How do exemptions work?

To enroll in school a child must file either

a vaccination record or an exemption
form for the required vaccines.
A Exemption Form is needed for a
student to opt out of even one dose of a
School Attendance Required Vaccine.
Exemptors are
excluded from
school during an
outbreak

Exemptions are granted

by individual vaccine

Less than 1% of children avoid all

vaccines.
Most exemptions are
for Chicken PoxAlmost NO
exemptions are
for all shots

The double paperwork requirement of

both vaccination records and exemption
forms for children that are opting out of a
shot make for confusing statistics. The
exemption rate only measures the
number of children with a form on file, it
does not mean they are unvaccinated.
A child with all of the core, traditional
vaccines- DTaP, MMR, Polio, will show
up as both vaccinated, yet also as
exempt for the Varicella or Hep B.
Vermont children have no vaccine
requirements prior to Kindergarten, (unless
enrolled in a daycare or pre-school). In recognition
of this fact they are allowed to start
school with a temporary Provisional
exemption lasting up to one year to come
into compliance.

Is the Philosophical Exemption Rate Climbing?

Vermonts Kinder PE rate jumped, from about 2.5% to 5% when Chicken Pox and
Hep B were added as School Attendance Requirement, then dropped back and is
stabilizing. These statistics are deceptive due to Vermonts small population. Parents
are not abandoning the traditional schedule but are being thoughtful of new additions.
Ve rmo n t K in d er ga rt en Immu n iza tio n
Exe mp tio n s a n d Pro v isio n a l Sta tu s
p hilosophic e xem pti ons (% )
p rovi si onal status (% )

V aric ella (2 dos es )

and hepat itis B
requirem ent added
to s c hool rules in
2008.

10%
8%
6%
VT 7th Grade
2.43% PE

4%
2%
0%

'00-01

'01-0 2

'0 2-03

'03-04

'04-05

'05-06

'06-07

Yea r of Enrollm ent

'07-08

'08-09

'0 9-10

'10-11

Surveyed

12%

Percent of Students

14%

2010/11 Data - VTDOH is

not releasing current data

Is Vermont at Risk?
This map full of red dots
is misleading.
The small enrollment size
of many schools in
Vermont leads to
deceptive percentages.
The state average of
philosophical exemptions
is only 5.08%.

2010/11 Data - VTDOH is

not releasing current data

The red dots on this map represent 71 individual schools

with Kindergarten classes that have a greater than
6% Philosophical Exemption Rate.
A single child with a Chicken Pox Philosophical
Exemption in a school with 16 Kindergartners results in a
6% plus exemption rate.
Two children with a Chicken Pox Philosophical
Exemption in a school with 32 Kindergartners results in a
6% plus exemption rate

2010/11 Data - VTDOH is

not releasing current data

One of these red dots is Brookfield

Elementary, which in 2010/11 had a single 13
student Kindergarten class. All of the 13
children are fully vaccinated for DTaP, Polio,
MMR, and Hep B. 12 of the 13 are
vaccinated for Chicken Pox, with 1 student
requiring a Philosophical Exemption to opt
out. Because of the way VT DOH measures
exemptions, this school has a
7.7% Philosophical Exemption Rate.
In 2007 this school would have had a 0%
exemption rate, because Chicken Pox was
not a requirement until 2008.
Is one child not receiving a Chicken Pox
shot, which was not a requirement prior 2008,
a threat to Public Health?

2010/11 Data - VTDOH is

not releasing current data

Another red dot is Sudbury Country, a school

with a 33.33% Philosophical Exemption Rate!
Sudbury has 3 Kindergarten students.
All 3 are fully vaccinated for
DTaP, Polio, MMR and Hep B.
Only 2 of the 3 are vaccinated for Chicken Pox,
with 1 student using a Philosophical Exemption,
resulting in the schools
33.33% Philosophical Exemption rate.
In 2007 this school would have had a 0%
exemption rate, because Chicken Pox was
not a requirement until 2008.

Very few Philosophical Exemptions are for all shots.

No school in Vermont has more than 13 Kindergarten students with
Philosophical Exemptions. Vermonts population distorts statistical measurements.

Examine these schools to see why percentages are misleading.

This subject is much more nuanced than Exemptions equal unvaccinated

children. Consider North Bennington Grade School: 13 of 14 have DTaP,
Polio, MMR, and HepB; 11 of 14 have Chicken Pox, and 7 have Philosophical
exemptions. That means 3 Chicken Pox exemptors, and one exemption each
for the other vaccines.
Not 7 completely unvaccinated children

Johns Hopkins warns that the vaccinated

are a threat to the immunocompromised

Page 1 of 4

Care at Home for the

Immunocompromised Patient
Hand washing is the best way to prevent
infection.
Carry hand sanitizer with you at all times.
Wash with soap and water or hand sanitizer
-before and after you use the bathroom
Should an IC child really
-before and after preparing or eating food
be in the uncontrolled
-after touching pets or animals
environment of a
-after contact with someone who has an infection such
public school or other
as a cold or the flu
public spaces?
-after touching surfaces in public areas (such as
elevator buttons, handrails and gas pumps)
What can I do
to prevent
infection?

