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Amid the debate over school vaccines, a look at opt-out rates in two Minnesota counties

By Mike Kaszuba

The school year is more than half over at Menahga Elementary School in north central Minnesota.

On the surface, things seem normal.  The school celebrated “I Love to Read Month” in February, a month-long series of reading challenges and book fairs aimed at “fostering a love of books.”  The adaptive music class was invited to perform a concert in the Twin Cities.  The second and third graders worked on personal fitness goals as part of a Jump Rope for Heart campaign.

But one topic has received very little public discussion:  Kindergarten students in Wadena County have the highest rates of non-medical exemptions for vaccines in Minnesota.  Put simply, large numbers of parents are deciding not to have their children vaccinated for polio and other preventable diseases – a move that comes as the debate over vaccines has exploded nationwide.

In Wadena County, 20.3 percent of kindergarten students last year used non-medical exemptions to avoid the DTaP vaccine, a guard against diphtheria, tetanus and pertussis.  Statewide, the figure was 4.8 percent.

Public Record Media (PRM), a non-profit based in Saint Paul, used public data requests and interviews with officials at the Minnesota Department of Health and in Wadena County and Pine County to examine why the two counties have the highest percentage of non-medical exemptions in Minnesota for kindergartners.

Though the percentage in the two counties is unusually high, they mirror a gradual drop in school-age vaccines that has taken place across the state, according to Minnesota Department of Health (MDH) statistics.  “We continue to see rates for fully vaccinated children decline,” Danielle Ryan, a MDH spokesperson, wrote in an email to PRM.

Jason Kjos, the superintendent of the Menahga public school district in Wadena County, said the signs of vaccine skepticism in his schools are not hard to find.  During the 2023-2024 school year, 45.7 percent of kindergarten students at Menahga Elementary filed for a non-medical exemption in order to skip the DTaP vaccine.

Forty-four percent of kindergarteners at the school filed for non-medical exemptions for the polio vaccine, according to state health department data.

 

The non-medical exemptions “just come flying in”

“I was caught off guard a little bit with the number of people that called me [and] wanted to know, my first year, where to find, basically, the exemption” form,” said Kjos, who became the district’s superintendent in July 2022, after the peak of the COVID pandemic.

”It’s amazing.  I mean, literally, we had a lot – and when I say ‘a lot’, [it’s] a lot, a lot.  [When] they sign up for kindergarten, those [non-medical exemption] sheets just come flying in,” Kjos, who said he enjoys working with the parents and students in the district, told PRM.

 “I think it’s just their beliefs,” he added.

Louis Rutten, the principal at Wadena-Deer Creek, another elementary school in Wadena County, had his own thoughts.  “I would speculate it is because our rural area has the ‘Don't Tread On Me’ line of thinking when it comes to the government telling them what to do,” he said in an email to PRM.

“[These are conservative talk radio] fans and such out here who don't necessarily trust ‘big government’,” he added.

Kenneth Kjeldergaard, the pastor of Christian education at Verndale Area Christian Academy in Wadena County, was more blunt.

“This isn't really a big deal for us,” Kjeldergaard wrote in an email to PRM, referring to the declining immunization rates.  “I think mainly because we don't make it a big deal.

“It's a parent's right to refuse immunizations, and it is a growing trend due to mainly the [COVID] pandemic, as well as more and more research pointing to the effects of unnecessary immunizations on children,” he wrote.

 

Trump, Robert F. Kennedy Jr. and vaccine skepticism

The immunizations rates in Wadena and Pine County come as the debate over school immunizations has reached a boil nationwide, especially with the confirmation of Robert Kennedy Jr. as President Trump’s new U.S. Health and Human Services Secretary.  Kennedy, an anti-vaccine activist nominated by President Trump, was heatedly questioned during a recent U.S. Senate hearing on his past statements regarding his skepticism over the effectiveness of vaccines and his previous statements that vaccines were known to cause autism.

In his first address to employees at the U.S. Department Health and Human Services (DHS) in mid-February, Kennedy said that one of his priorities would be to scrutinize childhood vaccine schedules and added that “nothing is going to be off limits.”

