HB2009 UPDATE MATERIALS- IMPORTANT-

PLEASE READ IMMEDIATELY

Dear Legislator,

If your HB2009 briefing included the statements:

1. That Washington has “dangerously low levels of vaccination rates in some

communities” : See “K Rate slide, 6th Grade slide, K-12 Exemption slide”

2. That every exemption represents a completely unvaccinated child, or easy;

See “Exemptions are All or Nothing” & “Certificate Of Exemptions” slide

3. That many schools have unsafe, high percentage use of exemptions;

See “Dangerous Pockets Slide”

4. That states offering only medical exemptions have superior vaccination

levels and outcomes: See “UHF WA compared to WV / MS slide”

5. If this was presented to you by a Washington State Medical Association

member or lobbyist, or WA DOH personnel; See “WSMA Corrections” slide

YOU HAVE BEEN MISINFORMED!

If you were told that, “our state’s vaccination rate for kindergarten-age children

remains below the 90 percent federal baseline for preventing outbreaks”, and

that the Personal Belief & Philosophical (PB/Ph) Exemptions are causing this- you

were told a MATHEMATICAL IMPOSSIBILITY! The PB/Ph Kindergarten Exemption

Rate is only 3.2%! A 3.2% Exemption rate can only reduce a vaccination rate by

3.2%. 100% ideal – 3.2% PB/PH exemptions = 96.8%. Exemption Use is Dropping!

Kindergarten Rates are deceptively low due to missing records, not missing shots!

PLEASE GET THE FACTS!

School Year

Reported Number Enrolled % Complete % Conditional

% Out-of-Compliance % Exempt

% Ex Med

% Exempt: Personal /

Philosophical

% Ex: Rel

% Ext: Rel

Mem

% Complete Diphtheria &

Tetanus% Complete

Pertussis% Complete

MMR% Complete

Measles% Complete

Mumps% Complete

Rubella% Complete

Polio% Complete Hepatitis B

% Complete Varicella

1998-99 84,648 88.6% 5.3% 2.8% 3.2% * * * * 95.2% ** *** 97.6% 97.7% 97.7% 95.4% 91.9% ****1999-00 79,488 89.8% 2.8% 4.4% 3.0% * * * * 93.7% ** *** 96.9% 96.9% 96.9% 93.8% 94.3% ****2000-01 81,469 88.1% 2.4% 6.2% 3.5% * * * * 93.4% ** *** 91.9% 94.8% 94.8% 93.6% 94.4% ****2001-02 78,762 89.1% 2.0% 4.9% 4.0% * * * * 93.8% ** *** 92.9% 95.1% 95.2% 93.7% 95.0% ****2002-03 75,220 86.2% 4.2% 5.5% 4.1% * * * * 90.6% ** *** 92.4% 95.0% 95.0% 92.5% 95.1% ****2003-04 75,671 89.4% 2.2% 4.2% 4.2% * * * * 93.2% ** *** 91.2% 95.6% 95.7% 93.2% 95.2% ****2004-05 78,759 87.3% 1.7% 6.2% 4.4% * * * * 92.0% ** *** 95.6% 95.8% 95.9% 91.8% 93.7% ****2005-06 72,594 86.5% 1.6% 6.9% 5.0% * * * * 90.8% ** *** 93.7% 95.3% 95.3% 90.7% 92.6% ****2006-07 75,085 84.8% 1.9% 7.2% 6.0% * * * * 92.3% 91.9% *** 90.4% 95.2% 95.2% 92.4% 93.1% 92.7%2007-08 75,752 84.5% 1.7% 7.6% 6.3% * * * * 91.0% 90.9% *** 91.0% 91.2% 91.2% 91.5% 92.8% 93.0%2008-09 78,278 78.5% 2.9% 11.0% 7.6% * * * * 90.5% 90.4% *** 90.5% 90.7% 90.5% 91.0% 92.5% 83.8%2009-10 75,443 82.9% 2.3% 8.5% 6.2% * * * * 91.7% 91.4% *** 95.2% 91.7% 91.8% 91.7% 92.7% 88.6%2010-11 83,593 83.3% 1.3% 9.5% 5.9% * * * * 91.2% 90.4% *** 91.4% 91.4% 91.4% 91.8% 92.5% 90.5%2011-12 75,867 84.6% 1.8% 9.1% 4.5% * * * * 91.0% 90.9% *** 92.0% 92.0% 91.8% 91.2% 93.1% 90.6%

