Kentucky students aren’t getting all the shots they should have. What the stats show.

The latest statewide immunization survey of Kentucky students showed that the percentage of kindergarteners who received required immunizations against diseases ranging from chickenpox to hepatitis B was below the state’s goal of 95 percent.

University of Kentucky pediatric infectious diseases associate professor Sean McTigue is concerned about that data, including that the 2018 state immunization survey showed that only 91.6 percent of kindergarteners were immunized against chicken pox.

“This is very unfortunate and needs to be addressed,” said McTigue. “Aside from improvements in public sanitation and nutrition, no medical intervention has been as effective in reducing and in many cases eliminating disease as routine childhood immunization.”

“Fears about immunization are unfounded as their safety has repeatedly been scientifically documented,” he said.

A discussion on whether children should be vaccinated for chickenpox — or excluded from school if they are not — centered on Kentucky recently as a northern Kentucky high school student filed a lawsuit against his local health department.

He said he couldn’t play for his private school basketball team and that he could not attend school because he was not vaccinated for chickenpox.

The debate heightened when Kentucky Gov. Matt Bevin said in a radio interview that he deliberately exposed his children to chickenpox so they would catch the highly contagious disease and become immune, the Associated Press reported.

During an interview on Bowling Green radio station WKCT, Bevin said his children were “miserable for a few days” after contracting chickenpox but said “they all turned out fine”, the AP said. The governor also said “if you are worried about your child contracting something like chickenpox, then vaccinate your child. Don’t worry about what someone else is doing.”

McTigue told the Herald-Leader Monday that he stands fully with the American Academy of Pediatrics and the Centers on Disease Control on the issue of children being immunized against chickenpox.

“This vaccine is safe and effective and prevents chickenpox,” he said. “ Chickenpox is not a benign infection, especially for infants. Children with chickenpox are at risk of serious complications including pneumonia ... and severe skin and soft tissue infections such as necrotizing fasciitis. Immunization prevents these complications and also greatly reduces risk of shingles later in life.”

“Unimmunized children are not only at risk of becoming ill themselves, but also of infecting others who may be too young to be immunized or who may have ....medical problems such as cancer or taking medications that suppress the immune system,” McTigue said.

McTigue said that unless there is a valid medical contraindication to a specific immunization -- which are rare -- children should be kept out of school unless they are fully immunized. Unimmunized and under-immunized children are far more likely to become ill with serious infections that are highly contagious and easily spread in a school, he said.

In Kentucky in 2017-18, among 50,488 kindergarten students, there were 1, 853 missing immunization certificates; 161 students, or 0.3 percent, with medical exemptions; and 484; or 1 percent; with religious exemptions.

More than 90 percent of the state’s sixth graders in the survey received the required immunizations, which met the state’s goal. Chickenpox immunizations were the lowest at 93 percent. There were 814 missing immunization certificates, 0.8 percent or 223 medical exemptions and 1. 5 percent or 442 religious exemptions.

Among 3,376 kindergarten students in Fayette, there were six, or 0.2 percent, with medical exemptions and 36, or 1.1 percent, with religious exemptions. There were 51 missing certificates. Among kindergarteners in Fayette, more than 96 percent had received all of their required immunizations in 2017-18.

Compliance was not as good for Fayette sixth graders.

In Fayette County, the 2017-18 survey showed that among 3, 750 sixth graders, there were 25, or 0.7 percent, with medical exemptions and 36, or 1 percent, religious exemptions. There were seven missing certificates among the Fayette sixth graders in the survey. More than 95 percent had been immunized against measles, mumps, hepatitis B and chickenpox. The report highlighted that among Fayette County sixth graders, only 72. 8 percent had been immunized for TDAP, a combination vaccine for tetanus, diphtheria and pertussis or whooping cough and only 71. 2 percent had received meningococcal vaccines .

McTigue said he was very concerned about the low rate of pertussis or whooping cough immunization in Fayette County, reflected in the 2018 report for sixth graders.

“We have already seen many cases of pertussis in children from Lexington. In many cases these infected children are young infants who are at the highest risk of having severe complications such as apnea (stopping breathing). These young infants rely on herd immunity for protection until they can be fully immunized. Herd immunity is the protection that is afforded by high rates of vaccination making encounters with infected individuals very unlikely. Low rates of immunization make herd immunity ineffective,” said McTigue.

Fayette County Public Schools spokeswoman Lisa Deffendall said the numbers point to the need for additional education for families about “this very important public health matter.”

“Although the vaccination requirements for entering sixth grade have been in place for several years, there are still families for whom this has not become routine,” said Deffendall. “Our school nurses work very hard to monitor vaccination compliance and ensure that all of our students are protected against contagious diseases. Our schools and nurses communicate regularly with families to remind them to send in the proper documentation and assist them in getting the required vaccinations for their children.”

Deffendall said school district officials were “reluctant to take legal action against families with limited resources or access to healthcare. As we are able to hire full-time nurses in our middle schools through the 10-point comprehensive safety plan, we expect it will help us increase these compliance numbers.”

Jessamine County had the highest percentage of religious exemptions for immunizations in the state in 2018 for kindergarten students with 3.1 percent.

District spokeswoman Patrice Jones said she reviewed the 2018 immunization survey with District Director of Health Services, Pat Glass.

According to the data in the report for the school year 2017-18, 17 of the 554 kindergarten students, or 3. 1 percent, and 20 of 671 6th grade students, or 3 percent, were granted exemptions due to parents declining on religious grounds. Jones indicated that district-wide, religious exemptions are about 2 percent and she mentioned that a number of those students were likely from the same families.

Jones said Jessamine County Schools nurses and other health professionals are in regular communication with parents regarding student medical needs and they provide educational information and assistance to parents to aid them in making informed decisions regarding their child’s healthcare, including vaccinations.

Lincoln County had the most medical immunization exemptions in the state at 5. 7 percent for kindergarten and 4. 9 percent sixth grade exemptions, according to the 2018 report.

“We worked very hard in the fall to get as close to 100 percent compliant on vaccinations as we possibly could.,” said district spokeswoman Brandi Hon. “We sent letters, calls and completed home visits to help with compliance. Some families chose religious exemptions. We have 19 out of approximately 3,800 students for the 18-19 school year. “

Kentucky recently passed a law saying that Kentucky students had to have Hepatitis A vaccines, but data on that compliance is not yet available, said Cabinet for Health and Family Services spokeswoman Beth Fisher.

This story was originally published April 2, 2019 at 3:24 PM.