Sept. 11, 2015

Several schools in the Willits Unified School District (WUSD) had low percentages of students fully up-to-date with their vaccinations in the 2014-2015 school year. With this year’s results expected in December or January, TWN found the district seemed unaware of any immunization issues.

On average, 85.67 percent of WUSD schools with available statistics were up-to-date on vaccines last year, spanning early childcare, kindergarten and 7th-grade, according to data released by the California Department of Public Health (CDPH).

 

The lowest were Brookside Elementary School kindergarteners, 76 percent of which were up-to-date, significantly less than the state average of 90.4 percent. That placed the program under the CDPH’s statewide “Most Vulnerable” category. Baechtel Grove Middle School in contrast had 95 percent of 7th-graders up-to-date, Brookside Preschool was 86 percent up-to-date and New Horizons Independent Study was 100 percent, the school said.

While WUSD’s schools have a small group of students with Personal Belief Exemptions (PBEs) and Permanent Medical Exemptions (PMEs), the majority of students not up-to-date came from Conditional Enrollments in Brookside’s kindergarten program. Twenty-one students, or 17 percent of the 123, were what’s called “Conditional Entrants” — students who do not meet all vaccination requirements, and must be followed-up with periodically. Until follow-up is complete, conditional entrants are considered under-vaccinated.

 

The California Code of Regulations section 6070 states, “The governing authority shall see that the immunization record of each pupil admitted conditionally is reviewed every 30 days until that pupil has received all the required immunizations.” According to district policy 5141.31, “if such documentation is not presented, the student shall be excluded from school until the required immunizations have been administered.”

However, TWN has learned of at least one student who was conditionally admitted to the kindergarten program that fell through the cracks for several years. The child still has not been fully vaccinated and is now attending Blosser Lane Elementary School. An unknown number of former conditionally admitted kids may still need to complete their vaccinations. About 43 kindergarteners were admitted to school on a conditional basis this school year.

 

The Centers for Disease Control have stated a 97 percent vaccination rate is needed to prevent the spread of measles in particular. Only 80 percent of Brookside Elementary School kindergarteners were up-to-date with MMR (measles, mumps, rubella) vaccines.

Sherwood School was among the schools whose data the Dept. of Public Health did not have listed, due to the low student population at the school. WUSD tracked the kindergarten class at 7 students last year. District employees were not able to produce immunization records from last year by press time.

 

Cynthia Carni, RN at Frank R. Howard Hospital and WUSD Board President, said there needed to be more education about immunizations in general.

“Generations before, we didn’t have the global experience and exchange as much as we do now,” she said. “It takes one persno to get infected.”

WUSD has been out of compliance for not having a credentialed school nurse for some time. One health coordinator has served the needs of the district’s 1,525 students (a hot-seat count of this year), providing screenings, medical attention and collecting and submitting immunization data. The first step on the salary schedule for WUSD’s health coordinators is $14.26 per hour.

 

A second health coordinator was recently hired, also a nurse, who was willing to go through the 3-5 year process of becoming that credentialed school nurse. WUSD Superintendent Pat Johnson said she was not aware there was a concern with the immunization levels at Brookside Elementary School, but thought the new health staff would help.

“We never wish to shirk our responsibility to the health and welfare of our students,” she said. “When we find there is a deficiency in our work, we need to fix that. Had I been aware of it, I would have taken measures last year.”

 

Johnson was confident through that the recent hires, which include three assistant health positions to be located at schools, would provide more support to immunizations and healthcare in general at the schools going forward. While the health assistants will have little capacity as medical professionals, they will be trained in CPR and first aid, and may help with paperwork like immunizations, she said. The jobs may evolve over time, she added, as needs are further identified.

Johnson said it was not the district’s responsibility to oversee immunizations — that’s something that should be handled at the school sites. If concerns arise, they should be reported to supervisors, who would then come to the district, she said. No plans are currently in place to provide further education and outreach to parents about immunizations. That’s outside of the regular 3-4 notices sent to parents throughout the year.

 

TWN spoke with several local healthcare providers following the measles outbreak late last December, who indicated concern at the level of vaccination rates in Willits schools. Willits dodged the Disney outbreak, which the CDC believes originated outside the U.S. and spread through unvaccinated individuals.

Carni added that Howard Hospital had done trainings in the past on what questions to ask people when coming to the ER with one of these diseases, especially measles.

“It’s such a communicable disease,” she said.

 

Senate Bill 277 was signed this year by Gov. Jerry Brown which removes the option for a Personal Belief Exemption after Jan. 1, 2016. Prior PBEs will remain valid until the student reaches the next immunization checkpoint (i.e. kindergarten or seventh-grade). For a student in 8th-12th grade, a previously-filed PBE will continue to be valid.

According to the Health and Human Services Agency (HHSA) for the county, districts are required and encouraged to file reports, but HHSA does not have the authority to penalize those who do not meet their requirements.

 

CDPH does not follow-up on conditional enrollments, except periodically for a sample of schools statewide. However, the California Department of Education has an audit procedure, which school districts originally send the immunization data to. Schools with a conditional admission rate greater than 25 percent may be audited, as well as other requirements with the Tdap vaccine in seventh-grade, and with measles in kindergarten.

This year’s data will be available in December or January, after schools report their vaccination results in October. Superintendent Pat Johnson said no students had been turned away from the elementary schools this year due to lack of vaccinations.

 

While the WUSD Board of Trustees approves the charters for Willits Elementary Charter School (WECS) and Willits Charter School (WCS), those schools submit reports on their own.

WECS had 74 percent students who were up-to-date last year, 17 of the 23 enrolled. Half the students who weren’t up-to-date were Conditional Entrants (13 percent, 3 students) and the same amount was true for those with PBEs. 83 percent had MMR vaccines.

WCS’s 7th-grade class, whose data was not reported in the CDPH data online, had 25 seventh-graders and 92 percent were up-to-date. 12 percent, or three students, had PBEs with one having a partial medical exemption.

 

La Vida Charter produced data for 2013-2014 after a TWN request for 2014-2015: 45 percent of students were up-to-date on immunizations, while 55 percent had PBEs.

Baechtel Grove Middle School again had 95 percent up-to-date (115/121), 5 percent (six students) with Personal Belief Exemptions, and no Conditional entrants. Brookside Elementary Preschool was 86 percent up-to-date (18/21 enrolled), 10 percent (two students) were Conditional entrants, 5 percent (one student) had a Personal Belief Exemption.

 

One district employee said they thought the complications in conditional enrollments came from a complicated system, especially for kindergarteners whose parents might register their student on the first day of school with promises to get further vaccinations later, sometimes falling under the conditional status.

Having conditional entrants is part of the system. Many kids are underage for vaccines come kindergarten or transitional kindergarten programs, where they start as young as four. However, another employee thought there was a lack of follow-through; while letters might go out to parents about their kids needing additional doses or other vaccinations for the conditional entrants, there is little staff time devoted to follow up.

http://www.willitsnews.com/general-news/20150911/low-vaccination-rates-little-response