Severe Chickenpox Outbreak Hits School Where Many Parents Refuse Vaccines

A significant number of parents at North Carolina's Asheville Waldorf School have expressed religious objections to vaccines.

A private school in North Carolina has reportedly been hit by the state’s worst chickenpox outbreak in over two decades.

Buncombe County’s health department suggested that parents claiming religious exemptions to the state’s vaccination requirements have contributed to the outbreak at the Asheville Waldorf School, CNN reports.

As of Friday, officials documented at least 36 chickenpox cases at the school, according to the Asheville Citizen-Times.

State data indicate that many parents at the school have claimed religious objections to North Carolina’s vaccination requirements. The school has one of the highest recorded rates of religious exemptions to vaccines in the state.

The school is asking kids diagnosed with the disease to stay at home. Since it can take 21 days for children exposed to chickenpox to show symptoms, classmates of contagious students are also being asked to stay home too, CNN reports.

Children who have gotten at least one dose of the chickenpox vaccine will be allowed to return, according to Dr. Jennifer Mullendore, the Buncombe County medical director. Kids whose parents can provide proof of immunity through bloodwork or a doctor’s statement will also be allowed to go back to school, she said.

“The vaccine for chickenpox and all vaccines out there are safe and effective,” she told CNN.

North Carolina law requires every child in the state to be immunized against certain diseases. Children are required to get two doses of the vaccine for chickenpox before entering kindergarten. But parents can claim religious or medical exemptions to the law. 

For religious exemptions, parents or guardians simply need to write a statement describing their “bona fide” religious objections to the immunization requirements. The statement may be given to schools and day cares in place of an immunization record. The statements don’t need to be notarized, signed by a religious leader, prepared by a lawyer or submitted to the state for review.

The Asheville Waldorf School is part of an international network of schools that use the Waldorf method, a teaching philosophy that focuses on creative learning and individual development. Generally, Waldorf schools are not affiliated with any church and don’t espouse a particular religious doctrine.

But at the Asheville Waldorf School, which serves children from nursery school to sixth grade, a significant number of parents have expressed religious objections to vaccinations. Nearly 68 percent of the school’s kindergarten class claimed religious exemption to immunizations last year, according to data from North Carolina’s Department of Health and Human Services. 

Of the school’s 152 students, 110 have not gotten the chickenpox vaccine, according to the Citizen Times

The school, which is incorporated as the Azalea Mountain School, has not responded to a request for comment. The school said in a statement on its website that it follows the state’s immunizations requirements “strictly.”

“We also recognize that a parent’s decision to immunize their children happens before they enter school,” the statement reads.

Overall, 5.7 percent of kindergartners in Buncombe County claimed religious exemptions to vaccines ― a higher rate than for any other county in the state. 

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A vaccine for the varicella-zoster virus, which causes chickenpox, was introduced in the U.S. in 1995.
Mixmike via Getty Images

Chickenpox is a highly contagious disease that causes a blisterlike rash, itching, tiredness and fever. The virus used to be very common in the U.S., affecting about 4 million people in the early 1990s and causing up to 150 deaths each year. But a vaccine for the disease, which was made available in 1995, has proved very effective in preventing hospitalization and deaths from chickenpox, according to the Centers for Disease Control and Prevention.

The CDC has found that two doses of the vaccine are about 90 percent effective at preventing chickenpox.

Mullendore told the Citizen Times that even though some parents may not think chickenpox is a serious disease, the outbreak at Asheville Waldorf should be taken seriously. Two to three out of every 1,000 children infected with the virus require hospitalization, 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,” she told the paper.

Mullendore told CNN that no complications or hospitalizations have been reported from the outbreak at the Asheville Waldorf School. 

Majorities of all American religious groups agree that vaccines should be required for schoolchildren, according to a 2016 Pew Research Center study that asked participants about the common childhood vaccine for measles, mumps and rubella. But some religious groups ― particularly white evangelical Protestants and the religiously unaffiliated ― expressed a little less support for requiring the MMR vaccine than others.

Susan Sullivan, a nurse who serves as a consultant to the state’s health departments on vaccine-preventable diseases, told the Citizen Times that pockets of unvaccinated people often serve as “reservoirs for disease.”

While chickenpox isn’t life-threatening in most cases, the CDC says it can still be dangerous to infants, pregnant women and others with compromised immune systems. 

That’s why Sullivan said getting vaccinated helps protect the larger community. 

“It’s not just about you,” she 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.”

