Immunization law targets school vaccination exemptions

California’s new immunization law, which went into effect in July, requires students to be fully vaccinated for school unless they have a medical reason and a doctor’s signature to prove it.

The new law shouldn’t be a burden for Richmond families this fall, said West Contra Costa County Unified School District Communications Director Marcus Walton. That’s because it was designed to eliminate so-called personal belief exemptions—which allow parents to forego required vaccines they object to for their children—and few such exemptions were filed in Richmond schools.

But the law does not address the most common reason some students in Richmond schools lack required vaccines: so-called conditional admission. Children who have not been fully vaccinated for their age or grade can start school “conditionally”—which means they pledge to get vaccinated eventually, but are not fully protected against the infectious diseases vaccines are meant to prevent.

The number of personal belief exemptions filed in Richmond has been historically low. A report released by the California Department of Public Health for the last school year shows that they were filed for just six students in the city’s schools. The tiny Contra Costa town of Byron, by contrast, has one school, Vista Oaks Charter, at which 47 percent of students lacked vaccines due to personal beliefs.

The same report shows that last year Richmond schools admitted 28 students with incomplete immunization data—meaning that they were missing certain vaccine doses or their entire immunization history.

A common reason for this, said Contra Costa Public Health Communicable Disease Programs Chief Paul Leung, is that children moved to the area from another part of the country, or from a different country.

Claudia from El Salvador, who chose not to reveal her last name, said she had her 6-year-old daughter, a first grader at Washington Elementary School, immunized in her home country, but that the schools here require different shots.

She then encountered another barrier to fully vaccinating her daughter: “I could not get the shots right away, because I did not have insurance,” she said.

An unknown number of conditionally admitted students in Richmond schools are immigrants from Central and South America who lack health insurance or legal documents—or both.

Families without insurance—or on MediCal—can get vaccines for free at Richmond’s public health community immunization clinics, but “fear can keep them from seeking such services,” said UC Berkeley epidemiology professor Arthur Reingold.

“Parents are worried and concerned about being discovered and deported and do not rush bringing their children for the free shots,” Reingold said.

Claudia eventually enrolled in Medi-Cal and said she now plans to obtain the missing vaccines for her daughter. But because schools report immunization coverage for kindergarten and seventh-grade students only, there is little way to know if and when children like her do catch up on their shots.

“By law, [schools] are not required, for example, to report a third-grade transfer student with incomplete immunization records,” said Leung.

This means it is up to school administrations to verify the immunization records of all students—and to “take seriously their responsibility,” said Reingold.

California Department of Public Health public information officer Ronald Owens said, via email, that “these children are at higher risk of contracting and transmitting diseases that are dangerous to themselves and others.”

To prevent disease outbreaks, schools with more than 25 percent of students enrolled conditionally may now be audited by the California State Controller’s Office.

But waiting until the conditional admission rate reaches 25 percent may not be the best way to stop the spread of disease. To prevent outbreaks of measles, one of the most contagious diseases, at least 95 percent of school students need to be immunized, said Reingold.

“By having more students vaccinated, we help protect children, the schools, the staff, the families and their communities,” Leung said.