California Schools Face Renewed Scrutiny as Vaccination Rates Dip and CDC Guidance Shifts
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California is auditing 428 public schools due to lagging vaccination rates among students, a response to a national resurgence in measles cases and evolving federal health policies. The state’s Department of Public Health identified these schools because more than 10% of kindergartners or seventh graders were not fully vaccinated during the last academic year, with 34 schools in Oakland Unified School District included on the list. An additional 80 schools failed to report their vaccination data to the state.
The increased focus on vaccination comes as the nation grapples with a rise in preventable diseases. In 2023, the U.S. recorded 2,255 measles cases – the highest total since the 1990s – and California reported 25 cases. A recent case in Napa County involved an unvaccinated student exposed to the virus during a trip to South Carolina, highlighting the ongoing risk.
While the number of schools under audit is lower than in the previous two years, 110 have appeared on the list for at least three consecutive years, indicating persistent challenges in achieving full immunization coverage. However, a slight decline in the number of audited schools doesn’t necessarily signal improved vaccination rates. Data from 2023-24 reveals that kindergarten vaccination rates dropped nearly half a percentage point to 93.7%, the most recent data available.
“California’s still in a good place in terms of the protections that we have,” said Catherine Flores Martin, executive director of the California Immunization Coalition. “A dip in California can be a couple hundred students, and that’s a lot of students, but compared to the rest of the nation we are ahead.”
Oakland Schools Under the Microscope
Oakland Unified School District is particularly affected, with 28 of its 53 elementary schools and six of its 11 middle schools facing state audits. Elmhurst United Middle School leads the list, with 63% of its 246 seventh-grade students still needing some form of vaccination.
School districts found non-compliant with state immunization regulations risk losing state funding, specifically average daily attendance (ADA) funding for unvaccinated students. “If an LEA (local education agency) continues to remain out of compliance, they will continue to receive audit findings and face the associated ADA and funding loss,” explained Scott Roark, a spokesperson for the California Department of Education, in an email. Districts are required to develop corrective action plans to address deficiencies and prevent future occurrences.
Despite these potential financial penalties, Oakland Unified has not yet lost ADA funding despite 14 elementary and four middle schools being on the audit list for three years. The district proactively reviews immunization records each summer and contacts families of students needing vaccines, providing information on access points. Oakland Unified has partnered with the Alameda County Public Health Department to offer on-site vaccination clinics and back-to-school events.
Progress is being made, with 12 Oakland schools that were previously on the audit list for three years now showing improved vaccination rates. Markham Elementary stands out, increasing its kindergarten vaccination rate from 65.2% lacking vaccinations in 2023 to 26.5% under-vaccinated last school year.
Required Vaccinations and State Regulations
California law mandates that children receive immunizations against 10 serious communicable diseases – diphtheria, Haemophilus influenzae type B (bacterial meningitis), measles, mumps, pertussis (whooping cough), polio, rubella, tetanus, hepatitis B, and chickenpox – to attend public or private schools and childcare centers. Studies have consistently linked clusters of unvaccinated children to outbreaks of measles, pertussis, and varicella. Proof of immunization is required upon entering kindergarten, seventh grade, childcare, transitional kindergarten, or when transferring from out-of-state schools.
The state offers exemptions for students in special education, home-based private schools, and those with medical exemptions. Since 2015, medical exemptions have been subject to increased oversight, requiring review by the California Department of Public Health for schools with immunization rates below 95% or if a physician has written more than five exemptions in a year. California is one of only four states – alongside Connecticut, Maine, and New York – that do not allow personal belief exemptions from school vaccination requirements.
National Trends and CDC Guidance
The situation in California mirrors a national trend of declining vaccination rates, fueled by vaccine hesitancy exacerbated by the COVID-19 pandemic. Adding to the concern, a recent decision by the Centers for Disease Control and Prevention (CDC) to de-emphasize certain vaccines could further reduce immunization rates.
Earlier this month, the CDC rolled back its recommendation for universal vaccination against the flu, hepatitis A, meningococcal disease, rotavirus, and RSV, suggesting these vaccines only for high-risk children or those whose parents consult a doctor. Similar scaling back of recommendations occurred last year for the COVID and hepatitis B vaccines for infants.
While this CDC decision does not directly impact California’s school vaccination requirements, Flores Martin of the California Immunization Coalition fears it could lead to more students falling behind on vaccinations. “Even though parents may not be in agreement with this administration, I think it’s still planting doubt, or it’s still planting concern in people’s minds,” she said. Many parents are confused by conflicting information and delay vaccination decisions. The California Department of Public Health now recommends parents follow the American Academy of Pediatrics vaccination schedule.
Despite challenges, Flores Martin remains optimistic. “I think there are still parents that are working hard to avoid vaccination,” she said. “But once children are enrolled in public school or day care, they don’t have that many options in California. They have to vaccinate.”
