Atlanta reporter checks up on school vaccination compliance

By Alison Young
The Atlanta Journal-Constitution

To protect against disease outbreaks, state laws require that children receive certain vaccinations before they are allowed to enroll in school.

But is your health department or local school district enforcing the law?

The Atlanta Journal-Constitution found Georgia school and health officials routinely ignore the law and take no actions against violators. As a result, thousands of metro Atlanta children were allowed to enroll and remain in school last year without proof of required shots, records show.

The findings came primarily from the newspaper’s review of required state vaccination compliance audit information for 625 public and private schools in five Atlanta-area counties.

The idea for the story came from an article in May in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report about a dramatic up-tick in U.S. measles cases.

From January 1 through April 25, the CDC had received 64 confirmed measles case reports. It was the most by that date since 2001 – the year after ongoing measles transmission was declared eliminated in the United States. The cases were associated with unvaccinated people who had traveled abroad to countries with outbreaks.

While many cases involved children too young to receive shots, 14 were children whose parents had claimed exemptions from school vaccination requirements because of religious or personal beliefs.

While none of the reported cases were in Georgia, the MMWR report made me wonder whether more parents are seeking exemptions from vaccination due to fears about vaccine safety and autism. Was there a way to identify pockets of unvaccinated or under-vaccinated children in metro Atlanta?

As it turned out, few Georgia parents were using exemptions. They didn’t need to at many schools.

Under Georgia law, children are not allowed to be enrolled and attend classes unless they:

1. have a doctor’s showing they have all required shots, or
2. they have a medical exemption from a doctor, or
3. their parents have given the school a notarized statement of religious exemption, or
4. they have received a temporary waiver (generally of 30 days) from the school to allow them to get shots or transfer records.

The state health department requires counties each fall to audit compliance among kindergartners and sixth graders at every school. I asked for a copy of the blank audit forms (which varied slightly depending on the grade audited) to see what information was collected at each school. Georgia’s one-page forms, among other things, tallied total students enrolled in the grade, percent in compliance, number certified as complete with all required shots, number missing required doses, number with religious exemptions, number with medical exemptions, number with temporary waivers and number with no documentation on file.

Because the state only had aggregate county data, I used the Open Records Act to request copies of audit forms from each health department and two self-auditing public school districts (in a few cases they had electronic information). I then put all the information into a spreadsheet.

The process of gathering the records and doing the data entry work took several weeks, but mostly was done while I was working on other stories. Some health departments attempted to charge hundreds of dollars for copies. To save time battling the issue, I got them to agree to let me review the documents for free and I took my laptop to their offices and did the data entry there.

If you do a similar story, be aware that many school principals may be unaware of the law. Be prepared to e-mail them copies of the law in advance of publication. By doing this and educating them prior to publication, I was able to head off what otherwise would have been unfounded challenges to the story’s accuracy after publication.

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Alison Young writes a weekly investigative column for The Atlanta Journal-Constitution. Until recently she covered the Centers for Disease Control and Prevention.