On a recent fall afternoon, Greenfield Middle School was letting out for the day. Kids flowed into cars and chatted with friends.
They looked like a typical group of boisterous tweens, but there is something that puts this school on one end of a bell curve when it comes to health status. The school has one of the lowest vaccination rates in the state.
“I had no idea,” said PTO president Andrea Michael, who — like most parents in this Franklin county town, and probably everywhere — does not check the state’s immunization data on a regular basis.
“I feel like it would be more on the radar if I heard about people having measles or … if there was a lot of illness,” Michael said.
In fact, her school and dozens of others in the region have what health experts call a serious gap in immunity.
"The gap, especially in some of the Greenfield schools, is just astronomical," said regional epidemiologist Jack Sullivan.
"You have to really drill down"
Health experts say a community reaches herd immunity when 95 percent of people are vaccinated. That means enough people are immune to an illness, like measles, polio, or whooping cough, that a few stray germs won’t take hold.
And while Massachusetts as a whole has one of the highest vaccination rates in the country, “you have to really drill down… for each of the towns and the schools,” Sullivan said.
Greenfield middle school has a vaccination rate of 77 percent for the full series, which includes about a ten different vaccines. Newton Elementary is 68 percent. Greenfield High is 51 percent.
And Greenfield is not alone. A number of schools in every western Mass county except Hampshire have vaccination rates well below herd immunity.
In the Berkshires, for example, Lee Middle/High School has a rate of 76 % for the full vaccine series. Pittsfield High is 73 percent.
Calls and emails from NEPM to multiple school districts were not returned.
Sullivan said there could be many explanations for low rates at any particular school, including poor record keeping or high exemption rates, since Massachusetts allows parents to opt out of vaccines for medical or religious reasons. Or maybe there’s just one vaccine missing out of the full series. In addition, unhoused children and refugees are not subject to the same state requirements.
“But … even if you bake all of those possibilities into it, there's still going to be a very high number that are not vaccinated or don't have the records,” Sullivan said. “And that’s where it gets concerning.”
"We don't want to keep kids home"
But not everyone feels that way.
“I think when you just look at the numbers and you don't put in all the outside factors, it can be worrisome,” said Megan Tudryn, public health nurse for Greenfield ad surrounding towns. “But I personally am not concerned about our vaccination rates.”
Tudryn said anyone who wants to get their child vaccinated has access to a free clinic or pharmacy.
“And if they choose not to, then I believe it's their choice,” she said. “They may become sick at some point, but the rest of the population is going to be protected if they've had their vaccines.”
And she acknowledges those children, even without official exemptions, will still be allowed in class.
“Technically, people can be excluded from school … if they're just choosing not to get vaccinated,” Tudryn said. “But we don't want to keep kids home. I don't know of any school that would actually enforce that.”
According to the Massachusetts Department of Public Health, even though vaccines are a state requirement, it’s up to local school districts to enforce the mandate. And they can choose not to – at least until there’s an outbreak of measles or another disease.
“It's a conundrum,” said Azell Cavaan, spokesperson for Springfield’s school department. “What are you going to do – have them stay at home and not become educated?”
About a dozen Springfield schools have vaccination rates under 90 percent, and a few, such as Commerce High School, are much lower. Two of Springfield’s charter schools, Martin Luther King Jr. School of Excellence and Baystate Academy, which operate separately from the district, have rates under 70 percent.
“We realize that it's not where we want it to be,” said Cavaan. “We also know it's not the absolute worst in the state, but we just think about the kids and the staff in our schools.”
Cavaan said it’s a “constant struggle” to get Springfield children vaccinated, especially among the city’s many immigrant populations.
“We have immigration populations who come from Muslim countries, Nepal, Somalia, African countries, Vietnam,” she said. “Even Puerto Rico has a different set of vaccination requirements than we do.”
So the city sets up free vaccination clinics and hires staff to coordinate medical visits for families.
“We try to find out what the barriers are [for families],” Cavaan said. “Sometimes it's their religious exemptions. Sometimes they're just uneducated. So we really try to take that route as opposed to keeping students out of school.”
"It's just sad that it's become political"
When ideology or safety concerns are the issue, epidemiologist Jack Sullivan said providers should focus on explaining the science of vaccines, including the reams of studies on their safety and effectiveness.
“It’s just sad that it's become political rather than scientific or medical,” Sullivan said. “I understand and I respect people's decisions when it comes to some of these, if they're based on the best information that they can get. And unfortunately, when politics starts to intrude in it, the best information is not always there.”
Andrea Michael of the Greenfield Middle School PTO said her children are up to date on vaccines. But she doesn’t know where many other parents stand on the issue.
“It's such a charged topic that I think people don't talk about it,” she said. “You don't know if you're going to run into somebody who's so anti vaccines and then you're going to have an uncomfortable conversation or maybe vice versa.”
And as long as western Massachusetts dodges the disease outbreaks that other states have seen – mostly among unvaccinated children – she’s hoping those conversations won’t be necessary.
