During the 64th legislative session, Montana became the last state in the United States to make chicken pox immunizations compulsory for children entering public school. House Bill 158 also added a booster for pertussis, or whooping cough, to the list of immunizations that are already mandated. Health officials are hoping the new rules will help reduce the incidence of common childhood illnesses.
"We're just happy the legislature agreed this is important," says Jim Murphy, a bureau chief at the Montana Department of Public Health and Human Services. Murphy testified in support of the bill, pointing out that in 2013, Montana had the highest rate of pertussis cases in the nation, with 69 per 100,000. Pertussis, a highly infectious cough caused by a bacterium, often lasts several weeks. It's most dangerous to infants but can also lead to complications for teens and adults.
"Teenagers are the most susceptible group [to pertussis], and it's a hard group to get a hold of, there's a lot of mixing of that population in schools, and when it gets started in that setting it's hard to bring it back," Murphy says. Previously, most children received just one pertussis shot in grade school, but research has shown the vaccine's efficacy wanes over time. Adolescents benefit from getting a booster, which is typically included in the tetanus, diphtheria and acellular pertussis shot, or Tdap.
Murphy says Montana has been slow to add these stipulations partly because, while most states authorize their health departments to adjust immunization requirements, Montana's rules can only be changed by the legislature. That can make it difficult to stay on top of evolving Centers for Disease Control guidelines.
- New immunization requirements for Montana public school children could combat whooping cough and chicken pox. Health officials say the illnesses are more common in the state due to lower vaccination rates.
In addition, Montana is not immune to the anti-vaccination movement that believes in a purported—and since discredited—link between vaccines and autism. Groups like Shot Free in Montana and Montana Families for Health Freedom have actively campaigned against vaccinations in the past, but faded in recent years. "Fortunately for us, the majority of the population does see the benefit of vaccines," Murphy says.
In 2013, 84 percent of Montana teens received a pertussis booster shot, compared to 86 percent nationwide, and 59 percent had the two-shot chicken pox vaccination, compared to 78 percent nationwide. Inoculating even more of the population can translate to a much greater level of group immunity, Murphy says.
The Bitterroot Valley in particular has struggled with pertussis outbreaks, acknowledges LuAnn Burgmuller, director of Ravalli County Public Health. She says some Bitterroot families opt out of vaccinations by claiming religious exemptions, which is still permitted by law. "We notoriously have low vaccination rates here in Ravalli County, and so that has increased pertussis rates," she says. "...We're hoping that having that [pertussis booster] in the vaccine will decrease some of our problems."
At Missoula County Public Schools, nursing supervisor Linda Simon says they'll soon be notifying families about the updated rules. She estimates that most students already have the recommended immunizations for pertussis and chicken pox. "But when you have 8,600 kids, and let's say 10 percent aren't compliant, that's still 860. That's a huge number to us," she says.
Simon adds that the methods for administering chicken pox vaccinations have improved in recent years, and today they're more effective than they might have been in previous years.
Simon encourages parents to keep a written record of their kids' immunizations or to contact their local health department or care provider for a record. The deadline for students to be up-to-date on immunizations is Oct. 1.