Schools consider impact of ending vaccination opt-outs

June 30, 2015

Updated June 30, 9:15 a.m.: Gov. Jerry Brown signed into law Tuesday the bill eliminating the personal belief exemption for vaccinating schoolchildren. In his signing message, Brown wrote, “The science is clear that vaccines dramatically protect children against a number of infectious and dangerous diseases.”

He continued, “While it’s true that no medical intervention is without risk, the evidence shows that immunization powerfully benefits and protects the community.”

In the pockets of California where hundreds and even thousands of kindergartners are not fully vaccinated, school districts are starting to think seriously about how a proposed law requiring vaccinations – which the Legislature approved Thursday –  could affect their enrollment and in turn, their funding.

The proposed law, Senate Bill 277, would end the state’s personal belief exemption for vaccinating schoolchildren, an opt-out practice that in a small number of schools and communities has become widespread. More than 13,500 California schoolchildren held a personal belief exemption in 2014-15, a relatively low number compared to the state’s overall kindergarten enrollment of more than 500,000, but a figure of public health and financial importance in some districts.

The bill, co-authored by Sen. Richard Pan, D-Sacramento, and Sen. Ben Allen, D-Santa Monica, passed the Senate May 14; the Assembly passed it Thursday. It will return to the Senate for approval of minor changes before heading to the desk of Gov. Jerry Brown.

“If it really does happen, it’s going to be wild up here,” said Sharyn Turner, coordinator of school health services at the Nevada County Office of Education.

If Brown signs the bill, parents will have three options for their kindergartners starting in fall 2016: obtain a medical exemption to vaccinations, enroll in homeschooling or independent study, or vaccinate.

“The school would be put in the position of saying, ‘I’m sorry. If you don’t provide the records, you are not going to be able to attend school,’ ” said Catherine Flores Martin, director of the California Immunization Coalition.

The law would apply to students in public schools, including charter schools, and private schools from transitional kindergarten through 12th grade. In addition, the law would require children in family day care, child care centers and preschools to be immunized. Students who hold a personal belief exemption before Jan. 1, 2016 will not have to provide proof of immunization until they move from preschool to transitional kindergarten or kindergarten or from 6th grade to 7th or if they change schools. The immunization requirement for entering 7th grade is the pertussis, or whooping cough, vaccination.

Perhaps no where would the choice be more pronounced than at the more than 40 Waldorf schools in the state, where students follow a pedagogy that emphasizes hands-on learning through art and movement and many families are like-minded in their refusal to fully vaccinate their children. Roughly half of the Waldorf schools in California are public charter schools and, like district public schools, are funded by the federal government and the state based on how many students are enrolled, known as average daily attendance. If those schools lost enrollment, their authorizing districts would lose funding.

At the Yuba River Charter School, a public Waldorf school in Nevada City, for instance, 70 percent of kindergartners in 2014-15 held personal belief exemptions to vaccinations. Those students wouldn’t be affected by the law until they reach 7th grade immunization requirements, but if their siblings or other families have the same aversion to vaccinations, it’s unknown how many would choose to leave the public school system and opt for homeschooling, said Sharyn Turner, coordinator of school health services at the Nevada County Office of Education.

Overall, Nevada County has the highest vaccine refusal rate in the state – 20 percent of kindergartners hold personal belief exemptions. The county’s student enrollment is 12,000, and if 20 percent decided to leave the school system, that would make a dent in an area that has faced declining enrollment, Turner said. And a change in the law would upend a way of life in a community of alternative medicine practitioners and ardent opponents to vaccination requirements.

“If it really does happen, it’s going to be wild up here,” Turner said.

“What we’ve heard from faculty and staff is that parents are in a big uproar,” said David Owen-Cruise, leader of administration for the Association of Waldorf Schools of North America, which represents private Waldorf schools.

“There are some folks in California that think we’re going to end up having to close the schools there, because there won’t be anyone enrolled,” he said. He added, “We don’t know what the outcome is going to be.”

If personal belief exemptions are eliminated, some families in Orange County — a region with schools such as the charter Journey School that have higher than average personal belief exemptions — may choose to enroll in a homeschooling program operated by the county office of education, the Community Home Education Program, said Dr. Marc Lerner, medical officer for the Orange County Office of Education.

Many counties offer similar independent study programs, and they appear to be exempt from the vaccination requirements under the bill as written, but the Orange County Office of Education would need to confirm that, Lerner said. If  independent study programs run by counties and districts are an option for unvaccinated students, “districts would still capture ADA (Average Daily Attendance)” funding, he said.

Teresa Fitzpatrick, president of the California Homeschool Network, said she was surprised that the organization had received in the last month only 10 phone calls from parents considering homeschooling their children in the event that personal belief exemptions are eliminated.

“The thing about homeschooling is it’s a huge commitment,” Fitzpatrick said. “It’s not a practical option for a lot of people.”

Mary Jane Burke, Marin County superintendent of schools, said she didn’t expect a change in public school enrollment, if the bill becomes law, and is continuing a public education campaign about vaccinations. “The decision to homeschool could potentially be more difficult to make than the decision to immunize their child,” Burke said.

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