Question: Regarding the emergency rule suspending the religious exemption for the MMR vaccine for 120 days to prevent a measles outbreak in Hawaii, where can we read the full emergency rule? Will K-12 students with religious exemptions who don’t get the MMR vaccine be kept out of school? If yes, starting when? How will the Department of Health be able to enforce this emergency rule at schools where immunization records are not up to date? According to the list posted on the DOH website, some schools lack immunization records on more than 60% of their students.
Answer: We’ve received a flurry of follow-up questions since the state Department of Health sent a letter home to parents of K-12 students in public, private or charter schools April 2, urging vaccination against measles. The letter (808ne.ws/3Gb4sdb) stressed that Hawaii needs to increase its vaccination rate to ensure “herd immunity” from the highly contagious disease and described a 120-day emergency rule that allows kids with religious exemptions to get the measles vaccine without losing their exemption for other vaccines. Here’s the DOH’s response to these questions:
“The full emergency rule should be posted (by Wednesday). It will be posted on DOH’s page of rules: Office of Planning Policy and Program Development | Administrative Rules (at 808ne.ws/4lvxFj2).
“The goal of the emergency rule is to remove barriers to obtaining MMR vaccination for students with a religious exemption by allowing students currently with a religious exemption the opportunity to obtain MMR vaccination without losing their existing religious exemption for other vaccinations. Previously students with a religious exemption could lose the exemption if they decided to receive a vaccination, such as MMR (measles, mumps and rubella).
“Children with no MMR vaccination will be kept out of school based on HAR 11-157, ‘If at any time, the director determines that there is the danger or presence of an outbreak or epidemic from any of the communicable diseases for which immunization is required under this chapter, the exemption from immunization against such disease shall not be recognized, and inadequately immunized students or children shall be excluded from school, postsecondary school, or child care facilities until the director has determined that the presence or danger of the outbreak or epidemic no longer exists.’
“In the past, students with religious exemption and no MMR vaccine have been excluded from school when they were exposed to a confirmed case, i.e. in the same classroom. If there is a measles exposure at a school, such as a student with a measles infection, we will work with the school to check vaccine records for exposed students (and staff). … Anyone without evidence of immunity to measles, such as students with religious exemption who did not receive the MMR vaccination, will be excluded from school until they are past the window where they could have contracted measles.”
As for immunization record-keeping at Hawaii schools, compliance does vary widely. Statewide the percentage of enrolled students whose immunization records were not up to date was about 21% during the 2023-2024 school year, but the percentage was far higher at some individual schools, including at about 20 where it exceeded 60%, according to the list posted on the DOH website, at 808ne.ws/4jF5koV. The category “Total Not Up to Date” includes the percentage of enrolled students who have either religious exemptions, medical exemptions, have no immunization record on file or are missing immunizations.
Write to Kokua Line at Honolulu Star-Advertiser, 500 Ala Moana Blvd., Suite 2-200, Honolulu, HI 96813; call 808-529-4773; or email kokualine@staradvertiser.com.
