It is immutable and persistent, but not with the same performance characteristics. It lacks Bagwell's data structures that allow structural sharing. Take a 10 million item list in elixir and 'change' (return a new) the 5 millionth element. Time how long it takes. Do the same with clojure. Compare.
Scala has a collections library that heavily emphasizes immutable/persistent data sructures. You aren't forces to use them but it is idiomatic Scala to be "pure"/non mutating.