Back to school means getting your vaccinations!

August 6, 2018 • community

School of Public Health & Texas Center for Health Disparities Community Blog

Erika Thompson, PhD, MPH, Assistant Professor, School of Public Health, UNTHSC
Alyssa Clader, Immunization Collaboration of Tarrant County

Summer is winding down, and it’s that time of the year to get ready to go back to school. You may be stocking up on school supplies, backpacks, and lunch boxes, but have you stocked up on health? Vaccinations are an essential part of getting ready for the school year. In Texas, children and teens in K-12 need to get certain vaccines to go to school. Sometimes it is hard to find time during the summer to get to a clinic before school is in session, but one organization in Tarrant County makes sure no one gets left behind. The Immunization Collaboration of Tarrant County hosts low cost immunization events each August, where children and adults can get a vaccine for $8 per shot or $24 for 3+ shots. As one parent states, “These events are extremely helpful and affordable. [It’s a] wonderful service to the community.”

Figure 1: 2018 Immunization Events from the Immunization Collaboration of Tarrant County

The Immunization Collaboration of Tarrant County (ICTC) was formed in 1990 during a measles outbreak in Tarrant County, resulting in 300 cases of measles among local children. Formed as a grass-roots group, ICTC aimed to educate the community about the importance of vaccines and provide support for children to receive the vaccines they need to stay safe. In 2017, the Tarrant County Public Health immunization team and the Collaboration served 8,509 clients and administered 17,499 doses of vaccines.

While early success occurred in the 1990s for childhood vaccinations, today Fort Worth and the surrounding area has been identified as a “hot spot” for non-medical exemptions (people are able to get out of vaccinating their children for reasons other than medical conditions, also known as “conscientious exemptions”) for required vaccinations among kindergarteners. In 2016-2017, there were 518 non-medical exemptions for kindergartener school-entry vaccines in Fort Worth – making Fort Worth the 8th highest metropolitan area in the country to opt out of vaccinations for non-medical reasons.

Figure 2: Map of counties with >400 kindergarteners with non-medical exemptions in 2016-2017. Source: Olive JK, Hotez PJ, Damania A, & Nolan MS. (2018). The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties. PLOS Medicine, 15(6): e1002578.


What increases the concern is that non-medical vaccine exemptions are increasing across Texas. In the last school year, 1.45% of students in Tarrant County had a conscientious (non-medical) exemption filed, which was higher than the state percentage of 1.07%.

Figure 3. Percentage of students with a conscientious (non-medical) exemption filed in Tarrant County and Texas from 2011 until 2018. Data come from the Annual Report of Immunization Status and the Texas Department of State Health Services.


“Herd immunity” occurs when enough people in a community (or herd) are vaccinated to provide protection for people who have weak or undeveloped immunity. What makes opting out of vaccinations concerning is that not only are these specific children not protected against vaccine-preventable diseases, but then people who can’t get vaccinated for medical reasons loose protection. These include children who are too young to be vaccinated, people with immune system problems, and those who are too sick to receive vaccines (such as some cancer patients).

Each year the Immunization Collaboration of Tarrant County serves approximately 7,000 children. But it’s not just children who need vaccinations. Adults are recommended to receive several vaccines, including shingles and pertussis. Immunization Collaboration of Tarrant County strives to serve the entire family – from birth and beyond. “We want to protect the entire life cycle” from immunizing parents and grandparents for newborns too young to receive vaccines all the way up to college bound teens needing their meningitis vaccine, Alyssa Clader explains.

Vaccines are safe and effective prevention tools to keep families healthy. Today, we don’t see large numbers of cases for these infectious diseases because vaccines prevent them from occurring. Whether it’s with Immunization Collaboration of Tarrant County or your local clinician, be sure to get up to date on vaccinations, especially to go back to school.


Research reported in this publication was supported by the National Institute On Minority Health And Health Disparities of the National Institutes of Health under Award Number U54MD006882. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.