2012-13# 83,082 85.5% 1.6% 7.5% 4.6% 1.2% 3.2% 0.2% 0.1% 91.9% 92.4% 91.7% *** *** *** 91.4% 93.4% 90.3%

2013-14# 78,924 83.3% 1.8% 10.3% 4.6% 1.2% 3.2% 0.2% 0.1% 89.6% 90.3% 89.8% *** *** *** 89.1% 91.8% 88.4%

Footnotes:* Beginning in school year 2012-13, Schools reported the counts of students claiming each exemption type.

** Beginning in school year 2006-07, Pertussis is reported separately from Diphtheria and Tetanus.*** Beginning in school year 2012-13, Measles, Mumps and Rubella are reported as the MMR combination.

**** Beginning in school year 2006-07, Varicella was required for school entry and reported upon.# Beginning in school year 2012-13, averages are weigthed to account for the number of schools that reported or not.

Data Notes:This report is based on total counts of kindergarten students' immunization status as reported by public and private schools with kindergartens to the department.Counts include first graders in schools with no kindergarten for school years prior to 2007-2008The student immunization status is based on parent-reports to the school and may not be healthcare-provider verified.Only schools that reported their student vaccination status report are included in this summary.The department makes no other claims about the accuracy of the data as reported by schools.Prioor to school year 2012-13, the average rate above are un-weighted, so do not account for the percentage of the schools reporting or not.

Immunization Status Definitions:Complete: The student meets all the school-entry requirements for their age and grade (that is, they are in compliance).Exempt: The student has a signed Certificate of Exemption on file at the school excusing the student from one or more vaccinations due to medical, personal or religious beliefs.Conditional: The student is missing the required Certificate of Immunization Status or is missing one or more required vaccinations and is making satisfactory progress towards compliance.Out-of-Compliance: The student is missing the required Certificate of Immunization Status or is missing one or more required vaccinations.

Office of Immunization and Child ProfileIf you have a disability and need this document in a different format, please call 1-800-525-0127 (TDD/TTY 711). DOH 348-399 May 2014

Statewide Multiyear Kindergarten Immunization CoverageSchool Years 1998-99 through 2013-14

WA Kindergartners start the year with average 90% coverage for DTaP, MMR, Polio & Hep B88.4% Chicken Pox

DTaP89.6%

MMR89.8%

Polio89.1%

Hep B91.8%

C Pox88.4%

WA children who are not enrolled in a state licensed daycare or preschoolhave NO vaccination requirements. For many children the first time theyencounter vaccine requirements is Kindergarten. In recognition of thisthere is a "Conditional" designation, for students who are "making satisfac-tory progress towards compliance", 1.9% in this report. "Out of Compli-ance" is kids who are missing documentation, 10.3% here. Both of thesecategories move into the "Vaccine Complete" as they catch up to theschedule or locate their records. There are many more families who vacci-nate and are missing records than there are families who are missingshots. By the end of the year and going into 1st grade rates quickly catchup to the 95% of 6th grade.

Only 3.2% PB/Ph Exemption Rate

Maximum impact of the PB/Ph

100% max vax - 3.2% = 96.8%Any Vaccination Rate below 96.8% is

UNRELATED to the PB/PhExemption. It is a mathematical

impossibility for the PB/PHexemption to reduce vaccination

rates more than 3.2%!

School Year

Reported Number Enrolled

% Complete

% Conditional

% Out-of-Compliance

% Exempt

% Exempt: Medical

% Exempt: Personal /

Philosophical% Exempt:

