The clock is ticking for parents who waited to get their children vaccinated, or who haven't yet acquired a waiver from vaccines.
A new state policy requires parents to attend an educational session with a county public health nurse to get a vaccine waiver for religious or philosophical reasons.
In the past, parents could just pick up the waiver at school and fill it out.
The policy is intended to reduce the numbers of children who attend school without being vaccinated against diseases.
Michigan has one of the highest rates of vaccine waivers in the country. There have been recent outbreaks of whooping cough and measles in the state as a result.
The waivers are required for all children in preschool, those entering kindergarten and 7th grade, and for students who are switching schools.
County health departments fear last-minute rush
"I'm not sure all parents understand this," says Mary Wisinski, a registered nurse and the Immunization Program Supervisor at Kent County Health Department. "First day of school, you have to have had at least one dose of immunizing agents, or you should not be admitted."
In the alternative, the parent should have attended a compulsory meeting with a public health educator or nurse to get a waiver.
Those appointments are getting scarce, says Wisinski.
Wisinski says Kent County's vaccination rate is pretty good, by Michigan standards. About 3.5% of kindergarten students enrolled with a vaccine waiver in 2014, and about 2.6% of 7th grade students had a waiver.
But even in Kent County, some individual schools have very high rates of unvaccinated kids.
Northpointe Christian Elementary, for example, a private school, had 17 kindergartners with vaccine waivers in 2014 - 21.5% of the total.
Creative Tech Academy, a public school, had 21.7% of its kindergartners with waivers.
Those gaps in vaccinations put the so-called "herd effect" at risk in those schools. For vaccination to work effectively, between 90 and 95% of children must be vaccinated, depending on the illness.
Livingston County could have a situation on its hands
Livingston County has one of the highest rates of vaccine waivers in the state of Michigan.
Chelsea Moxlow, Health Promotion Coordinator for the Livingston County Department of Public Health, says there are 800 children in the county who are unvaccinated and will need a waiver.
Those are just the unvaccinated kids in preschool, entering kindergarten or 7th grade.
In other words, the tip of the iceberg.
So far, only about 160 of the parents have attended an education session outlining the benefits of vaccination, and the risks of not vaccinating.
The county has four public health nurses and two health educators to get the rest of the 30-minute sessions done, in a little over one month.
"It's a very polite appointment."
Moxlow says nurses have been trained to answer questions about misinformation found on the Internet, and they have handouts to answer just about any concern a parent may have about vaccines.
She says many parents have been pleasantly surprised at the non-confrontational tone of the meetings. That's in contrast to what she's been seeing on social media platforms.
"There's a lot of information out there that is making the local health departments to be this evil entity," says Moxlow. ''And the reality is we are just trying to get correct information out into the community and to really work with the parents and alleviate some of their concerns. Because at the end of the day, we want what's best for their child just as they want what's best for their child."
Is it changing anyone's mind?
Both Moxlow and Wisinski say "a couple" of parents have decided to have their children vaccinated after attending an educational session.
Others say they plan to bring their kids to the pediatrician to get the vaccinations, but they leave with a waiver just in case they can't get appointment before school starts.
"And some don't want to discuss anything," says Wisinski. "I'll be very frank. They're not going to get vaccines no matter what you say to them."
Public health officials think the biggest effect of policy change could come from parents who got the waivers for their kids out of convenience. The waiver was there at the school, and it was easier to just fill it out than get the kids up to date on all their shots.
Now, that convenience factor is gone. For some, it will actually be more difficult to get an appointment with a public health nurse than it will be to get an appointment with the pediatrician.
Schools must tell the state the vaccine status of 90% of enrolled students by November - and 95% of enrolled students by February.
How did we get in this situation?
Vaccines are a victim of their own success, say those in the immunization field. Parents with school-age children do not remember the terror of polio.
They didn't live during a time when more than three million people contracted measles every year - with tens of thousands being hospitalized, and hundreds dying.
"Measles is an ugly disease," says Wisinski. "Yes, I had measles when I was a child and I did fine. But I went to high school with a girl who got it, she went in the hospital, and she died." She adds, "No vaccine is 100% safe. I'll give you that. There are side effects. Sometimes things do happen. But it comes down to benefit versus risk. If your risk of getting the disease is 1 in 1,000, and your risk of getting a side effect is 1 in a million, you look at the consequences just like you do for everything in your child's life. "
Wisinski says people also may not think about the potential consequences to people who can't be vaccinated.
"I might get whooping cough and I might cough for three months. But a baby could get it from me and it could be fatal. I'm not just protecting myself and my kids with vaccines, but all those around them."
Wisinksi thinks it would be reasonable to allow schools to refuse enrollment to unvaccinated kids.
That's what will happen in California next year. Children who wish to attend school in the state will have to be vaccinated.
But in Michigan, only a school that operates with no state funding can shut its doors to unvaccinated kids.
You can find the vaccine waiver rate for your child's school here:
http://www.michigan.
