Outbreaks of infectious disease might be more common this year as Tennessee’s kindergarten vaccination rates have been slipping. Usually, a decline in vaccination rates results from parents opting their children out of receiving them. However, many children are missing their required vaccines, many of whom are unvaccinated without any exemption.

Public health experts have always striven to ensure a 95% vaccination rate among kindergarteners and establish herd immunity for diseases like measles and whooping cough. Tennessee is just below that threshold. The DTaP (diphtheria, tetanus, and pertussis) vaccination rate currently stands at 94.8%, just shy of the 95% needed for herd immunity. Even a small gap like this can be dangerous and lead to unnecessary outbreaks that could have a lasting effect on a community.

The rise in exemptions has played a significant role in this decline. The 2022–23 school year saw more than 2,500 kindergarteners exempt from vaccines, according to the Centers for Disease Control and Prevention (CDC). This number has grown since 2018, when the CDC began tracking exemptions. Pre-pandemic, about 1,500 children were exempt, but the number has climbed each year, which means there is a growing trend of vaccine hesitancy among parents.

This hesitancy stems from various factors, such as misinformation, distrust in healthcare systems, concerns about side effects, and cultural or religious beliefs. Social media has played a key role in amplifying vaccine misinformation, making spreading false claims and intensifying skepticism easier. For parents with vaccine concerns, consulting a healthcare provider is the best way to receive accurate, up-to-date information.

While Tennessee’s exemption rate stands at 3.2%, ranking 27th nationwide, it is still seeing a sharp increase. The state ranks 12th in rising exemptions, with around 650 more children exempt in 2022–23 than in the previous year. States like Idaho, Oregon, and Utah lead with the highest opt-out rates, but Tennessee’s upward trend highlights the broader issue of vaccine hesitancy.

In addition to the rise in exemptions, there is another troubling trend: more children are falling into a grace period where they haven’t received their vaccines but also don’t have exemptions. The CDC has also been tracking these children, and their numbers are increasing. This may be a lingering effect of the pandemic when many families delayed routine healthcare, including vaccines, due to fear of contracting COVID-19. Studies have shown that during the pandemic, people also delayed other critical health screenings, such as for cancer and sexually transmitted infections.

As Tennessee’s vaccine rates continue to fall, the risk of outbreaks of preventable diseases like measles and whooping cough increases. Tennessee has already recorded its first measles case in five years, highlighting the need to reach the 95% threshold to help prevent further spread. Measles can easily spread among children and lead to severe complications, including pneumonia, encephalitis, and even death. The return of this disease, once nearly eradicated in the U.S., highlights the importance of vaccination. If Tennessee continues this downward trend, more diseases like this could start appearing and have a ripple effect in the community. As the colder months start, it’s critical to receive all the required vaccines to help prevent sickness from spreading as we spend more time indoors.

Sources:

CDC: Coverage with Selected Vaccines and Exemption from School Vaccine Requirements Among Children in Kindergarten — United States, 2022–23 School Year

CDC: Reported STDs Reach All-time High for 6th Consecutive Year

Jama Network: Cancer Screening Disparities Before and After the COVID-19 Pandemic

Recent flooding from Hurricane Helena has devastated Tennessee communities, and as recovery begins, many face significant challenges beyond just displaced families, damaged property, and disrupted services. One danger many people may not consider in these types of disasters is the increased risk of infectious diseases. Floodwaters cause physical damage and carry harmful bacteria, chemicals, and waste that threaten public health. It might seem unexpected, but getting vaccinated after a flood is important to protect yourself and others from worsening situations.

How Bad Can Floodwater Be?

The water doesn’t look nice, and there’s a reason. Floods create the perfect environment for certain diseases to thrive. These waters often contain bacteria, viruses, and chemicals mixed with damaged sewage systems and exposed debris from buildings and farms. This can spread infections like E. coli, hepatitis A, and leptospirosis, while stagnant water creates breeding grounds for mosquitoes carrying diseases such as West Nile virus. Exposure to floodwater can also lead to skin infections from minor injuries, and once the water recedes, mold growth in water-damaged buildings poses respiratory risks. In these conditions, even small cuts or scrapes can become dangerous if they come into contact with bacteria from floodwaters.

While some of these infections can’t be prevented with a vaccine, there are two that can:

Tetanus

Tetanus is a serious infection caused by bacteria commonly found in soil, dust, and animal waste. During floods, people may come into contact with many bacteria absorbed in the flood water and become infected through sharp debris or contaminated water. If the bacteria enter the body through a wound, it can cause severe muscle stiffness and spasms, which can be life-threatening if not treated immediately.

Tetanus can easily be prevented with a vaccine. The Centers for Disease Control and Prevention recommends that anyone exposed to floodwaters or debris check whether they’ve received a tetanus booster shot within the last ten years. If not, getting this booster can help protect yourself during cleanup efforts.

Hepatitis A

Another risk during flood recovery is hepatitis A, a virus that affects the liver. It can spread through contaminated food or water, which are common concerns after a flood, especially if local sewage systems have been destroyed. In areas where floodwaters have mixed with sewage, there’s an increased risk of the virus spreading through drinking water or poorly sanitized conditions.

Vaccination for hepatitis A is especially important for people living in or near affected areas, as well as for emergency workers and volunteers helping with recovery efforts.

Cleaning Up After Floodwater

To those who are volunteering their time or have been directly impacted by the floods, there are ways to minimize the risk to your health:

● Wash exposed areas: Use soap and clean water immediately. If you don’t have access to soap or water, use alcohol-based wipes or sanitizer.

● Care for wounds: Clean wounds thoroughly and seek medical attention, especially if the wound is deep.

● Wash contaminated clothes: Any clothing that comes into contact with flood or sewage water should be washed with hot water and detergent before wearing it again.

● Wear protective gear: If you are entering floodwater, always wear rubber boots, rubber gloves, and goggles to protect yourself from contaminants.

Protecting Public Health During Recovery

In the aftermath of a natural disaster, public health resources are usually stretched. Additional strain can make the system worse if more individuals start showing up with preventable diseases. This is why health officials stress the importance of prioritizing vaccines. By getting immunized, you can help reduce the risk of a secondary public health crisis and ensure a faster, safer recovery for everyone.

As recovery efforts in Tennessee continue, it’s essential not to overlook the importance of vaccinations. Floodwaters may recede, but the health risks will linger for months. By staying informed and up-to-date with recommended vaccines, you can protect yourself and help prevent the spread of diseases in the aftermath of this natural disaster.

Sources

CDC: Floods and Your Safety

CDC: Safety Guidelines: Floodwaters