Religious

% Exempt: Religious

Membership

% Complete Diphtheria & Tetanus

% Complete Pertussis

% Complete

MMR

% Complete

Measles

% Complete

Mumps

% Complete

Rubella% Complete

Polio% Complete Hepatitis B

% Complete Varicella

1998-99 80,963 94.3% 0.9% 2.0% 2.8% * * * * 97.9% ** *** 95.1% 97.1% 97.1% 97.8% 100.0% ****1999-00 78,728 91.8% 0.9% 4.3% 2.9% * * * * 97.6% ** *** 92.6% 96.3% 96.3% 97.5% 100.0% ****2000-01 83,793 91.2% 1.1% 4.7% 2.9% * * * * 97.3% ** *** 92.1% 95.9% 95.9% 97.3% 100.0% ****2001-02 85,479 91.6% 0.9% 4.1% 3.4% * * * * 97.3% ** *** 92.7% 95.9% 95.8% 97.3% 100.0% ****2002-03 78,812 90.8% 1.4% 4.2% 3.6% * * * * 97.1% ** *** 91.8% 95.9% 95.8% 97.1% 100.0% ****2003-04 80,153 89.0% 1.9% 4.3% 4.8% * * * * 97.4% ** *** 91.7% 96.5% 96.9% 97.1% 97.2% ****2004-05 79,927 87.9% 1.4% 5.8% 4.5% * * * * 96.5% ** *** 96.1% 96.9% 96.8% 96.5% 95.5% ****2005-06 68,363 89.5% 1.1% 4.5% 4.8% * * * * 96.4% ** *** 95.1% 97.2% 97.2% 96.3% 95.2% ****2006-07 77,974 84.8% 1.4% 8.0% 5.6% * * * * 99.8% 96.7% *** 94.9% 97.4% 97.4% 96.4% 95.5% 89.0%2007-08 76,307 70.8% 3.4% 20.3% 5.5% * * * * 78.0% 78.1% *** 95.9% 95.9% 95.9% 96.3% 95.3% 85.8%2008-09 74,998 74.9% 2.9% 15.8% 6.4% * * * * 82.3% 82.9% *** 95.9% 96.0% 96.0% 96.3% 95.6% 98.7%2009-10 69,978 76.5% 2.3% 15.1% 6.1% * * * * 82.1% 82.7% *** 96.0% 96.0% 96.0% 95.8% 95.5% 89.8%2010-11 76,768 79.2% 0.9% 13.6% 6.3% * * * * 91.8% 83.8% *** 96.1% 96.1% 96.1% 96.1% 95.4% 98.8%2011-12 73,065 79.3% 1.0% 14.2% 5.5% * * * * 92.7% 83.2% *** 96.4% 96.4% 96.4% 83.2% 95.3% 92.5%2012-13 74,856 82.4% 0.9% 11.3% 5.5% 0.64% 4.61% 0.36% 0.03% 85.2% 85.7% 96.1% *** *** *** 96.1% 95.7% 96.1%2013-14 75,503 76.8% 0.9% 16.8% 5.6% 0.70% 4.60% 0.40% 0.10% 79.5% 80.7% 95.4% *** *** *** 95.5% 95.3% 95.6%

Footnotes:* Beginning in school year 2012-13, Schools reported the counts of students claiming each exemption type.

** Beginning in school year 2006-07, Pertussis is reported separately from Diphtheria and Tetanus.*** Beginning in school year 2012-13, Measles, Mumps and Rubella are reported as the MMR combination.

**** Beginning in school year 2006-07, Varicella was required for school entry and reported upon.

Data Notes:This report is based on total counts of 6th grader immunization status as reported by public and private schools with 6th grades to the department.The student immunization status is based on parent-reports to the school and may not be healthcare-provider verified.Only schools that reported their student vaccination status report are included in this summary.The department makes no other claims about the accuracy of the data as reported by schools.The summary data in this report is un-weighted, so does not account for the percentage of actually schools reporting.

Immunization Status Definitions:Complete: The student meets all the school-entry requirements for their age and grade (that is, they are in compliance).Exempt: The student has a signed Certificate of Exemption on file at the school excusing the student from one or more vaccinations due to medical, personal or religious beliefs.Conditional: The student is missing the required Certificate of Immunization Status or is missing one or more required vaccinations and is making satisfactory progress towards compliance.Out-of-Compliance: The student is missing the required Certificate of Immunization Status or is missing one or more required vaccinations.

