School children on their way to class have their pencils and notepaper, but not every student has their vaccines.
Numbers gathered by the Iowa Department of Public Health show a sharper rise in religious exemptions last school year than in years past.
In Polk County, religious exemptions stayed in the 500s since 2011, but then spiked to 767 in the 2015-16 school year.
In rural Boone County, those exemptions stayed in the 20s since 2011 but then jumped to 70 in 2015-16.
Overall, Iowa has gone from .97 percent of students having a religious exemption to 1.3 percent.
Rhea Hutchcroft is a nurse practitioner and says that a discredited study linking vaccines to autism is partly to blame.
“The original study that got us in trouble with that whole connection was found to be completely fraudulent and it’s inaccurate. We see that autism continues to rise despite vaccination rates so there’s no link between them,” said Hutchcroft.
She says fewer kids getting their shots means diseases previously considered rare, are becoming more common.
“You start to get these pockets of unvaccinated areas and then you start to see this reemergence of a lot of different diseases that are vaccine-preventable,” said Hutchcroft.
Hutchcroft says some of these diseases include measles, mumps, and pertussis; which can be deadly to infants.
Parents sending their children back to school are paying attention, but say they can only do so much.
“It’s always a concern but I don’t think...there’s lots of things we could get hung up on and we just have to do what we feel appropriate for our kids and hope that everybody else will follow along,” said Cara O’Donnell.
Margaux Beckett is both a parent and a nurse. She firmly believes every child needs to be vaccinated, but ultimately says it's the parent's call.
“I mean everybody parents different and the only parenting you can give to somebody else is do what works,” said Beckett.
Polk County has four schools where the vaccination rate is below 90 percent.
North Fayette Elementary in Fayette County had the lowest immunization rate. Less than half of their 107 students had been vaccinated.
To see the data, click here.