State: Number of students without updated vaccinations increasing

New data from the Hawaiʻi Department of Health show the number of students in the islands not up to date with vaccinations is increasing, a cause for major concern for health officials.

“We are already seeing increased cases of pertussis and are at risk for a measles outbreak,” said State Health Director Dr. Kenneth Fink. “Immunizations are necessary to protect infants, children and adults from potentially serious and contagious diseases.”

Nearly 40,000 students, 21% or 39,583, were not up to date on their school-required immunizations for the 2023-24 academic year, a 25% spike from the 2022-23 school year.

The increase includes students claiming exemptions, without immunization records and missing individually required vaccines.

A majority of the rise in missing school-required vaccinations is from seventh-graders not getting required immunizations implemented in 2020 during the COVID-19 pandemic.

Data also show that 16% of kindergarteners throughout the state are not current with their school-required vaccinations this school year compared with 55% of seventh-graders.

“An increase in the number of students without up-to-date immunizations is a cause for concern,” said Fink.

Of the 382 schools reporting for the 2023-24 year, 282 reported more than 5% of their student populations were not up to date with Hawaiʻi’s school immunization requirements; 36 reported having more than 50% of their student body not up to date.

The Hawaiʻi Department of Education reported 36,026 public school 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.

Schools have until today to report to the state Health Department the number of students not up to date on immunizations.

“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,” Fink said. “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.”

Hawaiʻi has two forms of vaccination exemptions for schools: medical and religious.

Department of Health data indicate an average religious exemption rate of 4.1% throughout the state for the 2023-24 school year. Religious exemptions have been on an upward trend since 2019-20, when the average rate was 2.1%.

The U.S. Centers for Disease Control and Prevention also confirmed a similar upward trend in the state’s religious exemption rate over the last few years through a separate analysis.

Medical exemptions in the islands continue to remain low overall despite increasing from 0.07% in 2019-20 to 0.16% in 2023-24.

There has been an increase nationwide in vaccine hesitancy since the COVID-19 pandemic.

State health officials say the volume of misinformation about vaccines continues to grow and is a contributor to the trend. Access to health care, particularly in rural areas, also is a continuing challenge when it comes to missing vaccinations.

The state Health Department is working with its education partners and health care providers to address ongoing challenges to immunization, including:

• Educating families that vaccination is the best defense against certain life-threatening diseases.
• Working with pharmacies and physicians to increase access.
• Making it easier to collect, analyze and report accurate data about student immunizations by modernizing the Hawaiʻi Immunization Registry.

Click here to view the new immunization data by school.