Ouch! That Hurts

Laguna’s immunization rate remains the county’s lowest

Vaccination rates in all Orange County school districts increased markedly since a state law eliminating personal exemptions took effect last July, but more unvaccinated students are enrolled in the Laguna Beach district than any other in the county, says a report released this week.

In Laguna, the immunization rate rose to 86.5 percent in the current school year, compared to 71.1 percent in 2013-14, but remains below the recommended herd immunity threshold, says the report based on figures from the county Health Care Agency and state Department of Public Health.

The Centers for Disease Control considers a 92-94 percent immunization rate as necessary to achieve herd immunity to prevent the spread of disease.

Currently, 241 students out of a total enrollment of 2,992 students in Laguna’s four public schools have personal belief exemptions for childhood vaccinations, district spokeswoman Leisa Winston said. At the high school, 87 students sought exemptions; 38 are unvaccinated at the middle school, 61 at El Morro and 55 at Top of the World, she said.

“We have a large number of grandfathered personal exemptions and we have no authority to require these students to vaccinate,” Superintendent Jason Viloria said in a statement. “As these students move through our system, the levels of personal exemptions will drop off and our rates will continue to improve.”

He pointed out that district staff developed an outreach effort and internal controls to make families aware of the requirements under Senate Bill 277, which eliminated personal belief exemptions for mandatory vaccinations. The only exception now allowed is for medical reasons, such as those who are immune compromised or allergic to various vaccine components.

In March, an unvaccinated Laguna Beach High School student contracted measles, then only the second occurrence of the now rarely reported illness in the county.

Communicable disease experts imposed a quarantine on a handful of unvaccinated schoolmates that could have had contact with the measles-infected student, barring their attendance and instructing them to stay home until April 18.

School officials said seven students were initially excluded, though one produced proof of vaccination and was permitted to return. “We are fortunate that the one case did not result in further spread,” Winston said this week.

A known contact of the LBHS student who was also unvaccinated tested positive, but was already under quarantine and has not exposed others, OC Health Care Agency spokeswoman Jessica Good also said this week.

In the experience of Sarah Durand, PTA president at Top of the World Elementary, the topic was debated most among parents of preschoolers and the decisions of anti-immunization parents were often influenced by the stance of their pediatricians.

Laguna’s lower vaccination rate, she suggested, might be tied to affluent parents more likely to question conventions of western medicine. “We have a lot of challengers,” she said.

In a 2015 survey of 1,000 Canadian parents, 92 percent considered vaccines safe and effective, but 28 percent expressed uncertainty about a link between vaccines and autism, 27 percent worry that vaccines can harm their children, and 33 percent think drug makers are behind mandatory vaccinations. Findings were published in “Vaccine Hesitancy,” an article on the National Institutes of Health website.

The county grand jury report released Monday, May 15, shows that since the law was passed in June 2015, enacted after a measles outbreak at Disneyland that winter, districts have made use of staff, direct mail and other outreach methods to educate vaccine hesitant parents.

In Laguna, prior to the first day of school, lists are compiled at each school of students and the vaccinations they have yet to receive and dates that missing doses are due, Winston said. Each month, a district nurse evaluates the list and notifies parents by phone of upcoming vaccination dates, she said. If proof of vaccination isn’t provided within 10 days, the student is excluded from class. The nurse also runs a quarterly check district wide to ensure that vaccinations by newly enrolled students are current, Winston said.

Kindergarten enrollment forms require parents provide proof their children received multiple doses of six childhood vaccines: polio, chickenpox, hepatitis B and the combination vaccines for measles, mumps and rubella and diphtheria, tetanus and pertussis.

While not included in the grand jury report, the current school year kindergarten vaccination rate at Laguna’s largest private school, Anneliese Schools, is 94 percent, according to immunization rates available on the state Department of Public Health website.

Although the tightening of vaccination requirements for all California schools was predicted to be troublesome, it proved to be the opposite, according to the grand jury’s findings. While some suggested the law could impact public school enrollment and lead to more home schooling, student enrollment remained essentially unchanged, the report says. That was also true in Laguna, Winston said.

Source: Orange County Grand Jury Report, “Ouch! Now That Didn’t Hurt”