September doesn’t just mark the beginning of the school season — it’s also the beginning of immunization season as flu shots come on the market and parents rush to get their kids protected from various other viruses.

State officials and most medical providers recognize mandatory vaccines for children as a safe and effective public-health measure to help prevent illnesses that devastated communities before the 1950s.

by: PHOTO BY: RENEE KING - Ziling Zhen, 10, left, holds the hand of her sister, Ailing, 6, who prepares to receive an immunization from Alicia Nusom, a medical assistant with Providence Medical Group-Happy Valley. Ailing was starting first grade and only needed one immunization to be ready for the school year.Too many times people don’t think their kids need vaccines for diseases that are so rare, noted Dr. Kevin Grainger, who is in family practice at Providence Medical Group-Happy Valley. So as part of a statewide pattern, Grainger had seen more and more parents opting for “religious” exemptions to the mandates, which resulted in local outbreaks such as pertussis that had last affected the children’s great-grandparents with whooping cough.

“There is the possibility of more cases, and they are more likely to spread,” he said. “We don’t really have any fear of it, but if we have a lot of people getting out of vaccinations, then it would be a real issue.”

In response to Oregon having the nation’s highest immunization opt-out rate for nonmedical reasons, legislators passed Senate Bill 132A this year. Clackamas County parents sought the “religious” exemption for their kindergarteners at an especially high 7.4 percent rate. The Oregon Health Authority reported the statewide rate at 6.4 percent this year.

Now parents choosing any type of nonmedical exemption to immunization requirements must submit a document showing either a signature from their health care practitioner verifying a discussion of immunization risks and benefits, or a certificate of completion of the state’s interactive online educational video about vaccines.

“I think that would be good, because that education will address some of their concerns about preservatives and autism,” Grainger said. “There is no good evidence that the MMR vaccine causes autism, and every effort has been made to have minimal preservatives in vaccines. I feel comfortable giving these same vaccines to my own children.”

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Parents will need to check their children’s immunization records before Oregon’s official School Exclusion Day on Feb. 19, after which point they can be kicked out of learning facilities as a public-health risk. State law requires that all children in public and private schools, preschools, Head Start and certified child-care facilities have up-to-date immunizations.

Parents or guardians will receive a letter in late January or early February if their child’s immunization record shows that he or she has not received the required vaccinations. Grainger recommends a state registry called ALERT Immunization Information System ( where parents can check what immunizations their children have had.

Exclusion won’t be a problem for Grainger’s patient Ailing Zhen, 6, who was starting first grade and only needed one immunization to be ready for the school year. Her parents brought her to Providence’s Happy Valley clinic for a routine well-child check earlier this month.

New school and child-care requirements for 2013-14 mandate one dose of Tdap for seventh- to 12th-graders; preschool through fifth-graders now must get two doses to protect themselves from Hepatitis A. State records show nine out of 10 Oregon teens have had the Tdap vaccine to prevent pertussis, but only about two-thirds have been immunized against meningococcal disease. Even fewer have received the HPV vaccine, which prevents cancer and is now recommended, but not mandated, for boys as well as girls.

“After 12 years old, the well-child testing isn’t quite as consistent,” Grainger said. “In the case of HPV, it’s a new three-series vaccine, and the compliance rates for return visits is pretty low.”

Providence has worked with the Clackamas County Health Department for many years to provide free immunization fairs for low-income parents, and there will be at least one more next month, even though Obamacare through Cover Oregon should, at least in theory, be insuring everyone.

“That might take another year before everything’s up and running,” Grainger said.

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