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Low vaccination rates at some schools raise concerns

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From page A1 | October 10, 2013 | 12 Comments

Statistically speaking, the numbers are relatively small: The statewide percentage of California children entering kindergarten without having received all recommended vaccinations — because their parents have chosen not to vaccinate for personal reasons — is about 3 percent, according to the state Department of Public Health.

But not only has that percentage been climbing, the variation among schools is significant, and therein lies the problem, according to public health officials.

Preventing the spread of infectious diseases, like the pertussis (or whooping cough) epidemic of 2010, requires a herd immunity, public health officials say: The more people in a community immunized against the disease, the less likely it is to spread. And to achieve herd immunity against whooping cough, a 95 percent vaccination coverage reportedly is needed.

But some schools in California — including several in Davis — have immunization rates well below 95 percent for all diseases because parents are choosing not to vaccinate for personal reasons.

That prompted state lawmakers last year to pass legislation aimed at boosting immunization rates.

Under the new law, which takes effect in January, parents seeking a personal belief exemption from vaccinations must first visit their children’s health care practitioner for a discussion about vaccines and diseases.

Previously, parents simply checked a box saying they had exempted their children because of their personal beliefs; now they will need a health care practitioner’s signature as well.

“This bill is about explaining the value of vaccinations — both the benefits and risks — for an individual child and the community,” Gov. Jerry Brown said in signing the law. “Whether these are simple ‘information exchanges’ or more detailed discussions, they will be valuable even if a parent chooses not to vaccinate.”

Davis public health expert John Troidl says a simple conversation between doctor and parent can make a difference.

“A physician’s advice is typically taken very seriously,” Troidl said.

For example, he noted, research has shown that physicians simply telling their patients they should stop smoking reduces smoking rates by 15 percent.

“The idea that you need to run this by your physician is well-founded in science,” Troidl said.

In signing the bill, Brown added a caveat that upset some in the public health sector — namely, that he is instructing the state Department of Public Health to add a separate religious exemption for which a health care practitioner’s signature will not be needed.

Critics said that could end up defeating the purpose of the bill, which is to increase immunizations, since parents who previously checked the personal beliefs box could simply check the religious box instead.

Troidl said he isn’t sure what kind of difference the religious exemption will make, but he is adamant about the importance of all children who are attending school with other children being vaccinated.

“I think every parent that wants to claim any exemption should home school,” he said. “Immune-compromised kids should not have to be exposed to disease-carriers because their parents don’t want to vaccinate them. There is no ethical reason for that risk.”

In Davis, the percentage of children who entered kindergarten without being up-to-date on their immunizations varied widely from school to school last year.

A full 100 percent of kindergartners were up to date at Redbud Montessori and Merryhill Elementary schools, according to data provided by the state Department of Public Health, while the public schools ranged from a high of 98 percent of kindergartners at Montgomery Elementary to a low of 87 percent at Birch Lane Elementary.

While only one child at Montgomery was exempted due to a parent’s personal beliefs, nine Birch Lane kindergartners were.

The lowest vaccination rate in Davis — and in all of Yolo County, in fact — was at Davis Waldorf School, where only 33 percent of kindergartners last year were up to date on vaccinations, according to the Public Health Department.

Waldorf has seen a steady decline in that number, from 47 percent in 2010-11 to 43 percent in 2011-12 to 33 percent last year, including 19 kindergartners whose parents claimed personal belief exemptions, according to the state.

Another 14 Waldorf kindergartners last year were listed as “conditional entrants,” meaning the child was not up-to-date on vaccinations and lacked either a personal belief or medical exemption at the time of enrollment.

Yolo County supervisors briefly discussed the low vaccination rates at their meeting on Tuesday.

“This does concern me that we have some school sites in the county where the percentage of people choosing to opt out is getting very high,” said Supervisor Don Saylor of Davis.

“I share your concern,” said his colleague, Supervisor Jim Provenza, who added, ”There are immunizations that can’t be given to children under one year of age and yet their older siblings are not immunized and that puts the younger siblings at risk. We need to do everything we can here.”

County Health Director Jill Cook called the numbers concerning and added that the department is hopeful the new law will increase immunizations, but is unsure how the planned religious exemption will impact the law’s effectiveness.

Meanwhile, Cook reported improved immunization rates among seventh-graders in the county as a result of a new pertussis vaccine requirement that went into effect in the wake of the 2010 epidemic.

Most schools in the county reported between 93 and 100 percent of seventh-graders as up-to-date on vaccinations, with the exceptions being Waldorf, where 73 percent of seventh-graders were up to date and the Davis School for Independent Study, where 70 percent (or seven of the 10 seventh-graders enrolled) were fully immunized.

Unlike the personal belief exemption, medical exemptions for vaccines are extremely rare in Yolo County, with no seventh-graders in the county exempted for medical reasons last year and only one kindergartner.

— Reach Anne Ternus-Bellamy at aternus@davisenterprise.net or 530-747-8051. Follow her on Twitter at @ATernusBellamy

Anne Ternus-Bellamy

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Discussion | 12 comments

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  • Rich RifkinOctober 09, 2013 - 7:26 pm

    "The lowest vaccination rate in Davis — and in all of Yolo County, in fact — was at Davis Waldorf School, where only 33 percent of kindergartners last year were up to date on vaccinations, according to the Public Health Department." ....... Because that is a private school, I don't think the public health authorities can do anything about it. But you can make a lot of money betting that the parents of these unvaccinated children are also opponents of fluoridation. The conspiratorial anti-science mindset is precisely the same.

