Immunization Rates Vary Widely Here

Two years ago, when Dr. Nadia Persheff glanced around her daughter’s kindergarten class at Southampton Elementary School, she saw what many parents could not — large numbers of unvaccinated children.

“Day to day, I see they don’t want the vaccinations,” Dr. Persheff, a South­ampton pediatrician, said earlier this week. “But when they get into a group. Wow.”

Even she admitted to being more than a little astonished.

Dr. Persheff, who has been practicing on the South Fork since 1998, regularly encounters parents either delaying or refusing their child’s vaccines. Taken together, she estimates between 10 to 15 percent of her patients have zero vaccinations. The parents of unvaccinated children, she said, tend to be white, wealthier, and better educated than parents whose children are fully vaccinated.

According to the Centers for Disease Control and Prevention, from Jan. 1 to Feb. 6 of this year, 121 people from 17 states were reported to have measles. Recently, following two reported cases in New York, Dr. Persheff said, she’s been unable to sleep at night.

Immediately, her staff compiled a list of patients who were not vaccinated, or who were behind and in need of a booster, and made rapid-fire phone calls, urging parents to take in their children for the measles-mumps-rubella vaccine. Typically, the first M.M.R. vaccine is given around 12 months, with a booster followed at the age of 4.

“This is a health emergency,” urged Dr. Persheff. “If Ebola didn’t throw us all over the edge, measles is much more contagious.”

On Monday, the New York State Department of Health sent a letter to school superintendents reminding them of state public health laws requiring the vaccination of children prior to attending school. Public and private schools may not admit unvaccinated children unless the student has been “legally exempted for medical reasons or because the child’s parents hold genuine and sincere religious beliefs which are contrary to vaccination practices.”

For a child to be considered fully vaccinated, he or she must receive age-appropriate doses for nine communicable diseases. Across the state, as the number of students opting out of such vaccinations has risen, some schools and districts are put at an increased risk for outbreaks of illnesses such as whooping cough and measles.

According to the state’s Health Department, more than 22,000 medical and religious exemptions were granted for the 2013-14 school year — an increase of 27 percent from the year before.

Data from the 2012-13 School Immunization Survey, which the state’s Health Department released in June of last year, shows that among kindergarten students across the state, Suffolk County had the highest number of religious and medical exemptions. Among the 35,173 kindergarten students in Suffolk County, 308 received religious exemptions and 83 received medical exemptions. Across Suffolk County, 96.5 percent of kindergarten students were fully immunized.

Statewide, according to the 2013-14 data, public schools had an average immunization rate of 98.5 percent and private schools had an average immunization rate of 88.8 percent. For measles, public schools had an average immunization rate of 98.9 percent and private schools had an average immunization rate of 90.6. Further, a Health Department spokesperson warned that measles vaccination rates need to be higher than 90 percent (since the virus can live outside the body for up to two hours) for a school to be considered safe from a potential outbreak.

Here on the South Fork, immunization rates vary considerably. The recently released 2013-14 immunization survey reveals a particular discrepancy among students attending public versus private schools — with far lower rates of immunization at private schools.

Among students enrolled in the East Hampton School District, 98.4 percent were completely immunized, with .43 percent receiving religious exemptions. In total, 99.2 percent were immunized against measles. Richard Burns, the East Hampton superintendent, said that districtwide, three families had decided against vaccinating their children. Currently, six students at East Hampton High School, four students at East Hampton Middle School, and one student at John M. Marshall Elementary School are not vaccinated.

It should be noted that students are counted in the district where they are enrolled. For instance, kindergarten through eighth-grade students residing in Springs would be included in the Springs School’s data until they enrolled at East Hampton High School.

In Springs, 98.1 percent were completely immunized, with about 1 percent receiving religious exemptions and 98.5 percent immunized against measles. Debra Gherardi, the school nurse, said that “a few students” had received medical and religious exemptions, but declined to give exact numbers.

In Montauk, 96.9 percent were completely immunized, with 1.56 percent receiving religious exemptions and 97.5 percent immunized against measles. Karen Theiss, now in her 16th year as the school nurse at the Montauk School, said that only two families had religious exemptions. Among parents, the only trend she has witnessed is that families are delaying vaccination schedules, particularly among younger children, but that such children eventually receive all required vaccines.

For 2013-14, Bridgehampton saw a total immunization rate of 95.7 percent and a religious exemption rate of 4.29 percent, with 95.7 percent immunized against measles. By contrast, in 2012-13, 92.9 percent of students in the district were completely immunized. Lois Favre, the Bridgehampton superintendent, said that three children were not vaccinated because of religious exemptions.

Meanwhile, in Amagansett, 95.8 percent of students were completely immunized, with 4.21 percent receiving religious exemptions and 95.8 percent immunized against measles.

In Sagaponack, 81.8 percent were completely immunized, with no religious exemptions and 100 percent were immunized for measles. For 2012-13, the total immunization rate was 100 percent.