Office of Immunization and Child ProfileIf you have a disability and need this document in a different format, please call 1-800-525-0127 (TDD/TTY 711). DOH 348-398 June 2014

Statewide Multiyear Summary of Immunization Coverage for 6th gradeSY 1998-99 through SY 2013-14

DTP79.5%

MMR95.4

Polio95.5%

HepB95.3%

C Pox95.6%

DTaP looks low because a Booster is due in 6th Grade, and thereport is generated towards the beginning of the year. Families thatdo the MMR, Polio, Hep B and C Pox don't skip DTaP. Note the"Out of Compliance" rate of 16.8%, while the school nurses chasedown families for the documentation. In the past sympatheticschool staff using the incorrect PB/Ph Exemption instead of makinga family dig up vaccination records was the only "convenience "exemption use.

6th Grade Average 95.5% Coverage of the Required Vaccines

SchoolYear

ReportedNumberEnrolled

%Complete % Exempt

% Exempt:Medical

% Exempt:Personal /

Philosophical% Exempt:Religious

% Exempt:Religious

Membership

% Exempt:Diphtheria /Tetanus***

% Exempt:Pertussis

% Exempt:Polio

% Exempt:Measles

% Exempt:Mumps

%Exempt:Rubella

% Exempt:MMR

%Exempt:

Hep B% Exempt:

Varicella1998-99 1,061,202 * 2.8% 0.1% 2.5% 0.1% ** 2.1% *** 2.1% 1.8% 1.7% 1.7% **** 0.9% *****1999-00 1,024,430 * 2.9% 0.1% 2.7% 0.1% ** 2.1% *** 2.1% 1.9% 1.8% 1.8% **** 0.8% *****2000-01 1,061,491 * 3.0% 0.1% 2.8% 0.1% ** 2.2% *** 2.2% 2.1% 1.9% 1.9% **** 1.1% *****2001-02 1,048,259 * 3.5% 0.2% 3.1% 0.1% ** 2.2% *** 2.3% 2.3% 2.0% 2.0% **** 1.3% *****2002-03 1,002,085 * 3.8% 0.2% 3.4% 0.1% ** 2.4% *** 2.4% 2.7% 2.2% 2.2% **** 1.5% *****2003-04 1,014,866 * 3.9% 0.2% 3.6% 0.1% ** 2.5% *** 2.6% 3.6% 2.2% 2.2% **** 1.7% *****2004-05 1,036,005 * 4.4% 0.3% 3.8% 0.1% ** 2.6% *** 2.8% 2.1% 2.2% 2.1% **** 2.1% *****2005-06 921,571 * 4.7% 0.3% 4.2% 0.2% ** 2.8% *** 3.0% 2.2% 2.3% 2.3% **** 2.5% *****2006-07 1,019,137 * 4.8% 0.3% 4.4% 0.2% ** 1.3% 2.8% 2.8% 3.3% 2.4% 2.4% **** 2.8% 0.9%2007-08 1,022,779 * 5.2% 0.3% 4.7% 0.2% ** 1.7% 3.1% 3.0% 3.3% 3.1% 3.1% **** 3.2% 1.3%2008-09 997,040 * 5.6% 0.4% 5.0% 0.2% ** 1.9% 3.1% 3.0% 3.2% 3.2% 3.2% **** 3.3% 1.5%2009-10 928,253 * 5.9% 0.4% 5.3% 0.2% ** 2.3% 3.3% 3.1% 3.2% 3.1% 3.1% **** 3.6% 1.8%2010-11 1,016,892 * 5.8% 0.4% 5.1% 0.2% ** 3.2% 3.6% 3.7% 3.2% 3.1% 3.1% **** 3.5% 1.8%2011-12 984,593 * 5.6% 0.6% 4.8% 0.2% ** 3.2% 3.5% 3.0% 3.0% 3.0% 3.0% **** 3.3% 1.9%2012-13 1,104,311 88.3% 5.2% 0.7% 4.4% 0.3% 0.03% 3.2% 3.0% 2.9% **** **** **** 3.2% 3.2% 3.1%2013-14 1,038,562 87.7% 5.0% 0.7% 4.1% 0.3% 0.06% 3.2% 3.0% 2.9% **** **** **** 3.2% 3.0% 2.6%

Footnotes:* Beginning in school year 2012-13, Schools reported the counts of students complete.

** Beginning in school year 2012-13, Schools reported the counts of students claiming Religious Membership exemptions.*** Prior to school year 2006-07, % Exempt: Diphtheria / Tetanus inlcudes pertussis and beinning in school year 2006-07, pertussis is reported separately from diphtheria and tetanus.

