As fall semester beings, health officials are urging Michigan public and private colleges and universities to streamline policies and efforts to increase disease immunization among students.
Eden Wells, chief medical officer at the Department of Health and Human Services, urged higher education institutions to consider use of procedural tools like a standing order to improve vaccination rates on campus.
The recommendation follows a mumps case at Calvin College in May and a July bacterial meningitis death in Macomb County.
In an Aug. 8 letter sent to Michigan colleges, Wells “strongly recommends the review of vaccination requirements.”
The letter is a regular back-to-school reminder.
Adults age 18 to 24 have “remarkably low” flu vaccination rates, said Wells. As a population, they are hard to reach with disease prevention information.
Young adults have increased risk but “probably the least amount of knowledge about that risk,” she said. They tend to get vaccinated only after getting sick.
“College-aged adults are just getting out of the house,” she said. “Some have the mentality that they are invincible.”
Wells said diseases easily spread through campuses because students are in close contact while in class, dorms, on public transportation or at social gatherings. That, coupled with stress factors, can increase infection risk.
State law currently has little teeth in mandating adults get vaccinated. While grade-school students must be vaccinated for certain diseases unless they have a parental waiver, few colleges or universities require immunization of the school’s general population.
In Michigan, there are no statewide immunization requirements for entry into college or university. Other states do have those rules. Michigan colleges and universities can require age-appropriate vaccinations, according to the DHHS. Some schools require all vaccinations and others only require vaccines for students going into a health-related field.
At Grand Valley State University, for example, vaccinations aren’t required of incoming students but certain academic programs, work, or volunteer activities may have immunization requirements.
“This has been an ongoing discussion,” said Michele Coffill, spokesperson at GVSU. Vaccination is “recommended but not required now.”
Michigan Care Improvement Registry data shows college-aged adults have the lowest flu vaccination rate among state age groups. The state has promoted a flu vaccination “challenge” to entice immunization on campus in recent years.
In addition to outreach programs like the flu challenge, health officials want schools to issue standing orders for meningococcal vaccinations, among others.
In July, a children’s day camp instructor in Rochester Hills died after catching bacterial meningitis. The disease can spread through body fluid contact with someone who is infected. Health officials recommend everyone get vaccinated at age 11 or 12, followed by a booster dose at age 16.
Alicia Stillman, a Farmington Hills resident whose daughter, Emily, died at age 19 of Meningitis B while a student at Kalamazoo College in 2013, praised the DHHS letter, but said more action is needed.
Meningitis B is the only type of meningitis not included in the common meningitis vaccine given to adolescents across the United States.
“It’s time Lansing go further to protect our young people, and make the meningitis vaccine a requirement for students attending Michigan’s colleges and universities,” said Stillman, who founded the Emily Stillman Foundation.
“There was no vaccine for Meningitis B when Emily contracted the disease, but there is now,” she said. “Making the immunization a requirement for students on campuses across Michigan will save lives and prevent the kind of heartache my family experiences every day.”
In May, several unvaccinated Calvin College students were barred from campusfor almost a month after a student tested positive for mumps, a highly contagious viral illness characterized by swollen jaws and puffy cheeks.
“Mumps is not a mild issue once you’re an adult,” said Wells. Adult complications can include inflammation of reproductive organs, the brain and spinal cord.
Standing orders are not vaccination mandates, but instead are an administrative procedure for streamlining vaccination among large populations. The orders authorize nurses and pharmacists to administer vaccines to people meeting certain criteria without an individual physician order.
Having orders in place are important for dealing with outbreaks, Wells said.
Vaccination rates among children statewide are improving but “not quite where we want to see them,” she said. The state wants to improve the percentage of grade-school children completing their entire vaccination schedule.