With the start of school comes decision time for parents -- vaccinate their children or seek exemptions and let their children attend school unvaccinated.
The state requires students in kindergarten through 12th grade at public and private schools to be vaccinated against polio, diphtheria, tetanus, measles, rubella, mumps, hepatitis B, hepatitis A, meningococcal disease, chickenpox and pertussis, or whooping cough, according to the department.
However, parents can file with the state Health Department for exemptions for medical, religious or philosophical reasons, and more parents have been doing that in the past few years.
Statewide, the number of exemptions increased about 25% from 6,397 exemptions in the 2014-15 school year to 8,016 in the 2018-19 school year.
Parents who do not vaccinate their kids for nonmedical reasons often do not understand the risks involved, Dr. Joe Thompson of the Arkansas Center for Health Improvement previously said.
"They're parents who have never seen a baby with whooping cough or a child with measles," he said.
About 2% of children who had vaccination exemptions in the 2018-19 school year were exempt for medical reasons, according to the Health Department. About 32% of the exemptions were for religious reasons, and 66% were for philosophical reasons.
Eva Charles of Bentonville previously described herself as an "ex-vaxxer," meaning she got her kids some of their vaccinations but did not continue once she began questioning the vaccines' contents and side effects.
Charles said she suspects that vaccines that contain aluminum caused her son to have eczema, a chronic condition that makes skin red and itchy. He began showing signs of eczema weeks after he had shots as a baby, she said.
Charles said she is not against other parents choosing to vaccinate their children and understands other parents' fears about not vaccinating.
Vaccines are one of the most important tools in medicine, Dr. Robert Redfield, director of the federal Centers for Disease Control and Prevention, said last month.
"They are the best way to eliminate disease. They are the only way to eradicate disease," he said at Arkansas Children's Northwest Hospital in Springdale.
While people have the right to believe what they want about vaccines, parents and guardians should also have the right to know if they are sending their children into at-risk environments, said state Rep. Justin Boyd, R-Fort Smith.
Earlier this year, he sponsored and the Arkansas Legislature passed Act 676, requiring schools to keep public reports on the number and percentage of students exempt from vaccinations and who have not shown proof of vaccinations. The reports must be posted on the schools' websites and updated annually.
Act 676 states that allowing vaccination exemptions creates opportunities for outbreaks of preventable diseases, posing a nationwide health crisis. Reasonable steps should be taken to inform parents how many students have exemptions or have not shown proof of vaccinations, the law says.
"There's nothing in there that will identify a specific kid," Boyd said.
He said the law's purpose is to make the information, which anyone can already access through a Freedom of Information Act request, more accessible to parents and guardians.
"There has to be a certain number of people vaccinated against communicable diseases in order to protect the larger group," he said.
Thompson said previously that when 95% of a community is vaccinated against a disease, doctors call that "herd immunity," which means the risk of a disease outbreak getting out of control is relatively low.
"Vaccinations are safe and effective," said Dr. Jennifer Dillaha, medical director of immunizations at the Arkansas Department of Health.
She pointed out that the Health Department sometimes requires students to stay home from school during disease outbreaks.
Two cases of whooping cough were confirmed in April at Woodland Junior High School in Fayetteville. The first diagnosed student was unvaccinated. The school notified parents of about 30 students who were in close proximity to the first diagnosed student and parents of seven students who were exempt from vaccinations that their children would have a few days to get on antibiotics or be banned from school and school activities for three weeks.
At least 150 cases of mumps were confirmed or suspected in 2016, mostly in Springdale, and a few in Rogers last school year. Students who weren't vaccinated against mumps had to stay home for at least 26 days.
The number of students in day-care-through-college in Benton County who had vaccination exemptions increased by 27% from 1,225 in the 2014-15 school year to 1,557 in the 2018-19 school year, according to the Health Department.
In Washington County, vaccination exemptions increased by 23.5%, from 862 to 1,065, during the same time period.
This school year, unvaccinated, non-exempt students will be allowed to attend classes and school activities as long as they have appointments to receive their vaccinations, said Kathy Launder, school nurse coordinator for Springdale Public Schools.
She said it's important to remember that incoming kindergartners are not the only children who need updated vaccinations before they attend school. Students need certain vaccinations at ages 11, 12 and 16, she said.
Chickenpox, for example, can make teenagers sicker than it does younger children, and teens with chickenpox may have to miss 10 days of school, Launder said.
Parents whose children attend schools in the Pulaski County Special School District must show proof that the children have been vaccinated or the youths will be excluded from school, according to the district's website. Proof of exemption or proof of exemption application is required before school starts, it says.
Further, the website says "if there are reported cases of vaccine-preventable communicable disease, an exempted student may be excluded from school for up to 21 days."
"Children are very good transmitters of illnesses," Dillaha said.
She said parents can get their kids vaccinated at any of the state's county health units regardless of their ability to pay.
The World Health Organization lists vaccination hesitancy as among the top 10 global health threats.
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