School with high vaccine exemptions has N.C.'s worst chickenpox outbreak since 1995
ASHEVILLE — A chickenpox outbreak at a private school now ranks as the state's largest since a vaccine for the virus became available more than 20 years ago, health officials say.
As of Friday, 36 students at Asheville Waldorf School had contracted the varicella virus, known to most as chickenpox. The school has one of the highest vaccination religious exemption rates in North Carolina.
The viral infection manifests in an itchy rash in most cases and is not typically life-threatening. But the outbreak at Asheville Waldorf should cause concern, said Dr. Jennifer Mullendore of Buncombe County Department of Health and Human Services.
"People don't think it's a serious disease, and for the majority of people it's not. But it's not that way for everybody," Mullendore said. Two to three out of every 1,000 children infected with chickenpox required care in a hospital, she said.
"To me, that's not a mild disease, and if you're the parent of one of those children, you probably don't think so either," Mullendore said.
That's why health care providers for years have recommended all children medically able, namely those who have healthy immune systems, be vaccinated, she said.
Those recommendations have by and large have gone unheeded by the parents of Asheville Waldorf's 152 students — 110 of whom have not received the chickenpox vaccine, which was made available in the United States in 1995.
Leading the state in vaccination exemption
North Carolina's Department of Health and Human Services tracks the rate of kindergartners whose parents have claimed a religious exemption, allowing them to forego vaccination.
During the 2017-2018 school year, the last for which data were available, Asheville Waldorf had a higher rate of religious exemptions for vaccination than all but two other schools in the state.
Of the 28 kindergartners who enrolled that year, 19 had an exemption to at least one vaccination required by the state for school entry.
The school enrolls students from nursery age through sixth grade, Mullendore said.
The only two North Carolina schools to top Asheville Waldorf's religious exemption rate were private schools in other counties. Both had 100 percent exemption rate — one had only one kindergarten student, the other had two.
"The thing people need to understand is that when you have pockets of unvaccinated people, they serve as reservoirs for disease," said Susan Sullivan, a nurse with the state DHHS who consults with local health departments about vaccines and preventable diseases.
'It's not just about you'
According to the Centers for Disease Control and Prevention, chickenpox is particularly dangerous to infants, pregnant women, and those with compromised immune systems, such as people who are HIV positive or coming out of cancer treatment.
Each year, the chickenpox vaccine prevents more than 3.5 million cases of varicella, 9,000 hospitalizations and 100 deaths, the CDC states on its webpage.
Sullivan and Mullendore, echoing the position of healthcare providers at large, said that vaccination is important for protecting the community at large.
"It's not just about you," Sullivan said. "It's about the people you interact with: Pregnant women, people with AIDS, people finishing chemo. They're a part of our community, too, and we have to do what we can to protect everybody."