The pressure to vaccinate as many children as possible is on, especially in light of four measles outbreaks in different California counties this year. As of May 1, the California Department of Public Health reports 40 confirmed cases in 2019, up from 22 last year. They come at the same time schools are facing changes to vaccination laws – some take effect July 1 – as lawmakers crack down on the number of personal belief and medical exemptions.
Health officials argue that those exemptions chipped away at “herd immunity,” 95 percent, the point at which enough of the population is vaccinated against or immune to a disease to protect those who cannot be vaccinated, like infants and those with compromised immune systems. The state considers a school “safest” if it hits a 95-percent vaccination rate.
Most Monterey County schools are comfortably in the safe range. Eleven schools are considered either “moderately,” “more” or “most vulnerable,” according to state criteria. (See chart.)
Monterey Bay Charter School is listed on the state Health Department’s website, shotsforschool.org, as having the lowest vaccination rate in Monterey County – 76.5 percent of entering kindergartners for the 2017-18 school year were vaccinated.
“People want to look at that and say, ‘Your high numbers mean you don’t care,’” Monterey Bay Charter School Director Cassandra Bridge says. “We do want people to be immunized.”
Most parents, she says, want to comply, but for those who want to exempt their children from vaccinations, “that’s between them and their doctor and I have no control over it.”
Bridge’s job is to comply with the law by sending notices to families about legal requirements and collecting vaccination records – or medical exemptions signed by physicians – from parents.
In 2017-18, 16.2 percent of unvaccinated or partially vaccinated kindergartners at Monterey Bay Charter had medical exemptions, up from 9.2 percent the previous year. Bridge says the current numbers reflect that 92 percent of kindergartners are vaccinated.
"We recognize this is below the 95 percent herd immunity rate, but demonstrates our efforts at meeting this target just one year after personal exemptions were eliminated," Bridge says in an email.
Medical exemptions have been rising since 2016, when California Senate Bill 277 took effect, eliminating exemptions based on personal beliefs. In 2014-15, 0.19 percent of all California kindergartners, or about 1,000 students, reported they were unvaccinated due to medical reasons. By 2017-18, that number had more than tripled to 3,400. It’s an indication that some parents who could no longer comply based on personal beliefs sought out medical exemptions from doctors considered friendly to the anti-vaccination movement.
One Monterey doctor is not only friendly to the movement, he is its local voice. Dr. Douglas Hulstedt says the medical community has turned a “blind and dumb eye” toward vaccinations, which Hulstedt believes cause autism. That belief is not shared by major medical and autism organizations, which state overwhelming scientific research shows vaccinations do not cause autism.
Hulstedt says he’s “been known to give” exemptions, if they meet criteria in a letter by former Gov. Jerry Brown when he signed SB 277 into law. That criteria, however, is vague. Brown’s reasons for exemption include “circumstances, including but not limited to, family medical history, for which the physician does not recommend immunization… ”
School districts began seeing exemptions based on ailments like eczema. The law did not designate an agency to check the validity of medical exemptions, tying the hands of suspicious county health officials and school nurses who had to accept them. In February, pediatrician and State Sen. Richard Pan, D-Sacramento, introduced SB 276, which would give the state more control over the exemptions process.
In the meantime, districts are sending out notices to parents about the need for vaccinations. At Monterey Peninsula Unified School District, Superintendent PK Diffenbaugh says they’ve stepped up efforts to educate parents and make vaccines available, including hosting free vaccination clinics. “We’re really trying to remove all barriers,” he says.
One MPUSD school, Monte Vista Elementary, was outside of the safe range in the 2017-18 school year, but Diffenbaugh provided a document with numbers submitted in September 2018 showing 100 percent of the school’s kindergartners are vaccinated.
“I feel very confident in our processes. We’ve followed the state law to the T,” Diffenbaugh says.
The Pacific Grove Unified School District includes two schools below the 95-percent safe range. PGUSD Nurse Katrina Powley says the latest numbers reflect more vaccinated students. She hears from about five parents each year with questions or concerns about their children being “forced” to get vaccinated, then shares scientific data with them and talks about students who cannot be vaccinated, like those undergoing chemotherapy, and herd immunity.
“I don’t get a whole lot of pushback or concern once I educate them about the safety of the vaccines,” Powley says.
Editor's Note: This online version is longer than the article that appeared in print. It includes current vaccination rates of Monterey Bay Charter School provided by Director Cassandra Bridge. The numbers reported by the state are from the previous school year and administrators say improvements have been made in the current year.