Every year, health workers send out letters reminding families with incomplete or missing immunization records to get them up to date before their children are sent home from school.
Still, every year, Exclusion Day catches at least a few families unawares, usually with their seventh-graders.
Seventh grade is the year students are required to get the Tdap booster shot, which protects against tetanus, diphtheria and pertussis, also known as whooping cough. Exclusion Day, which was Wednesday this year, is the day schools send home students if they don’t have complete immunization records or exemption forms on file.
Greater Albany Public Schools sent home 55 students on Wednesday, most of which were from Calapooia Middle School, Memorial Middle School and Timber Ridge School.
Lebanon and Sweet Home reported similar results, sending home 32 and 30 students, respectively. In Lebanon, 22 of those students were from the middle school, with the others at various elementaries. In Sweet Home, 17 of the 30 students were from the junior high, with a dozen from various elementaries and one at the high school.
Joan Pappin, the nurse in Sweet Home, said the 30 exclusions represents the largest number she can remember. It's hard to understand, she said, given that she works for months ahead of time to make sure parents know about the requirements.
In the spring, Pappin sends out reminder letters to families who will have seventh-graders in the fall. Every December, she looks at the list of incompletes and sends out a letter before Christmas break, including copies of the vaccine records and highlighting what's missing. She also includes lists of clinics that will be open during the break.
"I called every single junior high parent on that list. Every one," she said. "And we still sent kids home. Other than actually going to every home with a needle in my hand …"
Karyn Walker, immunization coordinator for the Linn County Public Health Department, figures the seventh-grade booster shot is just an easy one for parents to forget. Most families make sure their children are up to date on vaccines when they were first enrolled in school, but don't think about it as much as the years pass.
"Once they reach the age of about 7 or 8, they don’t take them in for well-child checks anymore, so they're not vaccinating them," she said. "It's pretty much where the biggest numbers are, is the seventh grade and the Tdap."
Walker sent out 932 reminder letters to families with children of all ages this month, a number that's slightly skewed because it includes students enrolled at Oregon Connections Academy, an online school based in Mill City that takes in students from all over the state.
Closer to home, she sent out 263 letters to families with Greater Albany Public Schools, 145 letters to families with the Lebanon Community School District and 119 to the Sweet Home School District.
Families with private insurance who have a child at least 7 years old who needs a shot can get it done at a local pharmacy if a doctor's appointment isn't immediately available, Walker said. Families on the Oregon Health Plan or who don't have insurance can call the health department at 541-967-3888.
Exclusion Day totals and other statewide vaccine reports won't be known until May, after all county health departments get their reports in, said Stacy de Assis Matthews, school immunization coordinator at the Oregon Public Health Division. In some school districts, the reports won't be collected until Thursday because snow closed school Wednesday.
Right now, however, Oregon has moved back up to first place in terms of the percentage of kindergartners with a nonmedical exemption on file for one or more vaccines.
In 2016-17, the most recent information available, Oregon led the nation's rankings with 6.5 percent, Matthews said.
Oregon does allow families to opt out of vaccines, but must fill out paperwork indicating they've been informed about each vaccine for which they want an exemption.
Parents who want to opt out of immunizations have to file one of two documents with their children’s schools: either a printout from a specific online webinar showing they’ve received information about each vaccine, or a form signed by a physician saying they’ve been made aware of the potential consequences for choosing not to vaccinate.
"The first year that took effect, we saw a pretty substantial decrease in the nonmedical exemption rate. We’ve slowly seen it go up a little bit each year," Matthews said.
The state doesn't collect data on reasons for nonmedical exemptions. However, Matthews said: "The overwhelming majority (of parents) do choose to vaccinate."