Where students in Portland aren't getting their shots
There are 25 schools in Portland where more than one in 10 students aren't getting all their required immunizations. Health officials say rates like that could leave those populations, and the rest of the city, vulnerable to certain diseases.
Many of the least-vaccinated public schools are alternative and charter schools. Government vaccination programs tend to focus elsewhere, on the low-income population.
As the Feb. 21 deadline for public school children's vaccinations approaches, The Portland Tribune analyzed public data to find interesting trends among those who do not get all of the required immunizations on schedule.
Oregon law has required public schools to bar children who haven't gotten all of their required vaccines by the School Exclusion Day since 2015. Multnomah County public health analysts say about 5 percent of children receive exclusion orders.
But there are still fairly simple ways to apply for an exemption. Fewer than 1,000 children in the county receive exemptions for medical reasons. Nearly 2,000 in the county receive a non-medical exemption, which requires a conversation with a doctor or the viewing of an online video dispelling the myths of vaccine risks.
The vast majority of children get all of their required vaccines as recommended by the Centers for Disease Control. And not all preventable diseases are created equal.
Health officials say hepatitis B, which is a required immunization, is unlikely to infect young children. If, for whatever reason, parents elect to skip or delay that one — or any of the 22 required shots — their children would be counted in the Oregon Department of Education data as not in compliance.
But overall, an analysis of 2016-17 data from 133 schools in the city of Portland shows:
Brian Reeder, the Oregon Department of Education assistant superintendent of research and analysis, helped interpret the data. He cautioned that the analysis did not account for the number of students at each school, which could skew the data, and also said the issue needed further study to clarify all of the variables that affect vaccination rates.
View Vaccination rates at Portland schools in a full screen map
Below 90 percent is cause for concern
The Portland school with the lowest immunization rate, at 53 percent, was Portland Village School, a K-8 public charter school in North Portland. In fact, of the 10 least-vaccinated school populations in Portland, only one was a traditional neighborhood school: Kelly Elementary in Southeast Portland, which has a large number of parents citing religious-based objections to immunizations. The other nine schools were public charter schools or alternative magnet programs.
Nadine Gartner is worried for those school populations. Gartner founded the nonprofit Boost Oregon in 2015, after she felt pressure from friends to not vaccinate her baby and started researching the issue herself. She found a lot of fearmongering and misinformation, but wanted to create a place where parents felt safe discussing their concerns.
"We want people to feel empowered about choosing to vaccinate," she said, "and confident that the best decision for their health and their community's health is to vaccinate their children."
Gartner says she finds that often predominantly well-educated, white, upper- and middle-class families think that they can keep their children safe through healthy diets and access to higher quality health care. They worry that vaccines are toxic or can impact their children's long-term development.
But Gartner says science just doesn't bear that out.
"The evidence strongly shows that vaccines are safe and beneficial," she says.
Dr. Jennifer Vines, a public health official with Multnomah County, agrees and notes that Portland has an international airport that can be a vector for all sorts of viruses.
"When I see those numbers (of vaccination rates among charter schools), I tend to think that people who share a similar approach to their kids' educations, they share a similar approach to vaccinations," Vines said.
She cautioned against jumping to the conclusion that children at these schools haven't had any or even most of their shots.
"How worried I get in my role as a public health officer is what disease are we talking about," Vines said. She explained that measles is a good example, because it is incredibly contagious and the vaccine is highly effective. In that case, a vaccination rate between 90-95 percent is considered safe for "herd immunity."
There are 25 schools in Portland where more than 10 percent of students haven't taken all 22 immunization shots, but that doesn't mean they all didn't take a measles shot.
Vines cautions that many preventable viruses "are still alive and well in the world," including regular reports to the county of whooping cough and chicken pox.
High-poverty schools also highly vaccinated
In contrast, schools with large low-income populations and many students of color were much more likely to be fully vaccinated. Parkrose High School in Northeast Portland had the highest vaccination rate in the city at 98 percent. Sitton Elementary, Self Enhancement Inc., Roosevelt High School and George Middle School weren't far behind, at 97 percent.
Roosevelt High School nurse Nicky Zimmerman was delighted to hear her school was among the highest, and credited many staff for making that happen.
Zimmerman says that she tends to play detective to find all of her students' immunization records. She also cautioned school officials to take an educational approach as opposed to a "get it done" attitude.
"That may work, but there are many times you may have to take the time to explain about the diseases the vaccines are preventing, and answer concerns, especially for students and parents that are not firm 'immunization believers,' and think that they can be harmful or don't see the need for them," Zimmerman stated via email.
Interestingly, the Tribune's analysis also showed a marked gap between schools with nearly all of their children in poverty and those with more varied family incomes. While schools with varied family incomes also have variable compliance rates, schools with high rates of poverty have populations that are almost uniformly vaccinated.
This could be seen as the result of several health programs aimed at low-income families.
For example, Multnomah County puts on free vaccination clinics, the free Community Immunization Center at 426 S.W. Stark St. and 12 student health centers, located in area schools. Also, the federal Women, Infants and Children (WIC) program promotes vaccinations.
Kate Willson, a Multnomah County spokeswoman, stresses that the county clinics are open to all but acknowledges the county does not have a program specifically aimed at the alternative school communities.
How many Oregonians believe vaccines cause autism?
About three in 10 Oregonians believe there is some connection between vaccines and autism, or at least are open to the possibility, according to a poll by DHM Research. The belief is more common among conservatives (27 percent) than liberals or moderates (8 percent each). In Portland, only 8 percent "strongly" or "somewhat" agree there is a connection.
The American Academy of Pediatrics and advocacy group Autism Speaks say that two decades of research of research have revealed no connection between autism and vaccines. Likewise, the Tribune's analysis saw no correlation between the rates of students with disabilities and the rates of vaccination at Portland schools.
Multnomah County vaccination clinics are open to all: Feb. 17 from 10 a.m. to 2 p.m. at the David Douglas School District administrative building in East Portland; Feb. 21 from 9 a.m. to 3 p.m. at the East County Building in Gresham.
Dive into the data in our spreadsheets.