When Mainland Regional High School had a case of pertussis, or whooping cough, confirmed in December, school officials sent a letter home to all parents informing them of how the highly contagious disease spreads and how to take precautions, and suggesting they consider talking to their doctors about getting booster immunizations for their children.
That case was just one of 21 cases of pertussis reported in Atlantic County in 2014. An increase in whooping cough cases across the nation has medical professionals advising parents of the importance of childhood immunizations and booster shots as needed.
August is National Immunization Awareness Month, and the state Department of Health is encouraging parents to make sure all immunizations are up to date as the new school year starts.
“When children do not receive their age-appropriate vaccines, they are at increased risk for illness and can spread disease to others in their classroom and community,” Acting Health Commissioner Cathleen D. Bennett said in a statement announcing the campaign.
Childhood vaccines protect against serious illnesses by the age of 2. But while most children are vaccinated, controversy as to whether they should be mandatory remains.
In 2013, about 73 percent of New Jersey children ages 19-35 months completed their recommended vaccine series, according to the National Immunization Survey. The national average is 70 percent.
Children who attend state-licensed day care centers and preschools must be immunized by law. Atlantic County Health Officer Patricia Diamond said they audit centers and work with the state to educate owners on the requirement. She said the annual flu shot is the most challenging to enforce, since it must be done every year.
New Jersey also requires children to have a series of immunizations in order to attend public school, unless they have a medical or religious exemption.
According to state Department of Health data, about 89 percent of all children in New Jersey met all the state immunization requirements in 2014-15, down from 95 percent in 2012-13.
Statewide, less than a half-percent of all children, about 1,500, got a medical exemption in 2014-15. But more than 9,100 children, or just under 2 percent, got a religious exemption, up from 8,000 just two years before. The status of about 5 percent of children is unknown.
The reasons for the drop in immunizations and increase in exemption requests vary. Some parents are concerned about perceived health risks from the vaccines. Others don’t believe they are necessary.
For several years, groups such as the Alliance for Informed Choice in Vaccinations have supported a state bill that would add a “conscientious objector” exemption for New Jersey.
But as there have been resurgences of diseases such as measles, mumps and whooping cough across the nation, including an outbreak of measles at Disneyland, more attention is again being paid to the fact that the diseases have not disappeared.
This year, a bill was introduced in the New Jersey Legislature to increase the requirements for a parent to request for a religious exemption, but it has not yet been up for a vote.
In 2014, New Jersey reported three cases of measles, 39 cases of mumps, nine cases of meningococcal meningitis, and 387 cases of whooping cough. While typically none is fatal, they can lead to more serious complications.
The American Medical Association in June supported requiring all immunizations, except for medical reasons, and it encouraged states to eliminate philosophical and religious exemptions from state immunization requirements.
State data show children most likely to not be fully immunized are transfer students, with only about 64 percent immunized in 2014-15. Diamond said students may come in from other states or countries that have different immunization requirements, or none, so parents must be educated and children are more likely to enter school on a provisional basis until they catch up.
Children can be admitted to school as “provisional” if they have at least one dose of each required age-appropriate vaccine and are on scheduled to receive the rest. The school nurse is required to check every 30 days to assure compliance. About 2 percent of all children, or about 10,200, were in provisional status in 2014-15.
Many health departments offer child vaccination and health clinics for families that do not have insurance, or whose insurance does not cover immunizations. Atlantic County has clinics in Northfield and Hammonton.
Diamond said adults should also make sure their immunizations are up to date, especially if they may come in contact with infants who have not yet been immunized.
“We advocate for adults to get vaccinated for shingles, influenza and pertussis,” she said. “It protects them, and those around them.”