Measles vaccination rates at public schools lowest in poorest areas

Location of low measles vaccinations
Data shows lowest vaccine rates concentrated at Chicago's South and West Side Schools (Emily Hoerner, MEDILL)

By Emily Hoerner

Less than 90 percent of students at 14 Chicago Public Schools were vaccinated for measles last school year, according to data by the Illinois State Board of Education. Nearly all of those schools are located in low-income neighborhoods on the city’s South and West sides.

Francis M. McKay Elementary in the Chicago Lawn neighborhood had only 80.8 percent of students vaccinated last year, while Legacy Elementary Charter School in North Lawndale had 84.8 percent of children vaccinated against the measles. Both neighborhoods hosted more than one school with low vaccination rates.

Asian Human Services Passage Charter School in Uptown was the only North Side school with less than 90 percent of students protected against the measles.

An analysis by Medill Reports of Illinois State Board of Education data uncovered that the lowest measles vaccination rates from the 2013-14 school year were concentrated in public schools on the South and West sides of Chicago. (City of Chicago, Emily Hoerner/Medill)

Experts recommend that 90 to 95 percent of children be vaccinated in order to create so-called “herd protection.” When most people are immune to viruses such as measles, unvaccinated individuals become insulated from the infectious disease, according to the Centers for Disease Control and Prevention.

Mark Dworkin, a professor of Epidemiology and Biostatistics University of Illinois at Chicago, said, “When a community or population (like a school) lacks herd immunity, there is reason for concern because it is a signal that they are especially susceptible to an outbreak if measles is introduced into their population.”

Although Illinois requires all children to be vaccinated before enrolling in school or day care, religious exemptions are allowed.

Dr. Neal Halsey, a pediatrics and international health professor at Johns Hopkins Bloomberg School of Public Health, said low rates of vaccinations pose risks. In dense, urban areas, 93 to 95 percent of children should be immune to the disease, creating “herd protection,” he said.

“The objective is to try to protect those children who cannot be immunized or who don’t get a take or response from the vaccine,” Halsey said.

Ideally 98 percent of children should be given a vaccination to help ensure that those who can’t be vaccinated are protected, said Halsey, who specializes in the prevention of infectious diseases.

After focusing on measles control in Chicago during the 1970s, Halsey said he isn’t surprised that schools with lower vaccination rates are concentrated in Chicago’s impoverished neighborhoods.

“It’s hard,” Halsey said of getting children vaccinated. “Especially for low-income families who are under just as much time and pressure as we are to get everything done in their lives.”

Melaney Arnold, spokeswoman for the Illinois Department of Public Health, said because of the Affordable Care Act and the Illinois Immunization Program for children, low-income parents have help paying for care.

“As far as access, when it comes to cost, that’s not an issue,” Arnold said.

Halsey said that aside from immunization costs, vaccination rates might be lower in impoverished neighborhoods because they lack access to medical care or don’t know the importance of vaccines.

“Sometimes when these children are brought in for medical care, nobody is looking at the immunization record and giving them vaccines when they should have given them vaccines,” Halsey said. “Those are called missed opportunities.”

Improving the ability for doctors to check children’s medical records electronically at clinics and emergency care centers could help to get more children immunized, Halsey said.

Illinois does have I-CARE, a program to make electronic health records more available, Arnold said. Both the child and the facility have to be registered through I-CARE in order to access immunization records.

Last week the Illinois Department of Public Health confirmed six cases of measles, five of which stemmed from an outbreak at a suburban Palatine KinderCare Learning Center. Measles is a highly contagious respiratory disease, recognizable by its red rash.

“It’s definitely something that we’re concerned about, we’re monitoring,” said Mary Fergus, a spokeswoman for the Illinois State Board of Education.

Fergus said schools in Illinois have clear guidelines for dealing with a measles outbreak, and warned about focusing too much on student immunizations that aren’t up to par.

“[The data] shows a great percentage of students do have the vaccinations,” Fergus said. “So, I think that’s important to keep in mind.”

Photo at top: In 2014, some schools in impoverished areas of Chicago had lower measles vaccination rates than those in more affluent neighborhoods.(Emily Hoerner/Medill)