In Wainscott, 100 percent of students were fully immunized, with no religious exemptions. For 2012-13, by contrast, 87.5 were completely immunized, with a religious exemption rate of 6.25 percent and a measles immunization rate of 93.8 percent.

In Sag Harbor, 96 percent of students were fully immunized, with a religious exemption rate of 2.69 percent and a measles immunization rate of 96.2 percent.

At the Child Development Center of the Hamptons, 95 percent were completely immunized, with a religious exemption rate of 2.5 percent and a measles immunization rate of 95 percent. By contrast, for 2012-13, religious exemptions held steady, with a 96.3 percent total immunization rate and a measles immunization rate of 97.5 percent.

Locally, immunization rates at two private schools were far lower by comparison. It should be noted that private nursery schools are not required to supply such data to the state. Only students in kindergarten through 12th grade are included in the survey data.

Both the Hayground School and the Ross School saw decreases in vaccination rates between 2012-13 and 2013-14. Among the 78 private schools in Suffolk County included in the 2013-14 data, Hayground had the fifth lowest vaccination rate and Ross had the 15th lowest.

Over the past two years, Hayground saw a drop in immunization rates of 5.4 percent. In the 2013-14 school year, only 63.6 percent were completely immunized and the same percentage were vaccinated against measles, with 33.3 percent receiving religious exemptions. By contrast, for 2012-13, 69 percent were completely immunized, with a religious exemption rate of 25.9 percent and 74 percent were vaccinated against measles.

Ross, meanwhile, saw a nearly 7 percent decline in vaccination rates. For 2013-14, 86.3 percent of students were completely immunized, with 1.4 percent receiving religious exemptions and 89.6 vaccinated against measles. By contrast, for 2012-13, 93.2 percent were fully immunized, with 97.3 vaccinated against measles.

Both Hayground and Ross officials declined to be interviewed.

Liza Tremblay, a mother of two young children and co-owner of Bay Burger and Joe and Liza’s Ice Cream in Sag Harbor, sees a potentially worrisome cluster forming on the South Fork — one made up largely of well-educated, wealthy parents who equate making natural and healthy choices with not vaccinating their children.

“Traditionally, kids not vaccinated were under-resourced and now it’s swung in the entirely opposite direction, with wealthy enclaves of college-educated parents making these choices,” said Ms. Tremblay, who observes a younger generation of parents, never having lived through a measles or whooping cough epidemic, becoming complacent. Growing up in Edgewater, N.J., her sister was hospitalized with whooping cough, or pertussis, at 6 weeks of age. “Everyone feels invincible.”

During a trip last week to Walt Disney World in Florida, Ms. Tremblay kept Rosie, her 10-week-old daughter, who is still too young for the M.M.R. vaccine, in a carrier. And when looking to employ a potential baby sitter, she only considers applicants whose vaccination history is up to date.

“There’s always that moment of panic when they get these shots. What if she gets a fever? What if she has a seizure?” said Ms. Tremblay, referring to Rosie, who recently received her diphtheria, tetanus, and pertussis vaccine. “But there’s no good reason in the world not to do it, even if for a moment it might feel a little scary.”

Jennifer Haagen’s children, ages 10, 11, and 13, are among the 1.02 percent receiving religious exemptions at the Springs School. Her three children have not received vaccines in the time frames recommended by the current immunization schedule.

She describes her eldest daughter, who has autism, as a “vaccine-injured child.” Ms. Haagen believes that an M.M.R. vaccine at 17 months triggered a cascade of symptoms, rendering her previously verbal child suddenly unable to speak. A potential link between vaccinations and autism, which is not supported by prevailing scientific data, gives many parents pause about immunizing.

“I want an open and honest discussion,” said Ms. Haagen. “You’re either pro-vaccine and pro-science, but if you question the safety and efficacy, you’re labeled as a conspiracy theorist, anti-science, and irrational. If anything, I can be accused of being overly logical.”

Over the past 5 to 10 years, as the number of parents unwilling to vaccinate their children has continued to rise, Gail Schonfeld, a pediatrician who has practiced in East Hampton since 1982, has changed her policy: She no longer treats non-vaccinating parents and their children. A firm believer in the life-saving power of vaccines, Dr. Schonfeld reasons that if “parents don’t trust me with this, we won’t have a good working relationship,” she said, adding that “my reputation precedes me — people know what I’m going to say.”

While she allows parents to delay the vaccine schedule, with the same shots eventually administered (albeit on an elongated timeline), she now requires such families to pay for additional visits. Never one to mince words, Dr. Schonfeld urged that “we’re all at risk and no vaccine is 100 percent effective.”

Still, she sees rising rates of religious exemptions as particularly worrisome.

“You can raise your child however you want until you’re endangering your child and those around you,” she said. “That right, you simply do not have.”