Hannah Baleme/MDN Registered nurse Lacey McNichols prepares an immunization at First District Health Unit.

With schools back in session, the State of North Dakota has been seeing a slight increase in the number of immunization exemptions being filled out.

According to North Dakota Health and Human Services, at the kindergarten level during the 2019-2020 school year, measles, mumps and rubella vaccine rates were 94.75%. This number dropped to 91.83% during the last school year. Meanwhile, the exemption rates have grown.

Personal belief exemption rates were 2.86% in 2019-2020 and shot up to 3.16% in 2022.

Religious exemptions went from 0.74% to 1.65% during the same time frame.

Molly Howell, the state director of Immunization, said there are students attending school in North Dakota who have not claimed an exemption and are not up to date.

Howell concludes the reasons to be “lack of knowledge of immunization status, lack of access to healthcare, and getting behind during the pandemic, which was the prevalent trend across much preventive care.”

First District Health Unit Communications Director Lori Brierley said if a Minot Public School student’s immunizations are not up to date by Oct. 1 and the student is not working on it or does not have an exemption on file, they will not be able to attend until one of those things happens.

“It’s in the Century Code. Not all districts follow it closely, but I can only speak of Minot Public Schools, and we do follow it closely,” Brierley said.

According to the National Conference of State Legislatures, North Dakota is one of the few states with relaxed school immunization requirements. The only requisite is a parent signature.

It is also one of only 15 states that allow personal belief exemptions.

Other states require medical or religious exemptions and a healthcare provider or notary signature.

Dr. Diana Peterson, a pediatrician at Trinity Health, said the clinic is not seeing a decrease in immunization rates.

“Our numbers do not reflect a lot of the rest of North Dakota. COVID caused an enormous decrease, but we got things caught up. We are close to where we are supposed to be,” Peterson said.

However, overall, there are more people who aren’t immunized in North Dakota, and it’s hard to pin down exactly why, she said. Peterson believes some of it is fear, but also added, “I think a lot of it is related to homeschooling. People say, ‘My kids are not out in public, so they do not need them.'”

Trinity Health advocates for immunizations. As a group, Trinity pediatricians decline to take patients who are not immunized.

“But I disagree with that. We should see them so they can get diagnosed sooner. The things we immunize for are still out there, such as polio and meningitis. People are comfortable because they don’t see the diseases often. As a pediatrician, I have not seen a lot of them, but we still get outbreaks of pertussis and measles; they are devastating illnesses,” Peterson said.