Californian Schools Face Audit for Low Vaccination Rates Among Kindergarten and Seventh Grade Students
Over 500 public schools in California are being audited by the state for allowing students to attend classes without complete vaccinations, risking loss of funding. The audit list, published by the California Department of Public Health, includes 450 schools with low kindergarten vaccination rates and 176 schools with low seventh-grade rates, with 56 schools appearing on both lists. Additionally, 39 schools failed to report vaccination data to the state.
"The schools that allow unvaccinated students to attend may be subject to loss of Average Daily Attendance payments for those children," said the California Department of Public Health via email.
Students with pending vaccinations or conditional admissions are not considered fully vaccinated, according to the state. Students in special education or with medical exemptions are not required to be vaccinated.
California law requires schools to report vaccination rates to the state each fall and check on those catching up on vaccinations at least every 30 days. If a student catching up on vaccinations does not receive a second dose of a vaccine within four months of the first dose, they must be excluded from school, according to a state audit guide.
After the elimination of personal belief exemptions, it was discovered that many schools were behind in their reports and allowing many conditional admissions without proper follow-up, said Catherine Flores Martin, director of the California Immunization Coalition.
Oakland Unified Schools Dominate Audit List
More than half of Oakland Unified’s 48 elementary schools and eight of its seventh-grade schools are on the 2022-23 audit list. This includes Markham Elementary, where 65% of 66 kindergarten students were not fully vaccinated last year, the highest percentage in traditional public schools in California with over 20 students. Twelve of the 27 Oakland Unified elementary schools on the list had over 20% of their kindergarten students without all required vaccinations last year.
John Sasaki, spokesperson for Oakland Unified, did not comment on the 2022-23 audit list at the time of publication. Previously, he told EdSource that lower vaccination rates in some schools in 2021-22 were partly due to difficulties families faced in scheduling medical appointments during the pandemic and a delay in the district’s vaccination registration.
The Bay Area district is not the only large school district struggling with full student vaccinations, according to state data. Los Angeles Unified has 75 of its non-charter schools on the audit list, along with Pomona Unified (13), San Francisco Unified (14), and San Juan Unified in Sacramento County (8).
Pandemic’s Impact on School Vaccination Rates
The state’s vaccination rate, which had steadily grown since the elimination of personal belief exemptions in 2015, dropped in the months following school closures due to the COVID-19 pandemic. Thousands of California students could not begin the 2022 school year without their vaccinations.
The state did not relax vaccination requirements during school closures, but not all school officials cooperated with the requirements, said Martin. She is unsure if this has changed.
"Some schools may be out of practice, and in some areas, their leadership has changed, and it’s not a priority," she said.
The kindergarten vaccination rate in the state was 92.8% in 2020, down from 95% in 2018. Districts sent vaccination information home and organized vaccination clinics, helping to regain ground. By 2021, the vaccination rate had risen to 94%.
Since the 2021-22 school year, vaccination audits have been part of the state’s annual financial and compliance audit of public schools. In 2021-22, the vaccination audit found that 45 school districts did not meet state vaccination requirements, with 17 reviewed further for potentially allowing students to attend school without vaccinations, said Scott Roark, spokesperson for the California Department of Education.
Schools found in violation of state law must submit corrected attendance reports, likely reducing their funding, said Roark.
Parents do not have to vaccinate their children, but according to the law, children must be vaccinated against 10 serious infectious diseases to attend public or private schools and childcare centers.
Legislation and Vaccine Hesitancy
California has required school vaccinations for decades, but recent legislation has made them harder to avoid.
- Senate Bill 277: A 2015 measles outbreak linked to a Disneyland case led legislators to pass a law eliminating personal and religious belief vaccine exemptions.
- Senate Bills 714 and 276: These bills require the review of medical exemptions in schools with vaccination rates below 95% or where a doctor has written more than five medical exemptions in a year.
Some parents opposed to vaccines have found few options for their children as California laws have become more restrictive. Some have chosen to home-school their children or seek independent or virtual study options, mainly provided by charter schools. Students learning from home without any in-person instruction or school-related activities are not required to be vaccinated.
