LAS VEGAS — More than three-quarters of Clark County schools began the academic year with a reported kindergarten vaccination rate of less than 95%, the threshold needed to prevent an outbreak of the highly contagious virus, new data shows.

Five percent, or 16 schools, reported rates below 80%, with one charter school as low as 33%, according to data compiled by the state and obtained by the Las Vegas Review-Journal through a public records request to the Southern Nevada Health District.

Vaccination rates recorded the first day of school have since increased, the Clark County School District said, as more students got their shots or provided proof of vaccination. However, overall rates here and across the U.S. have been declining in recent years, with more parents obtaining exemptions for their children from state laws requiring that they be vaccinated to attend school.

The release of Clark County’s rates come at a time of a major outbreak in Texas with 505 cases, 57 hospitalizations and two deaths in school-age, unvaccinated children with no known underlying health conditions, according to the Texas Health and Human Services Department. With more than 600 measles cases reported in 21 states as of April 3, according to the Centers for Disease Control and Prevention, health authorities are gearing up for the possibility of an outbreak in Nevada, where no cases have been reported this year.

In Clark County, 23% of 311 public, charter and private schools reported in December that at least 95% of their kindergartners were up to date on their shots, while a full two-thirds of schools reported rates of 90% or higher. In Clark County School District schools, those rates were recorded on the first day of school. The health district provided the rates for schools with at least 20 kindergartners.

A vaccination rate of 95% will stop the spread of measles even to those who are unvaccinated, providing so-called “herd immunity,” according to health authorities.

“It’s great that the overall portion of children vaccinated is still pretty high,” said Vanderbilt University’s Dr. William Schaffner about Clark County’s rates. “Any school that is less than 90% is a matter of concern.”

And those below 80%, he said, are “very vulnerable.”

Cassius Lockett, district health officer for the Southern Nevada Health District, described the current situation as “very alarming.”

“We are definitively concerned about this outbreak spreading to neighboring regions including our state,” he said. “We do have pockets of unvaccinated communities that are well below the threshold” of 95%.

‘Any parent has a right to choose’

Nevada law requires that all children attending school be vaccinated against measles and other transmissible diseases, but as in other states, allows exemptions on medical and religious grounds. It also allows a child to enter school conditionally with a certificate from a doctor that the student is receiving the required immunizations, providing 90 school days to submit proof of vaccination.

“Published vaccination rates are recorded on the first day of school and may not accurately reflect current immunization compliance,” according to the Clark County School District’s media relations office. “School immunization rates are continually updated throughout the school year to correspond to the valid information provided by the parent/guardian. Schools follow up with families of students who are non-compliant with their immunizations.”

In an email, the state Division of Public and Behavioral Health said there may be “small discrepancies” in the state’s data based on when rates were recorded.

“School nurses have shared that some students may start school on the first day of classes as new enrollees, bringing their immunization records that day, so they would not yet be entered in school systems and would not be captured on the first day of school,” the division stated in an email.

In the case of at least one school, the discrepancy appears to be more significant.

The reported kindergartner measles vaccination rate at Elizondo Elementary School in North Las Vegas was 47%, the lowest among county public schools. However, the school district stated in an email that the school’s rate is now just under 91%.

School district spokesman Tod Story said the district would compile updated data for those schools with low vaccination rates, but it had not done so by publication time. Some states, such as California, provide school-level vaccination rates online though the data may not be current.

Veronica Chavez, whose kindergartner at Elizondo has had all the required shots, said she’s not concerned that some of her son’s classmates aren’t vaccinated against measles.

“I also think any parent has a right to choose whether they want their kids vaccinated,” she said.

The 16 schools in Clark County that reported rates below 80% in kindergartners include nine public, four charter and three private schools. Discovery Charter School – Sandhill, with the lowest recorded rate of 33%, did not respond to a reporter’s phone messages.

Of the charter and private schools in this category, two returned a reporter’s phone calls, including Nevada Prep Charter School, with a reported rate of 78%.

After reviewing its records, the school called a couple of parents to tell them that their children could not come back to school without documentation of vaccination.