**** Beginning in school year 2012-13, Measles, Mumps and Rubella are reported as the MMR combination.***** Beginning in school year 2006-07, Varicella was required for school entry and reported upon.

Data Notes:This summary is based on total counts of the immunization status of all students in all grades (kindergarten through twelfth, K-12) as reported by public and private schools to the department.The student immunization status is based on parent-reports to the school and may not be healthcare-provider verified.Only schools that reported their student vaccination status report are included in this summary.The department makes no claims about the accuracy of the data as reported by schools.The summary data in this report is un-weighted, so does not account for the percentage of actually schools reporting.

Immunization Status Definitions:Complete: The student meets all the school-entry requirements for their age and grade (that is, they are in compliance).Exempt: The student has a signed Certificate of Exemption on file at the school excusing the student from one or more vaccinations due to medical, personal or religious beliefs.

Office of Immunization and Child ProfileIf you have a disability and need this document in a different format, please call 1-800-525-0127 (TDD/TTY 711). DOH 348-401 June 2014

Statewide Multiyear Summary of Immunization Coverage for All Grades (K-12)SY 1998-99 through SY 2013-14

SchoolYear

ReportedNumberEnrolled

%Complete % Exempt

% Exempt:Medical

% Exempt:Personal /

Philosophical% Exempt:Religious

% Exempt:Religious

Membership

% Exempt:Diphtheria /Tetanus***

% Exempt:Pertussis

% Exempt:Polio

% Exempt:Measles

% Exempt:Mumps

%Exempt:Rubella

% Exempt:MMR

%Exempt:

Hep B% Exempt:

Varicella1998-99 1,061,202 * 2.8% 0.1% 2.5% 0.1% ** 2.1% *** 2.1% 1.8% 1.7% 1.7% **** 0.9% *****1999-00 1,024,430 * 2.9% 0.1% 2.7% 0.1% ** 2.1% *** 2.1% 1.9% 1.8% 1.8% **** 0.8% *****2000-01 1,061,491 * 3.0% 0.1% 2.8% 0.1% ** 2.2% *** 2.2% 2.1% 1.9% 1.9% **** 1.1% *****2001-02 1,048,259 * 3.5% 0.2% 3.1% 0.1% ** 2.2% *** 2.3% 2.3% 2.0% 2.0% **** 1.3% *****2002-03 1,002,085 * 3.8% 0.2% 3.4% 0.1% ** 2.4% *** 2.4% 2.7% 2.2% 2.2% **** 1.5% *****2003-04 1,014,866 * 3.9% 0.2% 3.6% 0.1% ** 2.5% *** 2.6% 3.6% 2.2% 2.2% **** 1.7% *****2004-05 1,036,005 * 4.4% 0.3% 3.8% 0.1% ** 2.6% *** 2.8% 2.1% 2.2% 2.1% **** 2.1% *****2005-06 921,571 * 4.7% 0.3% 4.2% 0.2% ** 2.8% *** 3.0% 2.2% 2.3% 2.3% **** 2.5% *****2006-07 1,019,137 * 4.8% 0.3% 4.4% 0.2% ** 1.3% 2.8% 2.8% 3.3% 2.4% 2.4% **** 2.8% 0.9%2007-08 1,022,779 * 5.2% 0.3% 4.7% 0.2% ** 1.7% 3.1% 3.0% 3.3% 3.1% 3.1% **** 3.2% 1.3%2008-09 997,040 * 5.6% 0.4% 5.0% 0.2% ** 1.9% 3.1% 3.0% 3.2% 3.2% 3.2% **** 3.3% 1.5%2009-10 928,253 * 5.9% 0.4% 5.3% 0.2% ** 2.3% 3.3% 3.1% 3.2% 3.1% 3.1% **** 3.6% 1.8%2010-11 1,016,892 * 5.8% 0.4% 5.1% 0.2% ** 3.2% 3.6% 3.7% 3.2% 3.1% 3.1% **** 3.5% 1.8%2011-12 984,593 * 5.6% 0.6% 4.8% 0.2% ** 3.2% 3.5% 3.0% 3.0% 3.0% 3.0% **** 3.3% 1.9%2012-13 1,104,311 88.3% 5.2% 0.7% 4.4% 0.3% 0.03% 3.2% 3.0% 2.9% **** **** **** 3.2% 3.2% 3.1%2013-14 1,038,562 87.7% 5.0% 0.7% 4.1% 0.3% 0.06% 3.2% 3.0% 2.9% **** **** **** 3.2% 3.0% 2.6%

Footnotes:* Beginning in school year 2012-13, Schools reported the counts of students complete.