Of California’s 1,300 charter schools, 67 are on the 2022-23 audit list. Agnes J. Johnson Charter School in Humboldt County had the highest percentage of kindergarten students not fully vaccinated last year, with 90% of 11 kindergarten students still needing at least one vaccine. Mountain Home Charter in Oakhurst had the second-highest percentage, at 83%, followed by Gorman Learning Center at 76%, serving 140 kindergarten students in San Bernardino and Santa Clarita areas.
Gateway Community Charters has been working to improve vaccination rates at Reach Community Academy by partnering with a nearby medical provider to offer vaccination clinics and having a nurse on-site daily. Despite these efforts, nearly a third of the 219 kindergarten students at Reach Community Academy were reported as behind on vaccinations last fall.
Vaccine hesitancy has contributed to lower vaccination rates across the country and has caused outbreaks of infectious diseases, including measles outbreaks in Disneyland in 2015 and Ohio in 2018. Last year, there were 121 reported measles cases, up from 49 cases in 2021, according to the Centers for Disease Control and Prevention.
A UNICEF report published in April shows that 67 million children worldwide missed one or more vaccinations between 2019 and 2021 due to strained health systems, scarce resources, conflicts, and a decrease in vaccine confidence. The report states that while overall support for vaccines remains strong, vaccine hesitancy appears to be growing.
Bernardo Lafuente is not worried about his son, Gavril, contracting measles or other childhood diseases. He doesn’t trust reports of outbreaks.
"I don’t believe what they’re saying. I don’t see an epidemic. I haven’t seen anyone with measles or Smallpox; they’re practically non-existent in America," he said.
Lafuente and his family left California in 2018, partly due to vaccine requirements, and moved to Nevada, where vaccines are not required for school attendance.
"The government in Nevada promotes vaccination for everyone, but in Nevada, we have a choice," he said.
Gavril, now in fifth grade, received some vaccines when he was younger, but his father established a different vaccination schedule instead of the one recommended by the CDC. He has no plans for Gavril to receive more vaccines.
"He’s vaccinated except for the boosters. I’m not against vaccines if someone else wants to get them. Personally, I’m against vaccines. I don’t think everyone should get vaccinated, unless there’s an outbreak, but even then, it should be a choice," Lafuente said.
Low Vaccination Points Found in Most Districts
Even districts with high overall vaccination rates often have schools with low enough vaccination rates to be on the audit list. In 2021, the last year general student vaccination rates were available, 95% of Sacramento City Unified students were fully vaccinated. However, the district had eight schools on the 2022-23 audit list.
"We encourage everyone to get vaccinated," said Susan Sivils, chief nurse at the Sacramento City Unified vaccine clinic. "If they object for some reason, we follow up. The vast majority of people don’t object to getting their vaccines."
The district is working to increase its vaccination rates with weekly free vaccine clinics throughout the year and two weeks of clinics before the school year begins. Last year, the district increased the number of vaccine clinics and called parents directly to inform them about the vaccine requirement and clinics.
Cecilia Reyes and her older sister Chzaray waited nervously for their turn at a vaccine clinic at the district headquarters on August 22. Cecilia was preparing for her first day of kindergarten, but this would be her first time receiving a vaccine. The COVID-19 pandemic prevented the family from obtaining necessary appointments, said their mother. Chzaray, entering seventh grade, needed four vaccines to be up-to-date. The sisters may need multiple appointments before they are fully vaccinated.
The Sacramento City Unified vaccine clinic vaccinated around 50 students that day in preparation for the first day of classes. The number of students visiting the district’s vaccine clinic increased from 1,154 in 2021-22 to 1,739 visits last year, said Sivils. Students without insurance or on Medi-Cal qualify for the clinic.
Damien Burkholder blinked back tears as a nurse administered his Tdap booster last Tuesday. The vaccine is required for all seventh-grade students. His mother watched as the nurse placed the band-aid on his arm.
As schools face audits and parents grapple with vaccine requirements, California continues to monitor vaccination rates and work to ensure that students are protected against preventable diseases.
