Measles outbreak: Bay Area day cares show high rates of unvaccinated kids

Vaccines are ready to be administered at the Family Justice Center clinic in Oakland, California. According to health officials, diseases such as measles, chicken pox and others are making a comeback. (Jane Tyska/Bay Area News Group)

This article originally appeared in the San Jose Mercury News and other Bay Area Newsgroup Newspapers.

As new measles cases continue to surface every week, Bay Area parents are still on high alert. While much of the recent attention has focused on kindergartners who aren't fully immunized, preschools and day cares may also be beds of infection, state data show. 

In Santa Clara County, 12 percent of preschoolers and day care kids 2 and older were not up-to-date on their shots at the beginning of this school year. In Alameda County, more than 9 percent of preschoolers were not fully immunized, and some reports from individual preschools showed far higher rates of under-vaccinated children.

Statewide, only 89.4 percent of kids at child care facilities were fully immunized when they started last fall. That's below the U.S. Centers for Disease Control and Prevention's recommended vaccination rate of 92-95 percent to create "herd immunity," which experts say protects a community from infectious diseases.

In addition, the 89.4 percent figure reflects only schools that reported their rates. Statewide, 12 percent of child care facilities failed to submit their required reports last fall.

By the time a child is 18 months old, he or she should have received three doses of the polio vaccine, four doses against whooping cough, one dose of the MMR (measles, mumps and rubella) vaccine, one dose of Hib, three doses for hepatitis B and one dose against chickenpox. While day cares and preschools may admit younger children, the state immunization data counts only those between the ages of 2 and 4 years, 11 months.

Four Alameda County schools — a Fremont KinderCare Learning Center, Precious Time Christian Preschool, Valley Christian Preschool and Peace Terrace Academy — reported that none of their children was completely up-to-date on required immunizations as of the start of this school year. 

Countywide, 7.55 percent of Alameda County's preschool kids were undervaccinated, entering school as "conditional entrants," with immunizations started but not completed. And that does not include an additional 1.71 percent of county preschoolers who were unvaccinated because their parents sought "personal belief exemptions," or the 0.39percent of kids with medical exemptions.

In Santa Clara County, 9.42 percent of preschoolers started the school year as conditional entrants, 2.06 percent were unvaccinated due to personal belief exemptions, and 0.45 percent were unvaccinated because of permanent medical exemptions.

Santa Cruz County, long a hotbed of parents who refuse to vaccinate their children, stands out with 23 percent of its preschoolers and day care kids lacking complete immunizations. St. Andrew's Preschool reported just one of its 18 students with complete vaccinations at the start of this school year, while at Montessori Scotts Valley, only four of its 29 students were vaccination-compliant. At Santa Cruz Toddler Care Center, two of its 11 students were up-to-date.

Statewide, 7.40 percent of preschoolers started the year as "conditional entrants."

"Seeing some with such high rates says to me it's an education and training issue more than anything," said Amy Pine, director of the immunization program for the Alameda County Public Health Department. "When you become a child care provider, you are given a list of requirements that you have to fulfill that include 'check immunization records,' but you're not necessarily trained in how to fulfill those requirements." 

Pine has made it her mission to bring up immunization rates in Alameda County. She's focusing specifically on the high number of "conditional entrants" in kindergarten, helping schools to follow up with kids whose shots are due. 

Students may enter school on a conditional basis if they have received at least one dose of each required vaccination and are not yet due for subsequent doses. The condition is that they get up-to-date as soon as the shots are due.

A Southern California lawmaker this week introduced a bill that would require all child care and preschool workers to get vaccinated against measles, pertussis, influenza and other diseases.

"We must do everything in our power to protect California's children who spend time in day care," Sen. Tony Mendoza (D-Artesia) said.

In addition to these high rates of unimmunized and underimmunized kids, some Bay Area preschools did not even submit the mandated report to the California Department of Public Health in the fall. In fact, more than 10 percent of facilities in both Alameda and Santa Clara counties did not submit a report at all. 

Those schools will have to wait until the next school year to correct the record. 

"There is not a way for them to submit their information to the state once all of the deadlines have passed," Pine said. "All that we did this year was instruct them that this is their obligation and they must submit the information next year."

To motivate schools to report, Pine hopes the state will change the designation from "did not report" to "noncompliant."

Still, the state has no teeth to force child care facilities and preschools to report their vaccination rates.

The California Department of Public Health "does not have enforcement authority over these state statutes and regulations," Dr. Gil Chavez, deputy director of the department, said. Instead, he said, the department notifies the state Department of Social Services of the child care facilities that fail to submit reports and then notifies those facilities that the Department of Public Health has reported them.

Palo Alto parent Leah Russin said she signed up her 17-month-old son on Thursday for a drop-in play group offered by Parents Place in Palo Alto now that it is requesting that all toddlers and preschoolers be up-to-date with their vaccines. 

"Some day cares and preschools have terrifyingly low vaccination rates," said Russin, 40, adding that in order for her son to be safe from vaccine-preventable diseases, he has to be up-to-date with his shots, as does the rest of her family and the greater community.

"The Parents Place policy makes me feel much safer bringing my child there to play and learn," said Russin, a former attorney who is now a stay-at-home mom.

"I hope more places adopt similar policies because, as a mother, I want to take my child to a park, a music class or a play date and provide him with opportunities for growth and friendship, not opportunities to catch vaccine-preventable illnesses."

San Jose Mercury News staff writer Tracy Seipel contributed to this report.


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Lauren M. Whaley

Freelance journalist Lauren M. Whaley is a photographer, radio producer and print reporter specializing in topics related to mental illness, reproductive health care and health disparities. She is also a childbirth photographer.This year, She is working on a series about how low-income parents access care for perinatal mental illnesses. The project is funded in part by the Rosalynn Carter Fellowships for Mental Health Journalism.She was a 2016-17 Knight Science Journalism Fellow at the Massachusetts Institute for Technology.Her work has been recognized by the Association of Health Care Journalists, the Scripps Howard Foundation and the Public Radio Exchange (PRX) STEM story project. She has contributed radio, video, photography and written stories to KQED Public Radio, Southern California Public Radio, the San Jose Mercury News, the New York Times and other media outlets. For six years, she worked as the Center for Health Reporting's multimedia journalist. She is a past president of the national organizationJournalism and Women Symposium (JAWS) and spent her early 20s leading canoe expeditions for young women, including a solo-led 45-trip in the Canadian Arctic. She is based in Los Angeles.

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