The students, who range in age from 4 to 11 years old, attend the Asheville Waldorf School. They began falling ill in mid-September, said Dr. Jennifer Mullendore, the medical director for Buncombe County Health & Human Services.

“The size of this outbreak and the fact that this school continues to have a large number of unvaccinated students makes it very likely there will be continued spread of chickenpox within the school,” Mullendore said.

North Carolina requires students to receive the chickenpox vaccine, but exceptions can be made for medical or religious reasons.

During the 2017-2018 school year, about two-thirds of the 28 kindergartners at Asheville Waldorf School received a religious exemption from the required vaccinations, state data shows, the highest percentage in the state for schools with kindergarten enrollment of at least three students.

“There is a significant amount of misinformation about vaccines on the internet and social media, which parents may find confusing and concerning,” Mullendore said. “We encourage parents to talk with their child’s health care provider and review medically accurate, scientifically sound information about the serious risks of vaccine-preventable diseases compared to the very rare risks of vaccination.”

School officials did not immediately respond to a request for comment.

Chickenpox is highly contagious and results in a blisterlike rash, itching, fatigue and fever.

It usually presents as a mild illness but can sometimes cause bacterial skin infections, bloodstream infections, pneumonia, infection of the brain — even death.

All 50 states have laws requiring school immunizations, but in 45 states and Washington, D.C., parents who object for religious reasons are exempt from the vaccine requirements, according to the Immunization Action Coalition.

Eighteen states permit exemptions for personal or philosophical reasons.

The New York Times

Christina Caron © 2018 The New York Times