Under Washington state law, children are supposed to be fully immunized to attend daycare or preschool.
But no one knows how many kids in child care centers are actually vaccinated, because the state’s not keeping track.
That’s been a problem for new mom Kate Schueler who is getting ready to send her red-headed baby daughter to daycare. It wasn’t easy to find child care – particularly one where she and her husband felt confident that the other kids were fully vaccinated.
At four months, Margaret is up-to-date on her shots.
But there are some shots babies can’t get until they’re older. That makes them especially vulnerable to diseases – at an age when the diseases could be fatal.
“In-home daycares that we looked at, they wouldn’t really tell us exactly what their rates were, and they didn’t require the parents to provide information on that,” Scheuler said. “It was sort of just, ‘Yeah we vaccinate, sure,’ and that just felt pretty unsafe for our family, and it wasn’t a choice that we were comfortable with.”
Under state law, child care centers are supposed to turn away children who aren’t up-to-date on their immunizations.
But enforcement of the law is lax. The state health department requires child care centers and preschools to report vaccination data annually. But the state doesn’t analyze that data.
And when the state Department of Early Learning does yearly child care center inspections, inspectors only ask for about five children’s records at random at each center.
As a result, no one at the state can say for sure which child care centers are in compliance with the law. Or what the child care vaccination rates are statewide.
When KUOW requested immunization data for daycare centers, the files received weren’t accurate. The state calls this “dirty” data, because the numbers often don’t add up and aren’t reliable.
Paul Throne with the state Office of Immunization and Child Profile says the state stopped monitoring the rates about a decade ago – when the Centers for Disease Control and Prevention stopped asking states for the data.
Throne says it was just too hard to get good numbers from child care facilities.
“Centers have a lot on their minds. Early education is a very complicated thing to try to manage,” he said. “Then on top of that, keeping with all the health records of all the children is a real struggle with a lot of these places.
In babies’ early years, they need new shots every few months. So a baby who is up-to-date on his shots when he’s enrolled can fall behind just one week later.
And, Throne says, there are so many unlicensed child care facilities that it’s impossible for the state to know which records it’s missing.
What’s more, Throne says vaccination paperwork doesn’t need to be signed by a doctor. It’s up to parents to remember which shots their children have gotten – and to tell the truth.
“When a parent is facing the choice of, ‘Does your child have this that they need to come in to the center?’ sometimes parents might be tempted to simply say yes, that they do,” Throne said. “We have no way of really knowing.”
Jeri Finch, the director of Learning Way daycare in White Center, said she used to photocopy the booklet that the doctor’s office stamped. But the state no longer accepts the official vaccination booklets as evidence, so Finch relies on parents’ word.
She says her staff is constantly following up with parents to get their kids’ latest vaccination records. “After a little while, then I’m on the phone. ‘We don’t have your update yet. May I please have it?’”
The state has a general sense of how many toddlers are current on their vaccines: Inside and out of child care, just over half of all 2-year-olds have all their shots.
Seattle Children’s pediatrician Wendy Sue Swanson says that’s a big concern, especially in a child care setting where kids are sharing a lot of germs.
“They lick each other, they kiss each other, they’ve got snotty noses, they’re sharing toys and books, they’re learning in a kinesthetic way – it’s a cesspool!” she said. “And that’s OK. That’s part of the experience of young children growing up with each other in a community.”
Swanson says a lot of illnesses can spread in child care centers – including potentially deadly diseases like whooping cough and measles.
“Measles is unique. It’s wildly infectious – one of the most infectious viruses on the planet,” she said. “We know that if you’re not protected against measles, even if you walk in a room two hours after someone with measles, 90 percent of the time you’ll get the infection.”
A recent measles outbreak in Washington state killed one person and sickened dozens more. In a Chicago-area daycare this year, half a dozen babies got measles. Again – babies don’t get the measles vaccine until they’re at least 1 year old.
No one can say what the measles vaccination rate is in Washington child care centers. But statewide, about 79 percent of all 2-year-olds are fully immunized against the disease by the time they’re 3.
Doctors say 95 percent of a population needs to be immunized to prevent the spread of measles. That’s a big gap.
Swanson says it will take more than the laws on the books to increase the vaccination rate. She says parents need to drive the demand by pressing child care centers – and each other – to be up-to-date and up-front.
“How great would it be to walk into preschools and daycares and have the standard dashboard on the wall say, ‘Today the UV index, the risk of sunburn is this. The high temperature is going to be 75. And 97 percent of our population is fully protected and up-to-date on their vaccinations'?”
That kind of vigilance – and a high vaccination rate – was what sold Schueler on the daycare she and her husband finally chose for baby Margaret.
“Before we can even go in, we have to give them our vaccination records, and then we have to update them every time she’s eligible for shots, so that was something that was really important to us,” she said. Turning to her daughter, she said, “It’s important that you stay healthy, huh? Yes, it is!”