RSU 9’s nursing staff, left to right, includes Janneke Strickland, Kathryn Clement, Wendy Schlosser, Katie Hallman, Kimberly Lloyd and Suzanne Abbott. Submitted photo

FARMINGTON — At the beginning of August, RSU 9’s head nurse became aware that the district did not have vaccine documents for about 180 students.

Wendy Schlosser said the district had not received proof that those students had been vaccinated or a medical waiver signed by a doctor.

“Two issues occurred with stricter enforcement of vaccinations,” Schlosser said. “One is that philosophical or religious objections to vaccination are no longer allowed. Unless a student is enrolled in a special education program, if parents choose to not vaccinate, their option is to home-school.”

But the second issue ended up being a bigger problem. Beginning last year, students entering seventh and 12th grades must provide proof that they have had the meningococcal vaccine. Meningococcal disease includes meningitis and septicemia (blood infection).

Seventh-graders are also required to have a booster shot against tetanus, diptheria and whooping cough. Vaccines for children in Maine are provided at no cost.

According to the Maine Department of Health and Human Services, meningococcal disease is rare but dangerous and strikes healthy young people without warning. The disease spreads easily in large groups through coughing or sneezing near others, by kissing a person on the mouth or by sharing a glass or cup.

Meningococcal infections can be treated with antibiotics, but even with treatment, about 10 to 15% of people who get sick will die. Another 10 to 20% will survive but suffer lifelong disabilities such as hearing loss, loss of arms or legs or brain damage.

The new law makes Maine the fourth state in the country to limit nonmedical exemptions. One exception is for children in special education. These students will be allowed to apply for such waivers for another two years.

It is not unusual for school health officials to have to chase down documentation after school starts.

“In the past, vaccination requirements were not highly enforced,” Schlosser said. “We would spend a few weeks after the start of school contacting parents and collecting either their documentation or their waivers. We didn’t have to report records to the state until the end of the calendar year and people were used to that timeline.”

When Schlosser reviewed the district’s health records, she was alarmed to see that more than 140 high school and middle school students and close to 40 elementary school pupils were out of compliance. And unlike previous years, now they would not be able to start school without proper documentation.

“RSU 9 communicated the new requirements to parents several times,” Schlosser said. “When March and June report cards were issued, information about the changing meningococcal vaccinations was included. And it was included in the packets mailed to all students starting their senior year. I was a little surprised that so many were not in compliance by August.”

Schlosser and Mount Blue Middle School nurse Suzanne Abbott began working the phones, spending several hours apiece over a couple of days reaching out to parents of seventh- and 12th-graders.

Vaccination records and medical waivers for about half of those students began to flow in, but the nurses weren’t able to reach everyone. The entire nursing staff met Aug. 22 and did a second blanket of phone calls and email notices to all affected students. The efforts Schlosser and her staff made to contact families about noncompliance was done during unpaid time.

“We didn’t want to have to turn kids away from school,” Schlosser said. “Mostly, we needed to remind parents that the rules had changed and will be tightly enforced from now on. But many kids still needed to have those meningococcal vaccinations. Some parents reported to us that their doctors were actually out of the vaccine, which was surprising. Not all providers have stocked up to meet the higher demand.”

The week before school started Schlosser said she was missing records for about 20 incoming seniors.

“But by the time school started, everyone who came the first day was in compliance,” she said. “All of the elementary school children had their proper documents submitted.”

By Aug. 30, only four remained out of compliance.

“Those last four, I have them as ‘pending.'” Schlosser said last week. “I’m relieved. It’s one of those things where change is difficult. It was a crazy few weeks. I’m just glad we were able to tackle it together and make sure our students were able to start school on the right foot.”