Image: AP

Many states are struggling with whether to eliminate vaccine exemptions, in the wake of surging measles cases. However, thousands of kindergarteners are unvaccinated without waivers—in many states, more of them than do have the waivers. Why? Great question.

The CDC reported that, based on info from 27 states that reported their data, “A majority of unvaccinated or undervaccinated kindergartners in at least 10 states were allowed to enroll provisionally for the last school year, without any formal exemption,” according to the Associated Press. Formal exemptions at least give some sort of sense what’s going on. Just straight-up no paperwork is more complicated. Public health officials have a lot of questions about why, because that would enable them to better address the issue. Unfortunately, that’s a mystery:

Poor access to health care keeps some of those children from getting inoculated against some of the most preventable contagious diseases, but for others the reasons are more mundane.

“It really could just be, ‘I didn’t have time to go to the doctor,’ or ‘I just don’t want to do this,‘” said Melissa Arnold, CEO of the American Academy of Pediatrics’ Ohio chapter. “From a public health standpoint, we really don’t know.”

“Experts say it’s likely that many or even most of those children ultimately get all their vaccinations, as state laws require, but no one knows for sure,” the AP added. Would that information be useful? Yes, yes, it would! Schools face a conundrum when they get a student without all the vaccines or the exemption paperwork, because ultimately, they want kids in class. Better info might help address whatever is happening here, but there’s no straightforward way to collect it.

It also might help if we actively organized society around making things like “getting your kindergartener vaccinated” easier! A lot of jobs in America will barely give you enough time off for a trip to the bathroom, much less running your kid down to the doctor or public health clinic, particularly if you live in a rural area and have to drive some distance to get it done.