Tracking the rate of vaccination and school exemptions

The deadly propagation of measles this year in rural regions of western Texas and other pockets in the United States has been a strong warning as to the way protection against deadly childhood diseases in the country.

It was a key conclusion of a six -month NBC News investigation, in collaboration with the University of Stanford, leading to date the most complete analysis of vaccinations and school exemptions.

NBC News has collected massive amounts of data from the governments of states and the archives of public documents reaching years or decades. With the help of researchers from infectious diseases in Stanford, NBC News has filed dozens of documents, including materials obtained under the Freedom of Information ACT, and has fought different types of data in a standardized format to map and compare rates in thousands of counties.

The analysis has revealed that a large strip of the United States does not currently have basic medical experts to soil immunity is necessary to stop the propagation of measles, which had formerly remote in the past.

The idea of ​​this project is from a conversation on how to cover changes in the policy and opinion of vaccines between the NBC News Health and Medical Unit and Dr Peter Hooz, vaccine expert and dean of the National School of Tropical Medicine at the Baylor College of Medicine in Dallas.

The conversation has led to scientific infectious diseases, Dr. Nathan Lo, at the University of Stanford, which had drawn up vaccination and exemption data in some states. LO has become an employee in this one -month data project, helping to identify the limits of broader vaccination trends at the state level which are collected by the centers for Disease Control and Prevention.

Epidemics start locally

We put vaccination trends under the microscope, up to the county level. The results could help public health officials predict better where the next epidemic can occur and how to allocate resources to stop it.

Or parents of children at high risk of complications from infectious diseases might know if their community is a potential hot spot.

Analysis has identified unexpected trends.

For example, Saint-Louis, a large diversified metropolitan region, is in the middle of a slide in immunization rates. This is why it is a report orientation.

These results discover a fracture in an already fragmented society: the fracture of the vaccine.

Our methodology

How NBC News collected data

NBC News has built a database in kindergarten vaccination and exemption information using data provided by state governments, mainly health agencies. Data combines public information available for certain states and data provided directly to NBC News.

The data cover kindergarten vaccinations for each academic year.

After the collection, the data was gathered and the exemption rates were calculated in order to be analyzed. The analysis focuses on four data facets:

1. Medical exemptions: Exemptions granted when students have a medical condition that would make vaccination potentially harmful.
2. Non -medical exemptions: Exemptions for students who undress from vaccinations required due to personal beliefs or religious condemnations.
3. Vaccinations MMR (measles-Mumps-Rubella): For states in which the data is subdivided by the number of doses, mmr vaccination is counted by the second dose.
4. Up -to -date vaccinations: students are considered to be “up to date” with their vaccinations if they have received the complete vaccination series required for registration in their school.

How the data was processed

With a meli-melo of formats, jurisdictions and collection practices between states, the task required in-depth work to ensure that the possible inconsistencies in the data were managed.

• Some states, such as Ohio and New York, required additional calculations to aggregate the data provided by the State.
• Other states required hundreds of rows of tabular data.
• All data has been verified for precision.

Analyze data

Each state collects its data differently. Some use health districts instead of counties. Some states have provided more than a decade of data, others only two years. Some states have expurred certain data due to confidentiality problems.

• Not all states have recent data. Florida has not provided data on kindergarten exemptions after the 2021-2022 school year. Montana has ceased to collect data on vaccines and exemptions after 2019, first due to COVID and subsequently due to the adoption of a state bill (HB 334) in 2021 which canceled the mandate so that the State collects data on immunizations.
• Some states (such as Arizona, Colorado and Minnesota) do not collect a global figure “up to date” representing the percentage of children’s gardens which comply with all the required vaccines. Others (such as Florida, New Hampshire, New Jersey and South Carolina) provided only “up to date” numbers.
• In other states – Mississippi, New Hampshire and South Carolina – the data was only provided for K -12 years, rather than specifically kindergarten children. Virginia-Western also enters this category for their exemption data. The Mississippi could only share pre-K-12 exemption data.
• Some States – Illinois and New York – do not collect data at the school level, so the data is for elementary schools as a whole (up to K -8 for Illinois, New York was based on the labeling of the New York State Education Department), rather than on planters in particular. Hawaii also fell into this category (up to K-5), because its data at school was more consistent than its specific kindergarten data. New Mexico includes children aged 5 and 6 in its data, and state officials told NBC News that the inclusion of children before entering kindergarten is one of the reasons why its vaccination rates are lower than other places.
• Other states have not provided data at the county level. Alaska, Kansas and Nebraska have provided data for other jurisdictions. Delaware and Rhode Island only provided figures at state level. Indiana has not been able to provide exemption data at the county level. Virginia-Western has not been able to provide data on vaccination at the county level.
• Some states (for example, Michigan, New Mexico) collect data per calendar year, rather than by the school year.
• Wyoming has not systematically reported data among children’s gardens, so the most coherent reported value was used instead: MMR at one dose in children from 19 to 35 months. Consequently, exemptions in children under the age of 5 were used to correspond to this age group.
• Virginia-Western has not been able to provide data on vaccination at the county level, but was able to provide exemption data by county, starting with the issuance of decree 7-25 in January, which canceled the long-standing ban on the state on non-medical exemptions.
• Alaska has not been able to provide regional exemption data for reasons of confidentiality due to small sample sizes.