pennsylvania Association of School Nurses and Practitioners, said of parental authority.
For parents who dutifully vaccinate their kids, their hesitant counterparts can be easy to write off as selfish, neglectful, or foolish. But Jennifer Reich, a sociologist at the University of Colorado Denver, argues the issue is much more complicated.
Reich, who wrote Calling the Shots: Why Parents Reject Vaccines, told How We Care that parents often make case-by-case decisions about immunizations. They might be more worried about one infectious illness than another, which influences their views on certain vaccines.
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—Sarah Boden, for Spotlight PA
