While the benefits of vaccines in preventing certain diseases is well-documented, a growing number of parents in coastal Orange County school districts, including Laguna Beach and Newport-Mesa, are excluding their children from certain recommended immunizations via a provision in current California law.
Parents may opt their children out of immunizations for diseases such as polio and chicken pox by citing personal beliefs, according to a California School Immunization Record, a state-mandated form that is part of a student's permanent record.
There has been a recent downward trend in immunization rates for students in California, according to a report from the Orange County Health Care Agency.
From 2003 to 2012, the percentage of immunized kindergarten children in Orange County declined to 89.3% from 92.9% , the report stated. The rate is even lower in the Laguna Beach and Newport-Mesa unified school districts.
This option to opt out is putting others at risk, according to Assemblyman Richard Pan (D-Sacramento) who wrote a new law meant to change the trend.
"Exposure to these preventable diseases not only places the individual child at risk, but the entire community, including infants too young to be fully immunized and individuals with compromised immune systems, who are vulnerable to complications of vaccine-preventable diseases, including death," Pan wrote.
Pan's law, set to take effect in January, will require parents who wish to exempt their child from vaccinations to receive information from a licensed healthcare provider about the benefits and risks of vaccination and vaccine-preventable disease, and both parties must sign the form, according to a report from the Orange County Health Care Agency.
"This measure would rectify this problem by creating a process where parents would be able to make an informed decision for their children," Pan wrote.
Rates of Immunizations
Laguna Beach Unified School District had the second-lowest percentage of kindergarten students with up-to-date immunizations, 77.9%, among Orange County's 24 school districts, according to the Orange County Health Care Agency's 19th annual Report on the Conditions of Children in the county for 2013.
Newport-Mesa Unified School District had the third-lowest percentage at 83.2%, this year's report said. That's a drop from 2012's 88.6% vaccination rate for the district's kindergartners.
Only the Capistrano Unified School District, with 71% of kindergarten students immunized, had a lower percentage than Newport-Mesa and Laguna.
California is one of 20 states that allow parents to justify not vaccinating their children based on personal beliefs or religious beliefs. The other 30 states only allow parents to opt out of the process for religious reasons.
At Laguna's El Morro Elementary School, 45 of 67 kindergarten students had completed immunizations as of Nov. 1, while 62 of 79 kindergarten students at Top of the World Elementary had completed the recommended vaccines, according to statistics provided by Laguna Beach Unified nurse Pam Majd.
More students opting out of vaccines due to personal beliefs at Top of the World, 16, than El Morro, six, statistics showed.
Sixteen students had not met all vaccine requirements and had not signed a waiver at El Morro as of Nov. 1 while one student at Top of the World had not met the requirements or signed a waiver by that date.
Neither Laguna school had any students who opted out of immunizations through medical exemptions.
Majd and school administrators are following-up with parents to make sure they complete all immunizations, she said.
Why Refuse Vaccines?
Required vaccines — for students whose parents do not use exemptions — target polio; diphtheria, tetanus, and pertussis (whooping cough); measles, mumps and rubella (MMR); and hepatitis B and chicken pox (varicella), according to the state's immunization record.
Common reasons for vaccine delay or refusal include concerns about vaccine safety and side effects, along with beliefs and misperceptions that the risk of infection is low or that the diseases are not dangerous, according to Orange County Health Care Agency public information officer Tricia Landquist.
Students who waive immunizations can be excused from school in the event of an outbreak, Landquist wrote in an email.
Using chicken pox as an example, the county's health care agency — working with United States Centers for Disease Control guidelines — could recommend a child without up-to-date vaccines stay home from school for 21 days following the last reported rash of the disease at school, Landquist said.
Published research indicates that U.S. parents and caregivers who delay or refuse vaccines are more likely to have mid- to high-incomes and have higher education levels, according to Landquist. These demographics are consistent in areas in Orange County where vaccination rates are lower, she said.
Kindergartners aren't the only student segment vulnerable to certain diseases, health officials say.
Pertussis, better known as whooping cough, has increased statewide from last year, even with a requirement for students entering seventh grade to receive a vaccine booster called tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap), according to the report.
Orange County public and private schools reported 97% of students completed the whooping cough vaccine requirement this year.
At Laguna Beach's Thurston Middle School, 264 out of 294 students completed their pertussis vaccines while the remaining 30 declined, using the personal belief exemption, according to Majd's statistics.
Laguna Beach parent Cindy Cohn made sure her 8-year-old girl and 12-year-old boy were immunized.
"While I know there are some opposing views, I do keep my children up to date with vaccinations, and trust my pediatrician's expertise in this area," Cohn wrote in an email.
Laguna Beach Unified board member Theresa O'Hare also had her two sons, who are now 23 and 26, vaccinated.
"The short answer as to why they were vaccinated is based on the advice of our doctor," O'Hare wrote in an email. "The balance of benefit over risk made sense to us at the time. That said, some of the vaccines that have raised some issues more recently were never an issue for our two [sons]."
Costa Mesa parent Jesi Pearce made the decision not to vaccinate her sons after researching the potential side effects of the immunizations.
Her twin boys, who both attend Newport Harbor High School, were given a round of vaccinations when they were a few months old and did not respond well.
"They had high fevers and were vomiting," she said. "I did research on my own, and I was pretty much appalled at what I found out. To me, the pros of not vaccinating them more than doubled the pros of vaccinating."
Pearce said she's not concerned about her sons becoming ill as a consequence.
"A lot of those diseases we vaccinate against were bred in unsanitary conditions," she said. "We're very sanitary here, so outbreaks aren't likely to happen."Copyright © 2014, The Baltimore Sun