Do I need to
wear a mask?

Can I have
visitors?

Wear an N95 respirator mask when you travel to and from

the hospital, when you are in the hospital, within two football
fields of construction or digging, and in any public place.
Close all car windows and turn on the re-circulate button of
your ventilation system.
Avoid crowds if possible. An area is crowded if you are
within an arms length of other people.
Avoid closed spaces if possible.
Tell friends and family who are sick, or have recently had a
live vaccine (such as chicken pox, measles, rubella,
intranasal influenza, polio or smallpox) not to visit.
It may be a good idea to have visitors call first.
Avoid contact with children who were recently vaccinated.

Do not take aspirin or aspirin-like products (such as Advil,

Are there any
Motrin or Excedrin) unless told by your doctor.
precautions I
You should wear a medical alert bracelet that identifies you
follow
Areshould
schools
currently as a cancer patient or bone marrow transplant patient at risk
aboutICmy
notifying
families whenfor bleeding or infection.
medicine?
fellow students have beenKeep a current medication list with you at all times.
recently vaccinated
Do not take any herbal products.
with live viruses?
Avoid grapefruit juice, which interacts with many
medications.
0965

2008 The Johns Hopkins Hospital

Descriptions of Terminology
The excel workbook titled 2011-12 Immunization Data Report: Public and Private Schools contains aggregate data submitted from
th
public and private schools by January 1, 2012 on the immunization status of kindergarten and 7 grade students.
The workbook contains:
descriptions of terminology
highlights of the 2011-12 immunization school data
a data summary sheet
12 sheets representing aggregate data from public schools only, located within each VT Health Department District Office catchment
area
a sheet with data submitted from each public school
a sheet with data submitted from each private school
two summary sheets with information submitted to the Centers for Disease Control and Prevention
Definitions:
Met: meets the vaccine requirements as defined by regulation. Includes students with evidence of immunity due to history of disease
Not met: does not meet the vaccine or evidence of immunity requirement. Includes students with medical, religious, and philosophical
exemptions, and students provisionally admitted
Medical, religious and philosophic exemption: includes students with a signed exemption form for one or more vaccines
Provisional admittance: includes students who neither meet requirements for all vaccines nor have a signed exemption on file
Provisional admittance no IZ record: a subset of provisionally admitted students with no immunization record
Limitations of the data:
Any student counted as not met for an individual vaccine must also be represented as either having an exemption or provisional
admittance
Exemptions and provisional admittance represent an individual student with one or more vaccines affected. When looking at the
individual vaccines by school or grade it is not always possible to determine why compliance was not met.

Highlights of the 2011-12 Immunization Data Report: Public and Private Schools
This report represents data collected from all public and private schools in Vermont. 93% of all students
entering kindergarten were in public schools and 92% of students entering seventh grade were in public
schools.
Students entering Kindergarten
The percentage of students entering kindergarten who were fully immunized was 87.0%. This is an
increase from the 83.2% who were fully immunized in the 2010-11 academic year.
The percentage of students entering a public kindergarten who were vaccinated against diphtheria,
tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B and varicella (chicken pox) increased for
each individual vaccine to levels higher than reported in the previous two years.
The vaccination rate of students entering public kindergarten is at least 10% higher for each individual
vaccine when compared to students entering private kindergarten.
The percentage of students in public and private kindergarten with a provisional admittance for one or
more vaccines was 7.3%. The provisional admittance rate decreased from 10.4% to 7.0% in public
schools and 14.8% to 11.5% in private schools from the 2010-11 to the 2011-12 academic year.
The percentage of students in public and private kindergarten with a philosophical exemption for one or
more vaccines was 5.2%, down from 5.4% in the prior year. The philosophical exemption rate
decreased from 5.1% to 4.7% in public schools and increased from 9.8% to 13.2% in private schools
from the 2010-11 to the 2011-12 academic year.
Students entering Seventh Grade
90.6% of students entering seventh grade had received one dose of Tdap, as required. Tdap protects
against tetanus, diphtheria and pertussis. Immunity against pertussis wanes and vaccination with Tdap is
important to prevent the spread of pertussis. In the recent pertussis outbreak in Vermont, 58% of the
cases were among those 10-14 years of age.
The overall philosophical exemption rate was 3.3% for students entering seventh grade. The
philosophical exemption rate for students entering seventh grade in public schools was 2.8%, while the
rate for private schools was 9.7%.

There was never a "Golden Age", in the past when Vaccine Acceptance and Vaccination rates were
higher than they are today. The truth is there are more US children getting
more vaccines for more infections at younger ages than ever in history!

Decades of
30% - 40%
unvaccinated
population with
no epidemics

The 90% plus coverage rates we see

today were first achieved in the
late 90's, and are the result of the
convergence of 3 programs1) School attendance requirements, which began in
the late 70's & early 80's;
2) The near complete indemnification for liability of
vaccine manufacturers and administrators by the
NVICP, The National Vaccine Injury Compensation
program in 1988; and
3) VFC- Vaccines For Children, a funding scheme
whereby the government buys and provides all
"required" vaccines, 1993.
Required vaccines are now
legislated purchases.