Cash-strapped school districts are grappling with the potential loss of funding for students sent home for not having a state- mandated whooping cough vaccination or exemption on file.
Many students still haven't gotten their shots on time, and their districts are at risk of losing aid.
Some districts are sending unvaccinated students home as the law states, and some are allowing them to attend classes even without the shots.
The question is: Will the state pay school districts for any unvaccinated student?
Natomas Unified was so concerned that it sent officials and a nurse door-to-door Friday to dozens of students' homes in hopes of getting them vaccinated.
School districts have 30 days from the first day of school to have proof that each seventh- through 12th-grade student received a whooping cough vaccination. Parents can file an exemption based on personal beliefs or a medical reason.
"The law is clear: Unvaccinated students are not supposed to be in school," said Tina Jung, spokeswoman for the California Department of Education.
But Jung said that doesn't mean that the state will penalize districts that allow students to attend classes without the vaccinations. "Our job is to educate children, not punish schools," Jung said.
The department is trying to decide whether to distribute money in those situations, Jung said.
Natomas Unified, Folsom Cordova Unified and Twin Rivers Unified each have allowed unvaccinated students on campus after their 30-day extension passed.
Natomas Unified officials said unvaccinated students were told to report to the school gym after their deadline passed Sept. 19. On Friday, the district sent a nurse to try to administer shots to some of the 51 noncompliant students. By Monday, Natomas Unified reported that 35 students still had not received the vaccine.
Twin Rivers allowed students to remain in class after their Sept. 12 deadline passed. Spokeswoman Trinette Marquis said unvaccinated students will be pulled from class twice and sent home with reminders before being excluded.
"We have another layer we are implementing before we have kids start missing school," Marquis said.
At Grant Union High School alone, Marquis said 1,450 students are not in compliance with the law, while 640 have turned in the required paperwork.
Marquis said the district has contacted the county about having a vaccination clinic at Grant.
Lawmakers passed legislation last year requiring a whooping cough, or pertussis, vaccination as the disease reached epidemic proportions and resulted in the death of 10 infants. Reported cases of whooping cough have dropped significantly since last year's outbreak, and no deaths have been reported in the state this year.
"The vaccinations have made an impact," said school nurse Dawn Fox, who is acting director of health services at Sacramento City Unified. "This has been making a difference."
Fox said Sacramento City Unified has been making steady progress. Currently, 80 percent of seventh-through 12th-graders are vaccinated or have an exemption on file.
"That still leaves about 4,000 students needing the vaccine," Fox said.
Because Sacramento City Unified's school year started later than the others in the area, its deadline is next week.
The new vaccine requirement is met by having a Tdap (tetanus/diphtheria/pertussis) booster shot on or after a student's seventh birthday. A student's shot record or an exemption must be turned in to a school or district office. The Tdap booster is covered by most health insurance, and school districts have held free clinics for families without coverage.
Elk Grove Unified has not allowed unvaccinated students on campus since its deadline passed two weeks ago. District spokeswoman Elizabeth Graswich said 21 students remain excluded.
At Folsom Cordova, which is not excluding students, there were 3,210 students without a vaccination or exemption on file as of Thursday. District spokesman Stephen Nichols said two more free clinics will be held this week.
At San Juan Unified, 562 students were sent home on Monday, the first school day after the district's deadline. District spokesman Trent Allen said 97.5 percent of the district's students are in compliance and the number of unvaccinated or exempt students has been decreasing steadily.
"It's not the best financial times for schools to take a hit to attendance rates," Allen said. "Our biggest concern is getting students back in classrooms with teachers."
Allen said San Juan looked at how other districts have handled noncompliant students and decided it was best to send them home.
"It is a health concern," Allen said. "We all have the same interest of keeping students in school to learn. We decided the letter of the law was the way to go."
KCRA: Many parents opting out of vaccines - Sept. 26, 2011
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