The number of Hawaii students not up to date with immunizations is increasing, according to new data from the state Department of Health, which described the trend as “a concerning development.”
A total of 39,583 or 21% of students from public, charter and private schools were not up to date on their school-required immunizations for the 2023-24 school year. That’s a 25% increase from the 2022-23 school year. This number includes those claiming exemptions, those without immunization records, or students missing individually required vaccines.
The majority of this increase in missing school-required immunizations is from seventh-grade school requirements that were implemented in 2020 during COVID-19. For the 2023-2024 school year, 16% of kindergarteners were not up to date with school-required vaccinations compared to 55% of seventh-graders.
Of the 382 schools reporting for the 2023-24 year, 282 schools (74%) reported more than 5% of their student populations were not up to date with Hawaii’s school immunization requirements.
Thirty-six schools (almost 10%) reported having more than 50% of their student body not up to date, according to the DOH.
For Hawaii public schools, the state Department of Education reported that 36,026 students were missing one or more required immunizations for the 2023-24 school year.
Preliminary data for the 2024-25 school year shows 28,300 students missing one or more vaccinations, the DOE said. Schools have until Friday to report to DOH on the number of students not up-to-date on immunizations.
“An increase in the number of students without up-to-date immunizations is a cause for concern,” Dr. Kenneth Fink, DOH director, said in a statement. “High vaccination rates help protect those who are unable to receive certain vaccines due to medical reasons and those with a non-medical exemption through what’s called herd immunity.
“Low vaccination rates mean unvaccinated keiki are at increased risk of infection, especially at schools with a high rate of the student population not being up to date. We are already seeing increased cases of pertussis and are at risk for a measles outbreak. Immunizations are necessary to protect infants, children and adults from potentially serious and contagious diseases.”
Hawaii has two forms of vaccination exemptions for schools: medical and religious. DOH data indicates a religious exemption rate of 4.1% for the 2023-24 school year when averaged across the entire state. This is an upward trend compared to prior years starting in 2019-20 at 2.1%. Medical exemptions have increased from 0.07% in 2019-20 to 0.16% in 2023-24 but continue to remain low overall.
The CDC also has confirmed a similar upward trend in Hawaii’s religious exemption rate over the last few years through a separate analysis.
Nationwide, including Hawaii, there has been a concerning increase in vaccine hesitancy since the COVID-19 pandemic. The volume of misinformation about vaccines continues to grow and has contributed to this trend, the DOH said. Also, a continuing challenge with missing vaccinations is difficulty in accessing health care, particularly in rural areas.
DOH is working closely with educational partners and health care providers to address ongoing challenges that may be contributing to this trend.