More Polk County kids are getting religious exemptions to vaccinations, driving up fears

More school-aged children in Polk County and across Iowa received "religious" exemptions to required immunizations last year, marking another increase in a trend that has concerned public health officials since the coronavirus pandemic.

Slow increase in exemptions also comes as childhood immunization rates continue to decline across the state, which some experts say is directly caused by vaccine misinformation that was rampant during the coronavirus pandemic.

Hesitancy surrounding new COVID-19 shots has spread to other shots, including routine childhood vaccines, leading to more young Iowans skipping vaccinations that offer key protection to serious disease.

“We've seen a rampant spread of misinformation, and some parents and caregivers can be vulnerable to that because of the backlash against COVID vaccines," said Elizabeth Faber, executive director of the Iowa Immunizes Coalition.

In 2023, more than 2,400 students in school districts across Polk County received a religious exemption to school vaccination requirements, according to the county health departments annual school audit report. That group makes up about 3% of student enrollment in Polk County.

That's nearly a 28% increase in religious exemptions from the year before, when 1,900 students had a religious exemption.

When can families opt out of school vaccinations?

Families may opt out of school vaccine requirements if immunization "conflicts with a genuine and sincere religious belief." Iowa law notes that that belief must be religious — not based on a moral or personal objection to vaccines.

However, parents do not have to cite a specific religious belief to obtain a religious waiver.

"For us at the health department, this is cause for concern. We are worried that we're seeing this number trending upwards," said Madisun VanGundy, public health communications officer at the Polk County Health Department.

"However, as a whole, Polk County is doing fairly well in terms of vaccination rates. So right now, we don't want to ring the alarm bells, but we are worried about religious exemptions increasing, so it is something that we're going continue to keep an eye on."

The vast majority of students at Polk County public school districts are fully vaccinated, according to the county health department's report. The lowest rate is seen among non-public students, with about 90% of those school-aged children fully vaccinated in 2023.

Polk County Health Department's report notes that the number of students who are not fully vaccinated has been increasing since 2020. The percentage of students without the full panel of shots rose from about 3% in 2020 to nearly 6% in 2023.

In all, more than 4,938 students did not have all of their school-required immunizations in 2023, a nearly 18% increase from the year before.

School audit reports statewide reflect similar trend in religious exemptions

Polk County reflects a similar trend seen statewide, according to 2023 immunization rates recently released by the Iowa Department of Health and Human Services.

Three percent of the more than 524,000 students enrolled in Iowa schools for the 2023-24 school year have a religious exemption to vaccines — about 16,000 total students.

That's an increase from the 2.6% in the previous school year, and 2.3% in the 2021-22 school year.

In all, 6.4% of students attending Iowa schools are under-immunized or not immunized, an increase from the 5.8% the previous school year, according to the HHS report.

Other childhood vaccines in Iowa, Polk County declined last year

In 2023, 69.7% of Iowa's 2-year-olds had received all doses of recommended vaccines.

Since 2020, Iowa has seen a slight decline in the uptake of the full panel of recommended immunizations for children by the time they reach age 2, which includes shots to protect them against polio, measles, meningitis and many other diseases.

Vaccination rate among that age group was about 76% in 2020. Vaccine uptake fell to about 73% in 2021 and to 70% in 2022.

Typically, public health officials believe 90% immunization rate is necessary to prevent spread of disease, Faber said.

“We are still finding hesitancy with certain vaccines,” Faber said. “Anecdotally, some of our providers are saying that they don't have as many patients requesting flu shots or things like that as they did in the past. Some of that hesitancy may have spilled over a little bit into other vaccines.”

Public health officials have said the pandemic upended routines for many families, meaning doctors' appointments to get those vaccines were delayed for some young Iowans.

Though vaccine hesitancy is a factor for this age group, Faber said other barriers may be preventing some families from keeping up with a frequent vaccine schedule, such as a lack of transportation or shortage of nearby health care providers. She also said some families may still vaccinate their children but are choosing to space out vaccine administration over a longer period of time.

Still, immunization rates among Iowa's youngest population has improved since 2015, when just 62% of that age group was up to date on all recommended vaccines.

In Polk County, about 73% of youth completed their 2-year-old immunizations last year, the same rate as 2022. That did drop from nearly 76% in 2021 and 79% in 2020.

Compliance with recommended vaccines for adolescents between the ages of 13- to 15-years-old fared better among Iowans last year, state public health data shows.

Overall, 88% of that population had received all of their recommended shots in 2023. That's a slight decrease from the 89% in 2022 and 2021. In 2020, immunization rate was 88%.

About 94% of Polk County adolescents were fully vaccinated with those recommended shots in 2023. That's the same as 2022.

Faber said it's often easier for families to stay up-to-date on recommended vaccine series for that age group, since there's a less demanding dose schedule to follow for those shots.

How health officials are trying to shore up confidence in vaccinations

Public health officials with Iowa Immunizes are working to address vaccine hesitancy among Iowans, with the goal of improving immunization rates among the state's youngest populations. Faber said primary care providers, who are often the most trusted sources of information for patients, are key to that effort.

“We’re definitely working to reduce that misinformation to make sure there's accurate information, and to make sure providers have the tools they need to share that accurate information in a trusting, caring manner," Faber said. "They care about their patients, they care about the community. They’re doing a great job, but we also have provider shortages.”

VanGundy also encouraged residents to seek out annual vaccines against COVID-19 and influenza.

"We definitely want to encourage people to get those vaccines if they haven't done so yet," VanGundy said. "It's still a good time to get them. We tend to see respiratory viruses circulate in our community until summertime, so even though we're seeing a decrease in hospitalization rates for flu, COVID and RSV right now, it's still a good idea to get those."

Michaela Ramm covers health care for the Des Moines Register. She can be reached at mramm@registermedia.com, at (319) 339-7354 or on Twitter at @Michaela_Ramm

This article originally appeared on Des Moines Register: Kids in Polk County, across Iowa missing routine vaccines rose in 2023