The Kennedy hearings have been but one example of the growing distrust of vaccines in America, especially among supporters of President Trump, who took office again in January.

In Idaho, a regional health board voted last October to prohibit the district’s four public health clinics from distributing the COVID-19 vaccine – three years after the vaccine first became widely available.  An official with the National Association of County and City Health Officials said it marked the first time that access to a vaccine had been curtailed because a local health board deemed it unsafe despite federal assurances.

More recently, the top health official in Louisiana told the state health department that it would no longer use media campaigns and health fairs to promote vaccines against preventable illnesses.  The official, Dr. Ralph Abraham, said patients would be encouraged by state health officials to discuss the risks and benefits with their doctors, but the state would “no longer promote mass vaccination.”

In Texas, more than 100 cases of measles – which was once declared to be eliminated in the U.S. -- have been reported since late January.  One child has since died.  Of the cases, five were patients who had been vaccinated.  The others were patients who were not vaccinated or those whose vaccination status was unknown.

Meanwhile, President Trump-- just weeks after being inaugurated – issued an order banning federal funds from going to schools and universities that require students to be vaccinated against COVID.  It was unclear how much of an impact the order will have – no states currently require K-12 students to be vaccinated against COVID.

With Trump now in the White House, the changing attitudes – and sometimes, confusion -- regarding vaccines are producing almost daily headlines.

On Feb. 18 – the same day Kennedy gave his inaugural speech to DHS employees – the Washington Post reported that the Trump administration was considering whether to shut down the program that has provided millions of free COVID-19 tests to the public.  While public health experts said there was now no urgent need for the free tests, given the low levels of COVID-19, others have urged keeping the tests on hand in case of another large outbreak.

But later that same day, the Post reported, the Trump administration was backing away from the proposal.

In Wadena County, Trump has remained a popular figure.

Trump won nearly 75 percent of the vote in the county in the November 2024 presidential election, compared to 23.6 percent for Kamala Harris, the Democratic presidential nominee.  In 2020 – when President Biden won the presidency – Trump won nearly 72 percent of the vote in Wadena County.

The voting results were similar in Pine County.

Trump won nearly 67 percent of the vote in the county in the 2024 presidential election.  Four years earlier – as President Biden won the presidency – Trump won more than 64 percent of the vote in Pine County.

In Minnesota, state health officials have continued to urge parents to have their school-age children vaccinated.

According to a recent MDH flyer, titled “Are Your Kids Ready?”, state health officials urged parents to “look for your child’s grade in the chart below and see how many total doses of each vaccine are needed for their grade.”  The chart, for example, showed that five doses of the DTaP vaccine are required for students in kindergarten through the sixth grade.

But the flyer also included a non-medical exemption form – the same form that Kjos indicated came “flying in” to his office from parents in the Menahga school district.

The form, which parents must have legally notarized, said that “a child is not required to have an immunization that is against their parent or guardian’s beliefs.  Choosing not to vaccine may put the health of your child or others they are around at risk.

“Unvaccinated children who are exposed to a vaccine preventable disease may be required to stay home from school and other activities for up to 21 days to protect themselves and others,” the form added.

When signing the form, however, parents and guardians do not have to explain why they want a non-medical exemption.

 

In Minnesota, higher rates of non-medical exemptions

The vaccination data in Minnesota meanwhile shows a continuing trend toward non-medical exemptions.

In 2014-2015, the percentage of kindergarten students in Minnesota obtaining non-medical exemptions for the MMR vaccine, which treats against measles, mumps and rubella, was 2.64 percent.  In 2018-2019, the percentage grew to 3.42 percent.  According to state health records, the percentage was 5.2 percent in 2023-2024.

In Wadena County, which lies northwest of Brainerd, MN, the percentage in 2023-2024 was 21.5 percent – the highest of any county in Minnesota.

In Pine County, another rural county which is north of Minneapolis and straddles Interstate 35W, the percentage in 2023-2024 was 12.8 percent – the second-highest rate of any county in Minnesota.

The move toward non-medical exemptions is also not just confined to rural Minnesota – and is particularly notable at private schools in the Twin Cities region surrounding Minneapolis and St. Paul.

