School-by-school vaccine data vital to moms of kids with compromised immune systems

Rachel McCann and Lindsay David are two people who are anxious to see the school-by-school data on the percentage of vaccinated students the state is expected to release today.

For both mothers, that data is a key tool in their efforts to protect their children.

Each has a four-year-old son whose immune system has been compromised by the chemotherapy he has been receiving to combat leukemia.

McCann, who lives in South Windsor and is a teacher, wanted to send her son Nolan to pre-school, but when she called about 20 programs in Connecticut and Massachusetts, she couldn’t find any that could ensure all of the children were vaccinated. There was one she especially liked, but four of the 22 children were unvaccinated.

“We couldn’t send him there with a good conscience that he would be healthy,” McCann said. “So we have  him at a home day care where all of the children are vaccinated, which is fine, except that he’s a four-year old who wants to go to pre-school.”

“… We have him at a home day care where all of the children are vaccinated, which is fine, except that he’s a four-year old who wants to go to pre-school.”

Rachel McCann

David is sending her son to a Catholic pre-school in the Hartford area because she thinks the percentage of students vaccinated there is higher than it would be at a public school.

“I know it’s not one hundred percent,” David said. “I’m Catholic and nothing says we can’t get vaccinated. If you’re in public school, I think you might have more of the range of people who might claim religious exemptions.”

McCann and David have watched from the sidelines as the vaccination battle has played out in Connecticut over the past six months, starting in the spring with a legislative proposal that would have prohibited children from attending school whose parents have claimed the religious exemption to forgo vaccinations. The legislative hearing on that proposal drew hundreds of parents who are opposed to eliminating the religious exemption.

Lawmakers originally planned to introduce a repeal of the waiver in the 2020 legislative session, but sped up their efforts last spring after two separate, overlapping events: the Connecticut public health department’s release in May of school-by-school vaccination data, and a national measles outbreak.

The data showed Connecticut has 102 schools where fewer than 95% of students were vaccinated for measles, mumps and rubella — the threshold recommended by the Centers for Disease Control and Prevention. Statewide, the percentage of kindergarteners who were vaccinated against those illnesses decreased between the 2017-18 and 2018-19 school years, to 95.9 percent, down from 96.5 percent, according to DPH.

Those percentages are particularly important to mothers like McCann and David because if the vaccination rate is very high in a community it achieves herd immunity, thereby limiting the spread of contagious disease.

“So when people in the population decide not to vaccinate their children that puts not only their children, but all children, at risk.”

Oncologist Michael Isakoff
Connecticut Children’s Medical Center

For children with compromised immune systems, herd immunity is vital because the chemotherapy needed to treat leukemia not only undermines their immune system but also reduces the protective effect of the vaccinations they received before the onset of their illness. McCann and David said their children can’t be re-vaccinated until about three to six months after chemotherapy treatment, which takes years, is complete.

The school-by-school data is therefore crucial information, McCann said.

“It helps parents like myself determine what to do,” she said. “Do I keep him in school? It helps you make a decision.”

Dr. Michael Isakoff, an oncologist at Connecticut Children’s Medical Center and clinical director of cancer and blood disorders, said patients who are immunocompromised are completely reliant on herd immunity.

When the percentage of those immunized drops, Isakoff said, there’s a chance that serious diseases could spread through the population.

“So when people in the population decide not to vaccinate their children,” he said, “that puts not only their children, but all children, at risk.”

Children long for ‘sense of normalcy’

In Connecticut, the percentage of unvaccinated students attending school has been creeping upward, at least partly because of the steadily increasing numbers of students whose families obtain waivers by claiming the religious exemption.

In the 2003-2004 school year, the first year in which the state made public the number of religious exemptions, 316 students claimed it. Fourteen years later, nearly four times as many students — 1,255 in 2017-18 — claimed the exemption.

In August, Connecticut health officials said the number of students who refrained from getting the measles, mumps and rubella vaccine jumped 25% from 2017-18 to 2018-19 –the largest single-year increase since they began collecting data. The state is expected to release 2018-19 school-by-school immunization data this afternoon.

“Their children are longing for some sense of normalcy in their lives, some of the things that defined their lives before they got sick. Attending school represents that hope and that normalcy.”

Kathy Kudish
Immunization program manager for DPH

Last spring’s legislative proposal to eliminate the religious exemption fizzled for myriad reasons, but it’s likely to be resurrected next year, lawmakers say. Both Gov. Ned Lamont and Department of Public Health Commissioner Renee Coleman-Mitchell have recently announced they support a repeal.

A Bristol couple, Kristen and Brian Festa, went to court in May to block the release of the 2018-19 immunization data. A Superior Court judged dismissed the Festa’s lawsuit last month but the couple has appealed, asking the court to stop the state from releasing the data today. A hearing on their motion is scheduled for this morning.

Av Harris, spokesman for the state Department of Public Health, said last week the department intends to release the data as planned unless prohibited by the court.