“As a small school, there are 10,000 things to do, but you’re reminding us that this is an important thing, with the measles outbreaks,” said academic director Jeff McAlpine. “We need our kids to be protected. And vaccination is absolutely the best way to do that.”

He said 17 of the school’s 20 kindergartners are fully vaccinated — a rate of 85% — with the remaining three scheduled to get their second shot in May, he said.

A first shot of the MMR vaccine – measles, mumps, rubella – is recommended for toddlers 12 to 15 months old and a second shot at 4 to 6 years old. Shots need to be given 28 days apart.

Data provided by the state Division of Public and Behavioral Health shows that MMR vaccination rates in children ages 5 to 12 have declined over the past decade, dropping in Clark County from 94.5% in 2016 to 92.4% this year. Most of the decrease has taken place since the pandemic, as vaccination skepticism got a stronger foothold.

‘A notoriously severe infection’

Measles is spread through coughing, sneezing and even breathing, with the virus lingering in the air for hours.

Symptoms, which appear one to two weeks after contact with the virus, include a high fever, cough, runny nose, red and watery eyes, and, after a few days, a rash. Measles can cause serious complications, especially in young children, such as pneumonia and encephalitis – swelling of the brain and spinal cord – that can result in death.

Before vaccination for measles began in 1963, 400 to 500 people died each year of the 500,000 reported cases, though actual case numbers were estimated to be as high as 4 million, according to the CDC. About 48,000 people were hospitalized annually, and 1,000 developed encephalitis.

“This was a notoriously severe infection,” said Schaffner, a professor of preventive medicine at Vanderbilt and a national authority on vaccination.

The MMR vaccine is an unusually effective one, with two doses providing lifetime protection at a rate of about 97%. A vaccinated person who does develop measles is likely to have a milder case.

Measles was declared eliminated from the U.S. in 2000, though it has remained common in other parts of the world.

The Texas outbreak began earlier this year in a Mennonite community with low vaccination rates and many children schooled at home outside of school-immunization requirements, according to a report by the Johns Hopkins Bloomberg School of Public Health.

The last outbreak in Clark County was in 2015, when seven cases were reported, said Brian Labus, an assistant professor in UNLV’s School of Public Health.

‘Introduce one sick kid … measles is going to explode’

Vaccination rates have decreased in part due to a growing number of students receiving exemptions, particularly religious exemptions.

In a single year, the number of kindergartners with religious exemptions grew from 5% to 6% in Clark County, according to a data dashboard by the Office of Analytics for the Nevada Department of Health and Human Services. Medical exemptions increased from 0.2% to 0.3% of students.

In Nevada, exemption requests do not require parents or guardians to provide proof of their religious beliefs.

Odyssey Charter Schools, with a vaccination rate of 54%, said the rest of its kindergartners have religious exemptions.

School superintendent Timothy Lorenz said this rate of exemption is in line with charter school trends.

“In terms of looking at what the law says and what our parents’ rights are, we’re just trying to be as respectful as possible to our parents,” he said.

Schaffner said that across the country, “We’ve seen an increase in medical exemptions, valid and invalid. We have seen a substantial increase in personal belief and so-called religious exemptions.”

“So-called,” he said, because some parents use exemptions simply to avoid vaccination, especially as vaccination skepticism has grown since the pandemic.

Too, some private schools may be lenient in checking immunization records.

“Parents send their children to certain schools without complying with the immunization recommendations,” he said. “And this, of course, permits these clustering events to increase.”

The root of outbreaks is typically unvaccinated kids spending time with each other, Labus said.

“If a lot of the kids get together and are unvaccinated, you introduce one sick kid into that, measles is going to explode,” he said. “That’s what they’re seeing in West Texas. That’s what we see when outbreaks occur.”

The health district has systems in place for early detection of measles cases, including formalized communications with local emergency rooms regarding suspected cases, Lockett said.

To schedule a measles vaccination at a Southern Nevada Health District clinic, visit snhd.info/immunizations. The health district provides free or low-cost immunizations for infants in lower-income families through the Vaccines for Children Program. For more information, call 702-759-0850.

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