AUGUSTA – It is a central point of contention between the two sides in the debate over Maine’s March 3 referendum on a people’s veto on new vaccine mandates passed by the Maine Legislature in 2019. How well are Maine’s students immunized?
of a new vaccination law (supporting “No on Question One”) argue that Maine’s
vaccination rate among students is too low and that to raise vaccination rates
and protect Maine’s students, the religious and philosophical exemptions
provided for in existing state law must be eliminated.
the bill, (supporting “Yes on Question One”) argue that Maine’s immunization rates
are above the national average and that the other side is misstating the data
for political advantage.
Maine Examiner dives into the numbers below to provide you the facts:
Rates In Maine’s Schools
According to data published by Maine DHHS and the Maine Center for Disease Control and Prevention, Maine’s rate of vaccination is equal to, or above the national average among kindergarten students.
An important caveat to the data below – in the previous year of data (2017-18 school year) from the state of Maine, as students transitioned to first grade, the average vaccination rate rose by more than a full percentage point, pushing all vaccination rates above 95%. Unfortunately, the state of Maine did not provide that data in the report for the most recent school year.
rates among kindergarten student have ranged from 94.5% to 96.3% since the
2014-15 school year, which is as far back as the latest report goes. In each
year, Maine’s DTaP rates have been above the national average. These data are
for 4+DTaP, which, according to the report, means the number of students who
have received at least 4 doses of
diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine.
In the 2017-18 school year, the last
year a comparison is possible, 95.3% of kindergartners in Maine had 4+DTaP
vaccine coverage, compared to 95.1% of students nationally.
DTaP is a vaccination against diptheria, tetanus and pertussis (whooping cough).
vaccination rates among Maine kindergarten students are up from where they were
in the 2014-15 school year, but down from last year. In the 2018-19 school
year, Maine is at 93.8%, but national numbers to compare Maine to are not
available. In the 2017-18 school year, Maine’s rate was equal to the national
rate, at 94.3%.
are for 2+MMR, which, according to the report, means the number of students who
have received at least 2 doses of
the MMR vaccine.
MMR is a vaccination against measles, mumps and rubella.
vaccination rates among Maine kindergarten students have been above the
national average since 2014-15 and were at 94.5% in the 2018-19 school year.
While the national data for the 2018-19 school year is not available, in the previous
year, Maine was 1.1 percentage points above the national average.
are for 3+Polio, which, according to the report, means the number of students
who have received at least 3 doses of
the Polio vaccine.
The Polio vaccine vaccinates against Polio.
Varicella vaccination rates among
Maine kindergarten students have been at or above the national average and were
at 95.9% in the 2018-19 school year. National data is not available for
comparison in the 2018-19 school year, but in the 2017-18 school year, Maine’s rate
was 96.5% compared to the national average of 96.2%.
are for 1+Varicella, which, according to the report, means the number of
students who have received at least 1
doses of the Varicella vaccine after the child’s first birthday, adjusted to
include history of varicella disease.
The Varicella vaccine vaccinates against varicella, also known as chickenpox.
Another interesting nuance to the data
provided by state agencies is the “Missing Records” data provided along with
the vaccination rates by vaccine.
The “Missing Records” data in many instances according to the state represents a significant portion of those students considered “unvaccinated” in the data. These are students who have a missing vaccination record and, as a result, are not counted by the state among those who are vaccinated.
Among kindergarten students, those with missing records make up between three-tenths of one percent to a full one percent of the students classified as unvaccinated. In two data sets, those students classified as having missing records more than cover the delta between the vaccination rate and a commonly held 95% vaccination rate.
According to testimony from the Maine CDC, any student who does not have a record of vaccination or exemption specific to each required vaccine is recorded as “missing records” and non-compliant, according to state law. During committee hearings, other details from CDC officials on the “missing records” data was vague.
Interestingly, a look through the school-by-school data provided by Maine CDC shows that most schools in Maine report zero missing records, while some, such as the Maine Coast Waldorf School (15.4%), Skillin Elementary (17.9%), Vinalhaven School (30.8%) and RSU 23 (12.5%) report higher numbers of missing records.
Overall, about one of every seven students considered part of Maine’s unvaccinated kindergarten student population fall into the “missing records” category.
Under state rules, schools can permit students to continue to attend school during a period of 21 calendar days to allow for the transfer of records from one school to another. School superintendents are required to submit an annual report to Maine CDC providing their student immunization data by December 15th of each year on a prescribed form.
The latest data published by Maine CDC still shows some schools not reporting data.
When we turn to examine Maine’s vaccine exemption rates as compared to national data, the comparison gets considerably more difficult. Because of the various state reporting methods and exemptions, the data all gets lumped in as “non-medical exemptions” which is not ideal for apples-to-apples comparison purposes.
Because of this, supporters of eliminating Maine’s philosophical and religious exemptions are able to cite Maine’s higher than national average “non-medical” exemption rate as a cause for concern. Still, those higher exemption rates they show in the data have not pushed Maine’s vaccination rate down below the national average.
According to the National Conference of State Legislatures, fifteen states have a philosophical exemption under their state law, with Virginia only allowing a personal exemption on the HPV vaccine. As a result those states without philosophical exemptions would not report “non-medical” exemption data, comparatively making Maine’s exemption rate look higher.
The NCSL says 45 states plus Washington D.C. offer a religios exemption of some sort, but in addition that Minnesota and Louisiana’s non-medical exemption covers religious beliefs as a practical matter.
Complicating the issue of using exemption data is the reality that CDC officials testified before a legislative committee that there is no way to determine from the exemption data how many students are exempt from all vaccines versus those that are exempt from just one, several, or students on on a different vaccine schedule but still vaccinated. As a result, the data can be interpreted to make the rate look more assuring, or more frightening, depending on how it is presented.
Information provided by the state of Maine in previous years showing rising vaccination rates as first graders complete their vaccination schedule suggests that there is some truth to the argument that the exemption data misrepresents the situation as a whole.
This imperfect comparison, reliant upon the patchwork of state laws, reporting and terminology, results in Maine’s rate of kindergarten students having a non-medical exemption rate that comes in at 5 percent in the 2017-18 school year. That compares to a national average of 2 percent.
There is certainly more to the debate around Question One than simply looking at the data. Questions and debates focused on religious and medical freedom, informed consent, the influence of large pharmaceutical companies, public health and safety, parental rights and the proper role of government are certain to play a role in the decision-making process for voters.
As far as vaccination rates among young students in Maine, our state is on par with, or ahead of, the rest of the nation with our existing religious and philosophical exemptions.
Read the 2018-19 Maine School Immunization
Assessment Report at the link below: