Too many school-aged youth in Hawaii are not up to date on their vaccinations for serious and potentially fatal diseases such as measles, meningitis and even tetanus, and that cannot be allowed to continue.

As the state continues to emerge from the COVID-19 pandemic, it is time that Hawaii’s Department of Health (DOH) and Department of Education (DOE) take immediate action for the sake of this aspect of public health.

Since the arrival of COVID-19, the percentage of Hawaii youth not vaccinated for illnesses such as measles, not receiving the full slate of shots or not having updated records showing compliance, as required by law to attend school, has jumped from 3.4% during the 2019-2020 school year to 18.6% in the current school year. With a number approaching 1 in 5, this is an extremely serious issue.

Only a small percentage of those missing or failing to report required vaccinations has sought legal exemptions from state requirements. About 2% of students claimed religious exemptions during the 2019-2020 school year, a percentage that crept up to 3% this year. About 0.1% of students have medical exemptions.

That leaves a gulf that must be resolved: more than 15% of enrolled students whose vaccine records are incomplete, for one reason or another.

In the specific case of measles, one of the biggest resulting threats, once the number of unvaccinated in a community rises above about 5%, the possibility of a “rebound” in the disease rises.

The measles vaccine has long been proven both highly effective and safe — and every complication and death related to measles is an avoidable tragedy that vaccinations could have prevented.

Much of this increase in Hawaii’s incomplete immunization rate is related to the COVID-19 pandemic, and similar patterns have been seen across the U.S. During this time, parents may have had difficulty accessing doctors’ offices for vaccinations, and/or felt unsafe bringing children to a medical facility.

The remedy here is to make a statewide push for parents to get their keiki up to date. This is an important public health issue, and DOH should participate, assisting the DOE with informative materials, for example, and campaigning statewide to communicate the importance of vaccines.

DOH state epidemiologist Dr. Sarah Kemble said the state remains in an “atypical situation” because of the pandemic’s continuing impacts. Record-keeping is incomplete at several schools; DOH is also aware of families, particularly on neighbor islands, that are having difficulty in getting appointments for catch-up vaccines. The agency is working “collaboratively” with schools and families to resolve these issues — but must push harder.

The more difficult issue is parental distrust of vaccines. Vaccine skepticism has been a worrisome factor in outbreaks of measles, mumps and chickenpox, leading families to forego safe protective techniques, thereby placing themselves and others in danger.

Kemble said Hawaii’s waning vaccination rates could lead to an outbreak of measles — a “scary” prospect.

In 2019 a measles outbreak in Samoa killed nearly 90 people, primarily young children, prompting Gov. Josh Green, a doctor who was then lieutenant governor, to bring a lifesaving medical mission to the island nation to administer thousands of vaccinations.

In Hawaii’s schools, the highest number of unvaccinated students are found in private and charter schools — among them Myron B. Thompson Academy on Oahu, where approximately 1 in 5 students are not fully protected.

Hawaii must recognize the potential for serious health consequences from lax attention to state vaccination standards. It’s time to consider narrowing allowances for exemptions, including at charter schools, and properly enforce vaccination and reporting requirements.