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  • Grant AcostaOctober 10, 2013 - 7:35 am

    "The conspiratorial anti-science mindset is precisely the same." Totally different, Rich. Dental disease is not contagious!

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  • Rich RifkinOctober 10, 2013 - 9:19 am

    I didn't say dental disease was communicable. All I said was that the conspiratorial anti-science mindset is the same. It's a mindset which plays on scientific ignorance. In Davis, it's mostly people from the far-left. But nationally, there are plenty of right-wingers (usually libertarians) who have the same conspiratorial ideas about science and the scientific process.

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  • Alan MillerOctober 10, 2013 - 11:32 am

    Nope. It may be the same mindset for some people. As you saw, the reasons for being against fluoride were varied. I disagreed with the reasons many sited, and clearly many on the No F side lied or stretched the truth (same for Pro F but not my point). My point is the politic of pointing to the embarrassing extremists on the side you oppose and then attempting to smear the entire side you disagree with by labeling all on that side of the issue as ascribing to the same mindset is juvenile, unproductive and extremely common. Adding showmanship, Rush Limbaugh built his radio career on this premise (all liberals have the traits of the extremes). Were we to remove this tactic from Davis politics, we would have much more civil, productive, factual discussions, with much less personal attacks and finger pointing. Would that it were, would that it were.

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  • Rich RifkinOctober 10, 2013 - 5:17 pm

    AM: "Nope. It may be the same mindset for some people." ........ Nothing I wrote contradicts that. I would add, though, that almost all of those who most passionately opposed fluoridation--in terms of being outspoken on the issue--are of that mindset. For example, look at the numbers of references to quack groups like the Fluoride Action Network. One person who passionately opposed fluoridation of our water cited some study which said that "fluoridated water causes" various kidney ailments. I looked up the National Kidney Foundation and discovered there was no truth to that. It was junk science. But no matter how bad the science, those who are predisposed to anti-science conspiracies tend to believe such things, and did cite such arguments as reasons to oppose fluoridation.

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  • Grant AcostaOctober 10, 2013 - 2:24 pm

    Rich, you implied that people against community fluoridation are anti-science. That couldn't be farther from the truth, in my opinion. Dental health is a personal health issue (not public). I, and many, agreed that a small minority of people could probably benefit from additional fluoride, but the vast majority don't need it. I simply don't want to supplement my fluoride intake. On the other hand, vaccinations are truly a public health issue, and parents ought to consider the ramifications of not immunizing their children.

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  • ErnestoOctober 10, 2013 - 4:44 pm

    If the public health apparatus is as sloppy and dogmatic on vaccinations as they are on water fluoridation parents are wise to question them. Their whole argument for fluoridation amounted to "trust us." Perhaps the they should spend some time and effort trying to figure out how to work effectively with parents rather than using threats and scare tactics. Every other advanced nation in the world manages as good or better health indicators than the USA with a much less aggressive vaccination schedule. Why do our children need so many more vaccinations than those in Germany or France? Parents are wise to question the aggressiveness of our vaccination schedule, and they should be able to expect an answer better than "trust us." Questioning is not anti-science, questioning is the heart of science. Read Einstein, Feynman, and Galileo. They are quite clear on the matter.

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  • Rich RifkinOctober 10, 2013 - 5:49 pm

    "Rich, you implied that people against community fluoridation are anti-science." ....... Actually, I think there were four types in Davis (with cross over into other categories by some) that opposed fluoridation: The anti-science conspiratorialists; the libertarians; the "if it ain't broke, don't fix-it" folks; and the anti-overkill people. ........ The last group makes a compelling argument against fluoridation: That treating 100% of the public for a health issue which harms only 30% of the public is overkill, and that we generally never approach public health questions in such a broad, unfocused manner. ........ Personally, I am fine with not having fluoridated water. It's not an issue I am passionate about. What I get worked up over is the passionate, and quite quack-laced arguments, which were made time and again by the Alan Pryors and his followers. I am not sure how large this group is. But it was evident to me that the most outspoken opponents of fluoridation were sold by the anti-science of quack groups like the Fluoride Action Network, etc. But again, I have never said that everyone who opposes fluoridation is an anti-science conspiratorialist. Yet those who are on fluoride, probably are on many other questions taken up by the quacks.

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  • Grant AcostaOctober 10, 2013 - 8:42 pm

    Rich, you sound like a conspiracy theorist yourself! You have all these theories about the anti-fluoride crowd being science-bashers with no real evidence. So a few people quoted a controversial website. Does that mean all of us subscribe to that opinion?

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  • DarcieOctober 11, 2013 - 11:29 am

    Dental caries actually is a communicable disease, although more likely to be spread at home from parent to child than in schools.

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  • Michelle MilletOctober 10, 2013 - 8:22 pm

    Using Birch Lane as an example, of the 13% of kids that are not up to date, do we know what percentage of these kids are not "up to date" because parents are opting out vs kids who are up to date but school records don't reflect it, because parents keep forgetting to send in shot record, or just haven't gotten latest shots yet but they mean too and are busy and just keep forgetting but plan too....

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  • Anne Ternus-BellamyOctober 11, 2013 - 7:46 am

    Michelle, 10 percent of Birch Lane kindergartners had signed personal belief exemptions last year, according to the state. The other 3 percent did not have exemptions on file but were not up-to-date on vaccinations either.

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