Every public school in the state on Friday morning will take an official count of how many students are sitting in their classrooms, a crucial annual census that will be used to determine how much money school systems and individual campuses will receive from the state and federal governments next year.

Not counted will be children whose parents don’t have health insurance and can’t afford to have their kids immunized against standard childhood diseases, such as mumps and measles, quickly. The Baltimore City health department, which has held free clinics for vaccinations, has no available appointments for weeks.

Some students are already missing school because they aren’t vaccinated. On Sept. 19, the city schools system was supposed to begin excluding students without the required childhood immunizations from schools until they had been vaccinated or had an appointment to get the shots soon. (Neither the state nor the city school system requires students to be vaccinated against COVID-19.)

The number of children who won’t be counted is unclear. The Baltimore City school system declined to provide figures on the number of unvaccinated students, but if the past is any indication, it could be in the hundreds or thousands. In 2020, more than 3,000 students hadn’t been immunized at this time of year, and the year before, 1,854 students had failed to supply evidence of vaccinations.

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That has left some schools scrambling to find a way to get their students immunized. When the uninsured parent of a seventh grader who needed TDAP and meningococcal vaccinations went with a school administrator to a pharmacy near Hampstead Hill Academy to get immunized, they found the cost would be $300. The mother couldn’t afford the bill, but for Hampstead Hill Principal Matt Hornbeck, the choice was easy. He paid the bill out of his school budget.

“That is the first time I have ever done that,” Hornbeck said. To have that student at school on Sept. 30 was worth $10,000 — the amount of money he gets from the school district for one student — in next year’s budget.

Shots for childhood diseases should be plentiful and free, he said, but they aren’t.

“I wonder if [Maryland State Superintendent of Schools Mohammed Choudhury and the Maryland State Department of Education] will end up actually taking the state portion of the per pupil [funding] away from districts that can show that a specific family is uninsured given the weeks- and monthslong wait lists for the free shots,” Hornbeck said.

The city health department said in a statement that it had provided vaccinations to 664 students at 36 clinics over the summer and in August and early September, including at eight different schools and at a Saturday clinic on Aug. 27 and Sept. 17.

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“Yes, clinics are full. These clinics primarily serve our uninsured and under-insured populations,” the health department statement said. “Typically these are immigrant families that do not have access to the expansive coverage offered through federally subsidized insurance programs like Medicaid and Obamacare.”

The health department said that “given proximity to the deadline, it will be challenging for any family to find a last-minute vaccination appointment anywhere. We encourage parents to reach out to their primary care provider as an initial attempt to schedule a vaccination appointment.”

The state has tried to help in one school through HealthCare Access Maryland’s Connector Program. The program helps state residents sign up for health insurance, including through the Maryland Health Benefit Exchange, which is the state’s version of the Affordable Care Act. Richard Amador, the Connector Program outreach manager for HealthCare Access, said he had helped use connections to schedule a city health department clinic in a week or so at a Sandtown-Winchester school where 11 students are still not vaccinated.

Amador said HealthCare Access was helping to address a community need in the community while hoping to help sign up residents for health insurance. “I am pairing the message of the importance of health insurance with a tangible community action.”

Sherry Christian, a spokeswoman for the city school system, said that when a student is missing required shots at the start of the year, “We work with the family and local health partners to ensure that the student gets fully immunized as quickly as possible to help minimize potential immunization-related absences while also keeping each school community safe.”

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According to Maryland state law, a student may only be admitted to school if their parent or guardian has provided documentation showing that the student is up-to-date on all required immunizations, Christian said. If a student has an immunization appointment scheduled within 20 days of the start of school, the student may be temporarily admitted while they await that appointment.

But that deadline has passed.

“We should make these vaccinations accessible for our students,” said Peter Kanamm, principal of Henderson-Hopkins, an elementary and middle school in East Baltimore. “We should make it easy.”


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