DOH: exemptions, outbreaks linked

LIHUE — Take a look at the Hawaii mumps outbreak of 2017.

That’s where state Department of Health Kauai District Health Officer Dr. Janet Berreman points when looking for results of Kauai’s reportedly high numbers of unvaccinated children as a reflection of the numbers in real life.

That outbreak lasted through 2017, and was declared over in the early months of 2018.

“When we looked at the data just for Kauai, the average age of people getting mumps on Kauai was significantly lower than the statewide average,” Berreman said Friday. “The pattern we saw here is consistent with the data we’re seeing from the schools about exemption rates.”

Throughout the rest of the state, data shows it was mostly late teens and young adults being diagnosed with mumps.

On Kauai, reports of mumps cases were mostly from elementary-school-aged kids.

“That says the disease has gotten into unvaccinated populations and is spreading quickly in unvaccinated populations, which are likely to be younger school-aged people,” Berreman said.

All that goes to show that disease spreads more easily when there are pockets of a population with a high rate of unvaccinated people, health officials say.

There are exemptions allowed to state Department of Education vaccination requirements for religious and medical reasons.

The DOH reports for DOE immunization exemptions for Kauai in the 2018-19 school year, last updated March 21, show some schools having as much as a 40 percent religious exemption rate for vaccinations.

Reporting that percentage is Alaka‘i O Kaua‘i Charter School, which has the highest percentage of students with exemptions on the island. The DOE reports Alaka‘i O Kaua‘i has 130 students, nearly half with exemptions.

Hanalei School reports 29 percent of its 252 students are religiously exempt. Kilauea School reports 33 percent of 312 students exempt, Kanuikapono Public Charter School reports 32.9 percent of its 207 students exempt, and Kauai Christian Academy with 21.9 percent exempt of its 73 students.

Medical exemptions are more rare, with only three schools on Kauai reporting a slight percentage, in the 0.3 percent range, in their student bodies.

Reporting no exemptions — religious or medical — are Kauai High School, Kahili Adventist School, Kekaha School, Ke Kula Niihau O Kekaha Learning Center, Kula Aupuni Niihau A Kaheleleiani Aloha PCS, and St. Theresa School.

Statewide, DOE officials say they’re on board with the goal “to protect Hawaii’s population from vaccine-preventable diseases.”

“This is especially true for susceptible groups like our children, and immunization is a proven means of stopping outbreaks before they happen,” said the state DOE Assistant Superintendent Heidi Armstrong.

Berreman says she’s an advocate for vaccinations and believes they save lives. She also points out she’s a pediatrician and a mother, and understands that “mamma bear” needs to protect her child.

With that, she acknowledges the charged conversation that surrounds vaccinations, and that there are concerns in the community about immunizations and vaccines.

“I think that passion comes from the extent to which people care about their children,” she said.

There are impassioned and entrenched perspectives on both sides of the argument, and the only way forward is to engage in respectful conversation.

“It comes down to trusting the experts in this field that not all of us have expertise in,” Berreman said. “I think, because Kauai is a place where we care about each other as a community, we can come together and at least have respectful conversation.”


Jessica Else, staff writer, can be reached at 245-0452 or

  1. Steve March 30, 2019 4:48 pm Reply

    Had no idea the exemption rates were so dangerously high. I wonder how many of those 30-40% attend church or are otherwise actively religious? Or are they just taking advantage of the exemption and putting the rest of us at risk? Yes it’s hard to quantify religious conviction but I wonder how many would stick to those convictions if they were required to live in UNvaccinated, like-minded communities—or maybe they prefer to enjoy the moderated immunity others provide them, while letting their own kids skip the shots—obviously a diminishingly effective (and unfair) strategy. Since you can’t argue the science, the only possible argument (besides medical) is religious. There is no moral argument, other than the one that compels you to do the right thing by your community.

  2. Art Bradbury March 31, 2019 1:21 pm Reply

    DOH must protect the community. This “no immunization for my children” has to do with ignorance and nothing to do with religion. If they feel so strongly about it then home schooling is the answer. Many other states have taken the position of “no immunization, no public school”. Given Hawaii’s susceptibility to infected visitors, the DOH has a responsibility to require all teachers and students have current vaccines so our community is protected.

  3. Charlie Chinknee March 31, 2019 9:08 pm Reply

    Aloha Kakou,

    Don’t listen to this phoney baloney medical scare tactics designed to sell drugs and inject manufactured laboratory toxins into kids. These chemical people should be arrested and made to learn the immune system.