At Mary Queen of Peace Catholic School in the Elk River school district, located in a suburb northwest of Minneapolis, state health statistics showed that 35.7 percent of kindergarten students filed a non-medical exemption for the DTaP vaccine during 2023-2024.  At Christian Heritage Academy, part of the Lakeville school district in suburban Minneapolis, the data showed that 21.9 percent of kindergarten students filed for non-medical exemptions for the hepatitis B vaccine during the same year.

The lower rates are not confined to private schools in the Twin Cities area.  At Pine Bend Elementary in the Inver Grove Heights school district, 13.4 percent of kindergarten students filed for non-medical exemptions for the polio vaccine in 2023-2024.  At Delano Elementary in suburban Wright County, 13 percent of kindergarten students filed a non-medical exemption for the polio vaccine during the same year.

Even within the same community – such as the Chaska school district, located in still another Minneapolis suburb-- the immunization rates can vary widely.

At Chapel Hill Academy, a private Christian school, 40 percent of the 60 kindergarten students filed non-medical exemptions for the varicella vaccine in 2023-2024.  At Carver Elementary, a nearby public school, just 3.5 percent of the 115 kindergarten students filed non-medical exemptions for the varicella vaccine.

In Wadena County and Pine County, some health officials have stepped gingerly around the subject of vaccines.

 

“An issue long before” COVID

“The low immunization rates in our county have been an issue long before [COVID],” Jill Davis, who leads the vaccine program at Wadena County Public Health, wrote in an email to PRM in early February.

“Some of the school districts within our county [one in particular], have many families that choose not to vaccinate,” she wrote.  “If you want more detailed information for reasons why, I think it would be best to contact those schools.”

Davis later confirmed that she was referring to the Menahga School District.

At Menahga Elementary, nearly 49 percent of kindergarten students filed a non-medical exemption in 2023-2024 for the MMR vaccine.  Nearly 56 percent filed non-medical exemptions during the same year for the varicella vaccine.

The school had 70 kindergarten students at the time, according to state health statistics.

Some Menahga school officials did not respond to questions from PRM about their kindergarten immunization rates.  The officials included school board chair Andrea Haverinen and Sara Makela, a school board member who chairs the wellness committee.

There were other indications that the lower immunization rates are not producing much official reaction.

PRM in December 2024 asked for all correspondence involving county health officials in Pine County related to kindergarten immunization rates and concerns.  PRM also asked for correspondence from any outside persons, including medical personnel and parents, regarding kindergarten immunization rates.

PRM’s data request covered four years, ending in December 2024.

The county produced one email.  “It’s one email,” Rebecca Foss, the director of Pine County Health and Human Services, wrote to PRM.

The email contained notes compiled by state health officials following a monthly webinar in March 2024 that included an update on vaccination rates statewide – the notes contained no specific mention of Pine County.

Similarly, MDH officials produced little correspondence with Wadena County and Pine County related to immunization rates during the same four-year time period.

State officials produced 19 pages of immunization data, though six of the pages were blacked out with redactions for immunization statistics for a local home school.

The data included an email from Davis, of Wadena County Public Health, asking in November 2024 for an extension to the deadline for reporting vaccination information.  “I am still working on getting compliance at my school I work with (constant struggle), do all of the heath plans for students in the fall, work part-time and run the vaccine program/flu season at my public health agency,” she said.

Today, in Wadena County, local health officials said many parents seem to have made up their minds on vaccines.

“I would say 90% of our exemptions are because they choose to not vaccinate their children,” Nicole Johnson, a health services official at Sebeka Elementary School in Wadena County, wrote in an email to PRM.

Abbie Schultz, the school nurse at Wadena-Deer Creek public schools, said the reality is what it is.  “We send out letters to families (saying) which vaccinations their students need,” Schultz wrote in an email.  “Whether they chose to get them or not is on the parents.  I feel like we fulfill the needs by getting the information out.”

 

(Supporting documents for this article can be accessed by contacting Public Record Media at admin@publicrecordmedia.org , or at 651-556-1381)

 


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