The true student immunization rates are unknown in Washington State.

In a new Washington State Auditor’s report, the Washington Department of Health (DOH) looked at data for the 2017-2018 school year before the state Legislature eliminated the personal and philosophical exemptions that parents could claim from the combined measles, mumps and rubella (MMR) vaccine for this year.

The audit, released Dec. 19, shows not all schools in the state followed the law, nor were they collecting immunization records consistently. Consequently the school years subsequent to the 2017-2018 data isn’t completely accurate.

All schools are required to send immunization data to the DOH. The audit looked at DOH data for the state’s 295 school districts for the 2017-2018 school year. In that year, 90 percent of schools reported student immunization data. However, schools in 29 districts either did not report immunization data or reported having zero kindergarten enrollment. That equates to an approximate one in 10 schools that didn’t submit any immunization data to the DOH.

Student enrollment data from the Office of Superintendent of Public Instruction shows that most of the districts do in fact have kindergarteners enrolled.

“Of the schools that did report, 8 percent of all kindergarteners lacked complete immunization or exemption records,” the auditor’s report said. “But because of the number of districts and schools that failed to report, the actual percentage of kindergarteners without records may be greater.”

Public health officials work to get at least 95 percent of the population vaccinated. The more people that are vaccinated, the fewer youth who are under a year old, have health issues and/or have exemptions are susceptible to becoming sick.

State law requires principals to collect immunization records and valis exemptions for every student at the beginning of the school year. The auditors looked at the data submitted by the districts and closely audited eight school districts. In four districts with high noncompliance rates during the 2017-2018 school year, the auditor’s office found principals did not exclude noncompliant students.

“District and school staff offered several reasons for not excluding these children. Some said they would rather educate students than exclude them,” the audit said. “Furthermore, by keeping students in school, they said they had a better chance to work with families and bring them into compliance.”

The top 10 school districts with the highest rates of noncompliance ranged from 90 percent in Orcas Island to 36 percent in McCleary.

Locally, Lake Washington School District (LWSD) had the highest rate of noncompliance with 18 percent, according to the 2017-2018 data.

Bellevue School District (BSD) followed with 13 percent. Northshore School District (NSD) had 9 percent. Mercer Island School District (MISD) and Snoqualmie Valley School District (SVSD) both had 5 percent. Issaquah School District (ISD) had no noncompliant students.

The audit listed common trends between school districts with low compliance rates and those with high compliance rates.

“Schools with high compliance rates ensured parents are aware of legal requirements related to vaccination documentation, all of the ways to comply with those laws, and the consequences of noncompliance,” the report said. “They communicated this information to parents well before the new school year and continued year-round. These schools had dedicated staff with clear roles and responsibilities who monitored students’ progress and kept administrators focused on the topic.”

Schools with lower compliance rates generally did not use those strategies to the same degree, the report said.

“In some cases, schools gave parents incomplete information and did not follow up on conditional-status students to the same degree,” the report said. “Training for school staff was inadequate. Finally, they had an insufficient number of school or district staff to complete immunization compliance duties.”

Common challenges for school districts in regard to vaccination included limited access to vaccination resources, parents choosing not to vaccinate their children or vaccinate on a delayed schedule, and language barriers that contribute to poor understanding of immunization requirements.

“Schools are not the cause of these barriers, but in several areas, staff reported being able to help parents overcome barriers and to positively influence vaccination outcomes,” the report said.

Going forward, the state auditor recommended school authorities make parents aware of legal requirements related to vaccination documentation, all of the ways to comply, and the consequences of noncompliance.

“Provide this information in languages other than English when appropriate. Ensure staff understand their roles and responsibilities related to immunization compliance and monitoring,” the auditor’s office wrote. “Exclude out-of-compliance students as the law requires. Finally, we recommend districts hold schools accountable for following the law.”