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Would you pull your kid from day care if other kids weren't fully vaccinated?

Nov 18, 2014

A new twist in the debate about children’s vaccinations: parents really have no idea how many little kids are not fully vaccinated. 

One in four preschoolers is not fully vaccinated.
Credit Jennifer Guerra / Michigan Radio

That’s one finding from a new national poll done by the University of Michigan C.S. Mott Children’s Hospital.

The majority of parents – 74% to be exact– say they would remove their kids from day care if another child was not up-to-date on vaccines.

But in reality, one in four preschoolers aren’t up to date on their vaccinations, according to the CDC.  

So the poll also asked parents how they’d like a day care to handle kids who aren’t fully vaccinated.

Less than half of parents (41%) said they would want kids excluded from day care until they got up to date. But only one in 10 parents says they would support allowing a child to attend day care regardless of their vaccine status.

Only one in 10 parents says they would support allowing a child to attend day care, regardless of their vaccine status.

And two-thirds of parents want to know how many kids at their day care aren’t fully vaccinated, though only 25% said they should actually receive the names of specific kids who are not up to date.

Sarah Clark is the associate director of the National Poll on Children’s Health and a researcher at the U of M Department of Pediatrics. She walked us through what this poll means in terms of parents, the risk for kids, and whether day cares should become vaccine enforcers.

Why is this specific part of the vaccination conversation important? What made you want to do a poll about how parents feel about vaccinations in their day cares?

SARAH CLARK: “We were actually talking with the members of our team that runs the poll on Children’s National Health, and we have a number of parents of all ages, and we were talking about how it seems like there’s a growing number of parents over time who are choosing NOT to have their kids receive all recommended vaccines.

“And one of the younger members with a child in day care wondered if that would include day care children, because they’re required to have vaccines.

"Often day care vaccine requirements are at the time of entry, and they're not required to check the status of vaccination each year for a kid."

“But often day care requirements are at the time of day care entry, and they’re not required to check the status of vaccination each year for a kid.

“So over time, there may be doses recommended for a kid that are not received.”

Before we get into the can of worms this opens, walk us through the law. In Michigan, how specific does it get in terms of what vaccinations a kid needs to have to go to day care?

“Not every child enters day care at the same age, and the requirements are different for age ranges.

“It depends on the age that the kid is entering day care.

“In Michigan, there are requirements for DTap (diphtheria, tetanus, and pertussis,) pneumococcal (for strep), Haemophilus influenza type B, polio, and Hepatitis B.

“So that’s a pretty comprehensive list of vaccine requirements. Some other states may only have one or two required for day care entry.

“There are exemptions for medical (if a kid has a specific allergy to a medicine,) philosophical or religious reasons.”

So before we start freaking out, are kids really that much at risk if other kids in their day care aren’t fully vaccinated?

About one in four preschoolers is not up to date on their vaccines, according to the CDC.

And the risk might be different from kid to kid.

"A kid that's two months old in daycare has had the opportunity to have only one dose of vaccines. They're not fully protected."

For example, a kid that’s two months old in day care has had the opportunity to have only one dose of vaccines. They would be up to date, but they’re not fully protected because he hasn’t received the full series of vaccines he’ll get when he’s older.

For some people, the effectiveness of vaccines might not be 100% because it varies from person to person.

And a really important risk is, who else in the household might be compromised if a kid gets sick? For example, grandma has cancer and she’s vulnerable. So the risks are for both the kid in day care and their household.

One of the central things your poll found was that 74% of parents say they would actually remove their kids from day care if other children are unvaccinated. Meanwhile, one in four preschoolers aren’t fully vaccinated, but people aren’t exactly fleeing their day cares. Also, it’s really hard to find good day care! Do you think there’s a difference between what parents tell a pollster and what they’d really do? What do you think that finding says?

I actually think that that’s a signal that most people have no idea how prevalent it is that kids are not fully vaccinated.

"In my mind, I don't want my child to be exposed to disease, but I also don't have any recognition that that might be the scenario at my child's daycare."

If we know nationally that 25% of preschoolers nationally are not fully vaccinated – they might be missing every vaccine, they might be missing one or two doses – but we also know that people aren’t leaving their day cares in droves, that 74% illustrates the disconnect between, in my mind I don’t want my child to be exposed to disease, but I also don’t have any recognition that that might be the scenario at my child’s day care.

Do you think it is a good idea for day cares to start being those almost enforcers in terms of requesting records and saying, look guys, if you’re not up to date we could potentially dismiss you? Is that good policy?

That might be something that’s best left to the individual day care.

You know there are a lot of steps prior to excluding kids. There might be reminding people that their kids need to stay up to date. For example, they know how old the kids in their day care are. When the kids turn six months (old), they could send parents a reminder email knowing that there are certain vaccines recommended to each age group.

Each fall they could remind parents to get their kids flu shots.

So there might be ways to encourage vaccination that doesn’t go all to the way to full-blown enforcement if they’re a little bit hesitant to go there.

And I think day cares may also want to assess whether they want to do an annual status check of the kids that go to daycare there, or in other ways kind of look at the way they’re handling the issue and make sure they feel comfortable that they’re protecting the daycare and tell parents hey, here’s the situation in this daycare.