    Thank God all the unvaccinated kids who contracted the mumps now have life time immunity after a mild bout with one of the 3 most common childhood illnesses…measles and chicken pox being the others that also rewards kids with lifetime immunity after naturally getting the virus.

    A few generations ago, these childhood illnesses were cause for “contagion parties” put together by the loving Mothers knowing a safe lifetime immunity was only a few weeks away and they’d never have to worry again about their offspring having to suffer adult mumps, or measles or chicken pox.

    Kids made to get the vaccine now have only 20 years of immunity and when they get the disease when they are older it is a horrible painful long lasting, if not permanent disease, with a horrible disfiguring of the face with a gross fat jaw hanging off one or both side of the face…this we have seen.

    Some scientist say the mumps, swelling of one or more of the 6 salivary glands located on the side and rear of the mouth where the teeth are, that make and secrete digestive enzymes into the mouth (specifically alpha amylase for sugar digestion…long story) and are a natural part of childhood development.

    New teeth in babies are also painful and can produce fever as well, should we have a vaccine to prevent teeth from properly developing.

    Stop the medical nonsense, these are just children. if we know mumps may augments oral digestive enzyme production in later life, what could be the benefits also of childhood measles and chicken pox.

    What, the scientists never bothered to look into this.

    Do they really think the Creator, God, made a mistake in making these 3 childhood illnesses. how you gonna call it? God = 0, lab scientist vaccinators = 3.

    3 more vaccines sold by the millions to increase the failing Disease Care System’s $4 Trillion Dollar a year profits. More and more Chemical drugs being made and sold and more and more diseases all on the increase. Disease Care is bankrupt, time to retire it and the chemicals polluting the earth and all of its inhabitants.



    1. Steve April 2, 2019 2:47 am Reply

      Sorry, Charlie: vaccines work by triggering the body’s NATURAL immunity. By injecting weak or dead infectious agents through the skin the body creates the appropriate immune defense. So would you rather see the immune response trigger accomplished thru having to endure the risk and pain of disease—with attendant complications and potential for fatality? Vaccines are one of the most well-researched interventions of all time. There is data from literally millions of children across the world demonstrating their safety. There has been more research on vaccines than almost any other medical advancement. The research has been done. Time and again. Vaccines are safe and effective. Sorry, but I’m not buying the hypothetical junk science based on self-intuiting, anecdote, wives’ tales, myth, internet theory, crowd-sourcing, all the rest of it. Had friends growing up who got polio. Know someone a lot younger than me in China still wearing the braces—China got the vaccines late. I thank God Mr Salk came along just in time, and that my school provided his vaccine while I was young enough to benefit. And I’ll wager you did too.

  4. Charlie Chimknee March 31, 2019 9:53 pm Reply

    Aloha Kakou,

    And if your child is not vaccinated but came into close or near contact with those who had the mumps, e.g., in the classroom or playing together or handling same objects like a ball or toys, or sports equipment, or even sharing a juice…

    Your child may have still gotten all the contagion, the contact, they need to develop a lifetime of immunity. The reason is many people with highly functional immune and nervous systems contract illnesses, childhood, teen, or adult, including infections that are internal like in the lungs or external as in a skin/flesh cutting injury or also a secondary exposure to bacterial infection from polluted fresh or sea water at beaches, especially those with human or animal E-coli…from feces. This pollution is referred to as a sanitation issue. Animal feces in mountain streams can find its way to the rivers and ocean, and even cess pools have that problem.

    Any invading organisms, like mumps, or influenza, or staph or srep or E-coli infection may be recognized immediately by the nervous and immune systems and an immediate immune response is elicited by the body and the bacteria or virus are “nipped in the bud” (similar tio being destroyed and excreted by our internal immune defense cells) and no signs or symptoms of illness or infection are produced by the body, as the immune and nervous systems rid the body of the invasive organisms.

    And that is why a cold or flu virus can pass through a classroom and only some of the kids appear to get sick. The ones who who do not get sick may have highly functional nervous systems and immune systems that stop the bacteria or virus before it can “settle into” the body.

    How do you develop or restore and maintain highly functional immune and nervous systems ?

    That’s another discussion for another time; but apparently not by those who can only prescribe a pill or vaccine for every ill. They have different training limited by the pharmaceutical industry. Stay with nature, it’s proven to be dependable.

    Another gland that increases in size during childhood up to about the age of 8 and is also a contributor to the lifetime immune response ‘team”. It is the Thymus Gland and it is normal for it to develop and increase in size while young. Let’s hope they don’t develop an anti-Thymus vaccine.

    Mahalo for reading,


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