“We have seen a rise in non-medical exemptions in Connecticut and the pace at which it is going up is increasing as well,” said Harris. “It’s a major concern that we might not be able to maintain the threshold level” that ensures herd immunity for a disease like measles.

Maintaining that high threshold level is very important to the parents of immunocompromised children, said Kathy Kudish, immunization program manager for DPH.

“They very much want their children to go to school. Their children are longing for some sense of normalcy in their lives, some of the things that defined their lives before they got sick,” she said. “They want more than anything to go to school to be with friends, to plan for the future that will hopefully be there when they don’t have this illness anymore. Attending school represents that hope and that normalcy. I really think these children should be given every opportunity to attend school in the safest environment possible.”

LeeAnn Ducat, who has been an outspoken leader of the anti-vaccine movement in Connecticut, said she is sympathetic to the concerns of parents with children who are immunocompromised, but argued that people just need to use common sense.

“[Those parents] are being terrified into thinking that if they take their kid into a public school, they are going to catch the measles,” Ducat said. “No matter who is sick, you stay home, whether you are vaccinated or not. You stay home.”

Kudish noted, however, that people with measles could be contagious for up to four days with no symptoms. In addition, she said, measles is spread through the air, so if a person with measles leaves a room, anyone who enters that room could catch measles for up to two hours after the sick person has left.

“Why can’t these kids wear masks or stay home if there’s an outbreak? Why are people with religious exemptions, why are they being thrown out of school?”

LeeAnn Ducat, parent and anti-vaccination advocate

But Ducat said banning unvaccinated students from school won’t protect children with compromised immune systems.

“If  you’re not going to send your child to school because of unvaccinated children, are you taking him into public places? Are you taking him to the library and Walmart and stuff? Because if this is your goal, you better make everyone at Target show their vaccine records,” she said. “The logic is so flawed.

“If they want to protect an immuno-suppressed kid, put a mask on the kid,” she continued. “Why can’t these kids wear masks or stay home if there’s an outbreak? Why are people with religious exemptions, why are they being thrown out of school? ”

Ducat said she is passionate about the issue partly because she believes her son’s immune system was compromised by vaccines, and because she believes they pose many other harmful side effects.

“Are your children vaccinated?”

At the height of the measles outbreak last spring, David did resort to putting a mask on her son, but it didn’t feel good.

“I found myself out of fear being that mom who is at a play date and, you know, I have a mask on my son because I have to ask, ‘I hope you don’t mind me asking, but are your children vaccinated?’ ” David said.

But if everyone who can do so gets vaccinated, she said, then children like her son will be safe.

“People who are anti-vaxxers, I don’t know that they see the whole picture that way,” David said. “I always say the downside of you not vaccinating your child has a direct impact on me … My kid was vaccinated. I did everything I was supposed to do, but then I had to give him chemotherapy to save his life.

“I vaccinated my children. I believe in it,” David added. “I believe there’s a reason why people in third world countries are lining up for days to get vaccinations.”

Gavin had his last chemotherapy pill on September 30. Now, his mother said he will wait three to six months for his immune system to rebound and then he will get re-vaccinated. She’s hoping that by the fall, he’ll be ready to go to school without having to worry about his immune system.

“My kid was vaccinated. I did everything I was supposed to do, but then I had to give him chemotherapy to save his life.”

Lindsay David 

McCann’s son, Nolan, is scheduled to finish his treatment on November 16, 2020. About six months after the treatment stops, McCann said, Nolan’s immune system will have rebounded enough for him to be revaccinated.

McCann remembers clearly the day her son was diagnosed. It was July 21, 2017 and she and Nolan were in Myrtle Beach visiting her parents. A week prior to vacation, Nolan stopped eating normally, was showing signs of exhaustion and had bruises in odd places, like the middle of  his back, but when McCann called her pediatrician they chalked it up to the normal bumps of toddlerhood.

When McCann landed in South Carolina, however, her parents noticed immediately that Nolan was pale and didn’t seem to be himself. McCann decided to take him to an urgent care center, where a doctor saw a growing sign of “petechiae” — a rash of red dots indicating something was wrong.

Nolan was diagnosed with acute lymphoblastic leukemia, which she said has a 90% recovery rate but requires a three-and-a-half year protocol of chemotherapy and other blood and platelet transfusions.

“He is my only child and my whole world crashed,” said McCann.

“I’m doing everything in my power to keep him alive. Obviously, my heart and soul are literally at stake with this. This is my one child.”

Rachel McCann

Because of her concern that Nolan will be vulnerable to serious diseases and because of the presence of unvaccinated children in public schools, McCann and her husband Daniel have decided not only to have him skip pre-school this year, but also to have him wait until the fall of 2021, when he is six, to start kindergarten.

“I’m doing everything in my power to keep him alive,” McCann said. “It might be one chance in a million, if not more, that he would get something, but why risk it? Obviously, my heart and soul are literally at stake with this. This is my one child.”