According to new data from the State Department of Health (DOH). the number of Hawaiʻi students not up to date with immunizations is increasing.

A total of 39,583 or 21% of students from public, charter and private schools were not up to date on their school-required immunizations for the 2023-24 school year. The data show a 25% increase from the 2022-23 school year. This number includes those claiming exemptions, those without immunization records, or students missing individually required vaccines.

The majority of this increase in missing school-required immunizations is from 7th grade school requirements that were implemented in 2020 during COVID. For the 2023-2024 school year, 16% of kindergarteners were not up to date with school-required vaccinations compared to 55% of seventh graders.

Of the 382 schools reporting for the 2023-24 year, 282 schools (74%) reported more than 5% of their student populations were not up to date with Hawaiʻi’s school immunization requirements. Unfortunately, 36 schools (almost 10%) reported having more than 50% of their student body not up to date.

For Hawaiʻi public schools, the Hawaiʻi Department of Education (DOE) reported that 36,026 students were missing one or more required immunizations for the 2023-24 school year.

Preliminary data for the 2024-25 school year shows 28,300 students missing one or more vaccinations, the DOE said. Schools have until Jan. 10, 2025, to report to DOH on the number of students not up-to-date on immunizations.

Hawaiʻi has two forms of vaccination exemptions for schools, medical and religious. DOH data indicates a religious exemption rate of 4.1% for the 2023-24 school year when averaged across the entire state. This is an upward trend compared to prior years starting in 2019-20 at 2.1%. Medical exemptions have increased from 0.07% in 2019-20 to 0.16% in 2023-24 but continue to remain low overall.

CDC has also confirmed a similar upward trend in Hawaiʻi’s religious exemption rate over the last few years through a separate analysis. (Vaccination Coverage and Exemptions among Kindergartners | SchoolVaxView | CDC).

Nationwide, including Hawaiʻi, there has been a concerning increase in vaccine hesitancy since the COVID-19 pandemic. The volume of misinformation about vaccines continues to grow and has contributed to this trend. Also, a continuing challenge with missing vaccinations is difficulty in accessing healthcare, particularly in rural areas.

DOH is working closely with educational partners and healthcare providers to address ongoing challenges that may be contributing to this trend. This work includes educating families that vaccination is the best defense against certain life-threatening diseases; working with pharmacies and physician practices to increase access; and making it easier to collect, analyze and report accurate data on student immunizations by modernizing the Hawaiʻi Immunization Registry.