Ongoing Chickenpox Epidemic in a North Carolina School – November 2018

A school in North Carolina is currently experiencing a months-long epidemic of cases of chickenpox.  Part of the Waldorf Schools chain, the school (the Asheville Waldorf School, in Asheville, NC) apparently was long known for having a large proportion of its students unvaccinated.  The school’s proportion of unvaccinated students was among the highest in North Carolina, according to reports.  

North Carolina law requires that school students be vaccinated, BUT allows medical exemptions (such as in the case of an allergy to a vaccine component) as well as “religious” exemptions, although there are no major religions in the U.S. that object to vaccination.  In fact, most have voiced strong support for vaccination, which is widely accepted as keeping children healthy.  As you can see below, the “religious exemption” apparently has nothing to do with religion per se, but only requires parents to write a note that states their religious beliefs and their objection to vaccinations.  

This is taken verbatim from the Asheville Waldorf School’s website in the section on immunization:

Immunization Records: Each child must have a completed health and immunization form on file before being admitted.  This is a requirement of the county health department and state law.   NC law provides for the following two exemptions:  1. Medical exemption in which a licensed physician certifies in writing that an immunization may be detrimental to a person’s health. A form for this is available.  2. Religious exemption in which the parents submit a written statement of their bona fide religious beliefs, and opposition to the immunization requirements, after which the child may attend the School without presenting a certificate of immunizations.

The school has apparently been experiencing an ongoing chickenpox outbreak since September; however as of last week (2 months later) they had still failed to control it.  

This is from the school’s newsletter to all parents dated 9/26/2018: 

Dear Parents and Guardians,

We are writing to inform you that there have been a few more children that have possibly contracted Chicken Pox at AWS. It is likely there may be more cases that will pop up in the next week or so as we near the end of the initial incubation period from the first child that was diagnosed earlier in the month, so please be on the look out for symptoms in your children.

Chickenpox is a mild and common childhood illness caused by a virus called varicella zoster. It is most common in children under the age of 10 and is contagious. The incubation period is approximately 21 days and the person is contagious from 1 to 2 days before the spots appear until the spots have crusted over (usually 5-6 days after the spots appear).

Groups of people that are most at risk of serious problems if they catch chickenpox are newborn babies, pregnant women and those with a weakened immune system; therefore it is important, if your child has chicken pox, to keep them at home while they are contagious.

Our school policy states that if a child is suspected of having chickenpox, parents will be contacted immediately and asked to collect their child from school. All children should remain at home until all chickenpox spots have crusted over to avoid further spread of the illness. Should any child return to school before this time, parents will be contacted and asked to collect them and take them back home.

We appreciate your understanding on this and if you have any questions, please do not hesitate to get in contact with us.

Kind Regards,
The Faculty and staff of AWS

Read a story about the school’s outbreak from CNN here:

It is not known if the Asheville Waldorf School made it clear to parents of current or incoming students that their school had a large number of children who were unvaccinated.  If they did not, and a child with a true medical exemption (say, a child with leukemia still getting chemotherapy) was infected by a healthy student whose parents claimed a so-called “religious exemption,” would the former child’s parents blame the school (and the other student) for hospital costs and medical complications?  Or, in this litigious world, what about a child who was infected by a classmate and whose mother simply missed a week of work from her very well-paying job in the busiest season of the year?

When a school (or preschool, or daycare center) has a stated policy that requires vaccination yet allows “exemptions” on the basis of nothing but a note from a parent, that institution is asking for epidemics like this to occur.  Since universal vaccination is known to be safe and to keep students healthy, how does a school justify not enforcing state policy???  If there is a complication from such a preventable illness, the school might easily be considered at fault by failing to adhere to infection control guidelines.  For a parent to claim “religious freedom” when there is NO religion that prohibits vaccination is deceptive.  For a school to accept such a flimsy excuse is neglecting its obligation to its own students. 

Although chickenpox is normally a mild disease (characterized by fever, lethargy, and blisters on the skin), it often lasts a week or longer, causing parents to miss work.  More importantly, chickenpox in very young infants can be much more serious, and potentially fatal to the very young and the very old.  About 1% of patients with chickenpox are hospitalized with a complication, and about 1% of those hospitalized (or 1 in 10,000 patients) die of the disease or its complications.  

So what is a state to do?

In California, a law was passed in 2015 that prohibited all personal and religious exemptions, while maintaining the exemption for true medical conditions.  The result was a sustained increase in vaccinated children throughout the state.  Why is every other state not following its lead????

What are your thoughts??  Please comment.

Author: marcgrella

Primary care pediatrician; vaccine advocate; hunger fighter; refugee supporter.

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