Vaccination rates for children in Wyoming have increased, but students in Natrona County School District still return to school with incomplete immunization records.

Wyoming law stipulates that students must be up-to-date on certain vaccinations. If a parent doesn't show proof of immunization or file for an exemption within 30 days after the start of school, the child can't return.

The exclusion date is Sept. 17, and more than one-fourth of the kindergartners at Grant Elementary School still do not have their immunization records updated, according to Suzey Delger, head school nurse for the district.

"This isn't a district policy," Delger said. "People think it's just us, but it's enforced throughout the state."

Delger said the majority of the nine kindergartners at Grant Elementary will receive their vaccines before Sept.17, as will the large number of seventh-graders who still need a tetanus booster.

The 20 school nurses throughout the district spend much of their first weeks of school tracking down immunization records, calling parents and touting the importance of childhood vaccines.

"We knock ourselves out as the immunization police," Delger said.

Delger said she was unsure of how many students across the district were still missing vaccinations, because she doesn't count them until the exclusion date.

Noemi Amaro had no idea her daughter, Jocelyn, was missing part of her Hepatitis B shot series until the school nurse called. Jocelyn began third grade at Mountain View Elementary School almost three weeks ago.

Amaro took her daughter to the Casper-Natrona County Health Department Wednesday for a free vaccine clinic. While they were there, Jocelyn also received vaccines for Hepatitis A and chicken pox, which aren't required but are strongly encouraged.

"In the waiting room, I overheard a woman talking about how back in the day, kids used to be sick more because there weren't vaccines," Amaro said.

The waiting room at the county health department was filled with parents and children waiting for free vaccines.

There's no reason parents shouldn't vaccinate their children, said Dr. Brent Sherard, director of the Wyoming Department of Health, because the state provides free vaccines for all children through the Wyoming Vaccinates Important People program.

The state has reported outbreaks of whooping cough, a disease that can be prevented through vaccine, in recent years, Sherard said. These diseases will come back if every child isn't vaccinated, he said.

Because vaccines and campaigns to vaccinate people have been so successful, people forget the devestation these diseases can cause, Sherard said.

It came as a surprise to Donna Hall when her grandson was diagnosed with whooping cough last September.

"I didn't even realize it was still around," said Hall, a secretary at Grant Elementary.

Because her grandson was only 3 months old when he caught the disease, he only received his first dose of the vaccine.

"It scared me to death," Hall said. "He was so congested, he couldn't breathe. His little eyes would just get so red."

The baby was sick for several months but recovered and received the rest of his vaccines, Hall said.

According to the Centers for Disease Control and Prevention, more than 130 people in 15 states have fallen ill with measles this year, representing the greatest surge in the disease in more than a decade.

Some parents fear vaccines can cause autism. Delger said "it's unfortunate" the myth has spread.

The CDC, American Academy of Pediatrics, World Health Organization and National Institute of Medicine agree there is likely no link between vaccines and autism.

Sherard said there is a small risk with vaccines just like there is a risk with any medication. But the risk of the vaccination is much less than the complications from one of these diseases.

"I wish every young mother could go visit an old woman in the nursing home and ask them what it was like in the 40s with whooping cough or the 1950s with the measles," Delger said. "Young moms don't get it because they haven't seen it."

Delger said there are a lot of seventh-graders who still don't have their booster for tetanus, and it's more difficult to make sure they do because sixth graders now go to larger middle schools instead of elementary school.

Delger finds it difficult to blame the schools for children missing required vaccines. She said the responsibility falls on parents' shoulders.

"When it comes to children's health, I would hope that this would be very important," Delger said. "These diseases are not eradicated throughout the state. They're just a plane ride away."

Contact health reporter Allison Rupp at (307) 266-0534 or allison.rupp@trib.com.

What do my kids need?

For kindergartners:

* Five doses of the tetanus and diphtheria vaccine (Td) or the newer tetanus, diphtheria and pertussis vaccine (Tdap). Most children receive three doses by about their first birthday. At least one of these doses must be administered after their fourth birthday.

* Four doses of the polio vaccine. At least one of the doses must be administered after their fourth birthday.

* Two doses of the mumps, measles and rubella vaccine. Most children entering kindergarten will need a dose before they start school.

* Three doses of Hepatitis B

For seventh graders:

* An additional dose of Td/Tdap. Health providers recommend students receive a dose of Tdap to protect them against pertussis, or whooping cough, if they haven't already.

* All seventh graders and transfer students must fulfill the immunization requirements for kindergartners, too.