Pastor Fred McGlone, superintendent at New Covenant Christian School in Waverly, has noticed a shift after more than 30 years working in education.

It seems to him that more parents are anxious about vaccines.

Last year, five of the 12 kindergartners at New Covenant had non-medical waivers to skip vaccines. That's nearly 42%, the highest rate in the tri-county area.

"It seems like there's more interest in natural, homeopathic types of medicine," McGlone said. "In our experience, we have young parents who have heard this or that about vaccines."

In the Lansing region, religious schools and Montessori schools are the most likely to enroll children who are not fully vaccinated, mimicking a pattern that can be found statewide.

"We do not discourage parents from having their children vaccinated," McGlone said. "We are blessed to have families that care deeply about their children. Ultimately, it is up to them and we respect their decisions. If they ask, I will say that I had my children vaccinated."

Scientific evidence overwhelmingly points to the individual and collective health benefits of vaccination. The American Academy of Pediatrics, the Centers for Disease Control and Prevention and the World Health Organization all support vaccination.

BY THE NUMBERS

Every school or childcare center with at least five students must report vaccination data to the Michigan Department of Health and Human Services for kindergartners, seventh-graders and transfer students.

Michigan parents can get vaccination waivers for medical, religious or philosophical reasons.

Last year, religious kindergartens in Ingham County had a 4.26% vaccine waiver rate.

At public and private Montessori schools in Ingham County, the waiver rate was 8.38% — more than double the 3.14% rate countywide.

Michigan 2016 vaccine waiver rates

All kindergartens: 3.66%

Public kindergartens: 3.31%

Private kindergartens: 7.58%

Mark Largent, an interim dean at Lyman Briggs College at Michigan State University and the author of "Vaccine: The Debate in Modern America," suggested that Montessori schools have more vaccine waivers because the parents are disproportionately "white, upper-middle class and educated."

That is a population, he said, with higher rates of non-vaccination on average.

"In the United States, upper-middle class Protestants tend to have confidence that they know what's best for their families," Largent said. "They feel they have a better sense than the experts."

Another factor, he said, is that more affluent families may be better able to "insulate themselves from the consequences" of not vaccinating.

For instance, such parents could afford healthcare if their child gets sick or they could afford private education if their child is barred from attending a public school, Largent said.

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Two of the 26 kindergartners at Montessori Children's House had philosophical exemptions last year and one had a religious waiver, giving the school the highest rate of unvaccinated kindergartners in Lansing at nearly 12%.

"Anytime you look at percentages of a very small number (only 26 students in this sampling) the results can seem misleading," Maureen Newton, the head of school, said in an emailed statement.

Among public schools in the Lansing district, Wexford Montessori Academy had the highest 2016 waiver rate at 11%. Six out of 54 kindergartners had vaccine waivers for non-medical reasons.

Robert Kolt, a spokesman for Lansing Public Schools, said the district is proud of its high overall vaccination rate, but declined to comment on Wexford's rate, specifically.

The waiver rate for kindergartners in the Lansing School District was 1.9% last year compared to 3.31% at public schools statewide.

At private schools in the city, the 2016 kindergarten waiver rate was 4.4%.

Nearby, several other public schools districts had lower percentages of unvaccinated kindergartners than the state average.

The 2016 kindergarten waiver rate was 2.91% for East Lansing, 3.14% for Okemos and 1.6% for Holt.

Waverly Community Schools had a higher waiver rate at 5% because there were six exemptions— one medical, one philosophical and four religious — out of a class with 119 kindergartners, according to the state's data.

Interim Superintendent Kelly Blake said the district complies with state laws and regulations. She referred to the district's policy, which states: "The Board of Education believes that immunization is one of the most cost-effective measures to protect children from vaccine-preventable diseases."

Historically, most Michigan vaccine waivers have been granted for philosophical reasons. That was still the case in 2016 when 74.2% of exemptions were philosophical. Slightly more than 20% were religious and only about 5% were medical.

Families have complicated, "highly personalized" reasons for seeking vaccine waivers, Largent said.

Many parents with discomfort about vaccines are not categorically "anti-vaccine," Largent said. Rather, they have have ethical concerns about specific vaccines or don't want to follow the recommended schedule for when each injection should be administered.

Parents may seek to delay vaccination if they feel their children are receiving too many shots within a short time frame, Largent said, though such delays involve health risks.

STRATEGY OF INCONVENIENCE?

Before 2014, Michigan had one of the worst immunization rates in the country. The state attracted negative publicity in because of preventable outbreaks of whooping cough and measles.

Michigan changed its rules in 2014 to make it more difficult to get a non-medical waiver. Before obtaining a waiver form, parents must now meet in-person with an official at their local health department for vaccine education

After the rule change, Michigan saw a 35% drop in the number of vaccines waivers from 4.8% in 2014 to 3.1% in 2015 and improved from the state with the 9th highest waiver rate in 2014 to the state with the 11th highest waiver rate in 2015, according to the Centers for Disease Control and Prevention.

Linda Vail, health officer at the Ingham County Health Department, believes that, before the change, many Michigan parents got waivers simply because it was easier than being vaccinated.

"I call them 'waivers of convenience,'" Vail said. "They weren't because the parents had true philosophical opposition to vaccines. It was more about forgetting to make a doctor's appointment before school started and thinking it was easier just to fill out the form and get vaccinated later."

Now, Vail observed, parents must make the effort to set up a health department appointment before getting a waiver. Because of this, the parents who come to the department tend to be a self-selecting group with strong opinions.

"In our experience, few of the parents who come in for waivers end up deciding to get vaccinated after they hear the information," Vail said. "Usually, they already have their minds made up."

Health experts say vaccinations are important beyond the individual benefits.

Some people, including cancer patients and pregnant women, cannot receive certain vaccinations for medical reasons. Herd immunity is the vaccination level necessary in a population to protect even those vulnerable, unvaccinated people from diseases.

For highly-infectious diseases such as measles, experts say a 90% to 95% vaccination rate is needed for herd immunity. For less infectious disease like polio, the immunization rate must be around 80% to 85%.

Like Michigan, most states allow personal belief exemptions from vaccinations. California, West Virginia and Mississippi, however, have eliminated all non-medical vaccine exemptions for students attending public or state-licensed private schools.

From a public health perspective, states should implement policies that create low vaccine waiver rates, Largent acknowledged.

He believes, however, that hard-line policies like California's risk unintended consequences if parents decide to homeschool their children rather than contend with intrusive state regulations.

"Americans cling strongly to their civil liberties," Largent said. "If this were Northern Europe, you could pass a law saying everyone has to go to the doctor once a year, but that would never work in the U.S."

Largent advocates a policy like Michigan's, which he characterized as a "strategy of inconvenience." Michigan introduced barriers to getting a waiver, but did not eliminate the option completely.

Research shows a correlation between states with more complicated processes for obtaining waivers and higher immunization rates.

"When you go too far you risk provoking a backlash," Largent said. "When it comes to public health, you do need to have kind of a soft touch."

How many kindergartners at your school have vaccine waivers?

Contact Sarah Lehr at (517) 377-1056 or slehr@lsj.com. Follow her on Twitter @SarahGLehr.