** Beginning in school year 2012-13, Schools reported the counts of students claiming Religious Membership exemptions.*** Prior to school year 2006-07, % Exempt: Diphtheria / Tetanus inlcudes pertussis and beinning in school year 2006-07, pertussis is reported separately from diphtheria and tetanus.

**** Beginning in school year 2012-13, Measles, Mumps and Rubella are reported as the MMR combination.***** Beginning in school year 2006-07, Varicella was required for school entry and reported upon.

Data Notes:This summary is based on total counts of the immunization status of all students in all grades (kindergarten through twelfth, K-12) as reported by public and private schools to the department.The student immunization status is based on parent-reports to the school and may not be healthcare-provider verified.Only schools that reported their student vaccination status report are included in this summary.The department makes no claims about the accuracy of the data as reported by schools.The summary data in this report is un-weighted, so does not account for the percentage of actually schools reporting.

Immunization Status Definitions:Complete: The student meets all the school-entry requirements for their age and grade (that is, they are in compliance).Exempt: The student has a signed Certificate of Exemption on file at the school excusing the student from one or more vaccinations due to medical, personal or religious beliefs.

Office of Immunization and Child ProfileIf you have a disability and need this document in a different format, please call 1-800-525-0127 (TDD/TTY 711). DOH 348-401 June 2014

Statewide Multiyear Summary of Immunization Coverage for All Grades (K-12)SY 1998-99 through SY 2013-14

Total exemptions 5.0%, PB/Ph exemption rate is 4.1%, but by vaccine exemption rates are only 2.6% to 3.2%?

If the Personal / Philosophical Exemption werebeing used by parents to irrationally avoid all

vaccines, then the 4.1% PB/Ph exemption rate wouldcarry over evenly across each individual vaccine.

Instead we see the variations one would expect whenparents are using the PB/Ph exemption to as a "ParentAdministered Medical Exemption". The higher exemp-tion rates are for the more reactive vaccines- DTaP, andMMR, which both have quantified seizure rates- and Par-ents are avoiding follow up doses. Or avoiding a vaccinefor a mild infection-Chicken Pox- or an infection that can-not be transmitted in school-Hep B.Why not use Medical Exemptions? Because it requiresa very uncomfortable, and potentially adversarialdiscussion with Health Care Providers who are very hardpressed to ever admit a medication they provide cancause trouble, especially not a vaccine. There are HCP'swho consider a Febrile Seizure to be a normal vaccineside effect, and will not grant an exemption even after achild has been in the ER. There is tremendous pressureon HCP's to support vaccination unconditionally andnever acknowledge risk. Granting Medical Exemptions isvery, very rare and difficult.

ChickenPox

added2006/7

What is the Problem?Compare 2012-13 to 2013-14

Total Exemptions down .2%PB/Ph Exemptions down .3%

Exemptions by vaccine are dropping or stable-Where is the crisis?

96.8% to 97.4% Voluntary Coverage of Required Vaccines

An exemption does not equal an unvaccinated child, and anexemption for a specific vaccine does not equal zero doses.

Very few children have zero doses of all vaccines.

Exemptions aregranted byindividualvaccines

Current Exemption Form Requires Doctor Consult

Haemophilus influenzae

...a child with an exemption is not necessarily Unvaccinated”.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6341a1.htm

http://www.americashealthrankings.org/states

?

This makesno sense-

The CDC says only2,866 out of 78,924

WA K students use aPersonal Exemption--

ONLY 3.6%100% - 3.6%

= 96.4%Any Rates below

96.4% areUNRELATED

TO THEEXEMPTION!

Not true- Vax K 90%, 6th grade 95%*

This document is filled with inaccuracies!

*http://www.doh.wa.gov/DataandStatisticalReports/Immunization/SchoolReports

3.6