Before You Go

12 Vaccines For Your Child
Hepatitis B(01 of12)
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Your newborn should get this shot even before leaving the hospital, and receive another dose at one to two months and a third at six to 18 months. The vaccine protects against an incurable, liver-infecting virus, hepatitis B, which can be passed to a baby during childbirth if the mother is infected. This virus spreads through contact with blood or other body fluids (sharing toothbrushes and utensils can put you at risk). Soreness at the site of the shot, or a slight fever, is the most common side effect, according to Gabrielle Gold-Von Simson, M.D., associate professor of pediatrics at NYU Langone Medical Center in New York.
DTaP(02 of12)
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The DTaP vaccine protects against diphtheria (a germ that can form a gray or black film in the throat), tetanus (an infection that can cause muscle spasms so strong they can break bones), and pertussis (a highly contagious disease that causes a severe, uncontrollable cough, known as whooping cough). Five vaccine doses are given to children at two months, four months, six months, 15 to 18 months and four to six years. (And boosters at age 11 or 12 and then every 10 years.) DTaP may be combined with other vaccinations to reduce the number of shots needed. "Now, it's DTaP with hepatitis B and the polio vaccine. So, it's five in one," Dr. Gold-Von Simson says.
MMR(03 of12)
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This combo shot protects against three viruses: measles (which causes high fever and a body-wide rash); mumps (which causes face pain, swelling of the salivary glands, and sometimes scrotal swelling in boys); and rubella or German measles (which can cause birth defects if the infection occurs during pregnancy). The first shot is given at 12 to 15 months of age and once again between the ages of four and six. MMR is sometimes combined with the chickenpox vaccine into one shot (brand name ProQuad). "All these different preparations are designed to reduce the amount of shots the pediatrician has to give," says Dr. Gold-Von Simson.
Chickenpox(04 of12)
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Chickenpox, a highly contagious rash that many people remember from childhood, is caused by the varicella virus. A varicella vaccine was first licensed in 1995 and now spares future generations this itchy misery.Chickenpox infections can be especially dangerous in adults who don't have immunity from the vaccine or haven't had it in childhood, and can also lead to shingles, an extremely painful blistering rash.The shot is given to children at 12 to 15 months and again between four and six years. The vaccine can cause soreness at the site of the shot, fever, and, in some cases, a mild rash.
Haemophilus Influenza Type B (Hib)(05 of12)
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"Haemophilus influenza type b is the bacterium that causes meningitis," says Dr. Gold-Von Simson. Meningitis, an inflammation of the membranes surrounding the brain and spinal cord, is particularly dangerous for kids under the age of five. Hib vaccines are generally given at two, four, six, and 12 to 15 months of age. Depending on the vaccine used, the six-month shot may not be needed. Fever, swelling, and redness at the site of the shot are potential side effects. (credit:Getty )
Polio (IPV)(06 of12)
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Polio vaccine is "such a success," says Dr. Gold-Von Simson. "Because of the vaccine, there are no more cases [of polio]." There are no more in the United States that is. The virus hasn't been eradicated worldwide, so kids still get the IPV, or inactivated polio vaccine, which is a shot containing killed virus. Polio is bad news, and can cause paralysis and even death. Children are given the IPV at two months, four months, between six to 18 months, and then again between the ages of four and six years. (credit:Getty)
Pneumococcal Conjugate (PCV)(07 of12)
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This vaccine, known as PCV13 (brand name Prevnar), protects against 13 types of Streptococcus pneumoniae, which are bacteria that can cause all sorts of mayhem, including meningitis, pneumonia, ear infections, blood infections, and even death.A total of four shots are given to kids (at two, four, six, and 12 to 15 months of age) to protect them against the germs, known collectively as pneumococcal bacteria.The most common side effects of the vaccine include drowsiness, swelling at the site of the shot, mild fever, and irritability.
Influenza (flu)(08 of12)
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Flu vaccinations are given each year starting in the fall. The Centers for Disease Control and Prevention recommends them for kids ages six months or older, although they aren't required for school attendance. (Connecticut and New Jersey require the vaccine for attending child-care centers and preschool.) Common side effects from the vaccine include soreness, redness, or swelling at the site of the shot. Fever and aches may occur too. "If you have an egg allergy, you shouldn't have the influenza vaccine," says Dr. Gold-Von Simson. (credit:Getty)
Rotavirus (RV)(09 of12)
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The rotavirus vaccine (RV) (brand names RotaTeq, Rotarix) is given to children at two and four months of age. (RotaTeq is also given at six months.) The vaccine protects against a virus that is the most common cause of severe diarrhea and vomiting in young kids worldwide. About 55,000 children in the U.S. were hospitalized each year due to rotavirus before the vaccine was licensed in 2006.It is not required for school attendance.The vaccine is in liquid form and given by mouth to babies. It may make them a bit more irritable and can also cause mild diarrhea or vomiting.
Hepatitis A(10 of12)
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Kids can catch hepatitis A from sharing food or drinks or by putting contaminated food or objects in their mouths. It's a viral infection that affects the liver, and can cause a number of symptoms, including fever, tiredness, jaundice, and loss of appetite.Children ages 12 through 23 months generally get two doses of the Hep A vaccine, with a minimum interval of six months between shots. Some states require the vaccine for school attendance.Soreness where the shot was given, headache, and loss of appetite are the most common side effects of the vaccine.
Meningococcal Conjugate (MCV4)(11 of12)
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This vaccine, known as MCV4 (brand name Menactra), protects against meningococcal bacteria, which can infect the membranes surrounding the brain and spinal cord. MCV4 is recommended for kids at 11 or 12 years of age, and anyone between ages two and 55 who is at increased risk of infection (people with certain health conditions, military recruits).Teens starting college should be vaccinated with MCV4 before going to school if they didn't previously get the shot. (Freshman living in dorms are at increased risk of infection.)A little pain at the site of the shot is the most common side effect.
Human Papillomavirus (HPV)(12 of12)
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Human papillomavirus (HPV) vaccine (brand names Gardasil, Cervarix) is given in three doses over a six-month period, and is approved for girls between ages nine and 26.While there are over a hundred types of HPV, this vaccine protects against two sexually transmitted types that are the most common causes of cervical cancer. Gardasil also protects against two types that cause genital warts and is approved for boys between nine and 26 as well.The vaccine works only if given before an infection, so doctors recommend it for kids well before they could become sexually active. Although most states don't require HPV vaccination, many are considering mandating it for preteen girls. (credit:Getty)