Children enrolling without vaccines

COLUMBUS, Ohio — States are heatedly debating whether to make it more difficult for students to avoid vaccinations for religious or philosophical reasons amid the worst measles outbreak in decades, but schoolchildren using such waivers are outnumbered in many states by those who give no excuse at all for lacking their shots.

A majority of unvaccinated or undervaccinated kindergartners in at least 10 states were allowed to enroll provisionally for the last school year, without any formal exemption, according to data reported to the Centers for Disease Control and Prevention. Only 27 states submitted information about the group, so the true size of the problem is unknown.

Poor access to health care keeps some of those children from getting inoculated against some of the most preventable contagious diseases, but for others the reasons are more mundane.

Experts say it’s likely that many or even most of those children ultimately get all their vaccinations, as state laws require, but no one knows for sure. It’s neither tracked nor required to be.

That leaves officials with a maddening lack of information as vaccination rates inch downward and diseases like measles, once declared eradicated, reemerge.

All 50 states allow students to receive exemptions from vaccinations for medical reasons. But formal vaccine exemptions for religious or philosophical reasons have recently come under fire as the CDC has confirmed 880 measles cases in 24 states since January, the greatest number since 1994.