A growing number of Sacramento-area children are starting school without getting vaccinated, a practice that Sacramento County Public Health Officer Olivia Kasirye says puts the community at risk.
The trend, which is echoed statewide, is particularly pronounced among the wealthy and those who send their children to Waldorf schools.
The number of kindergartners in the four-county region with "personal-belief exemptions" which allow them to skip a state-required vaccination increased by 34 percent during the past four years, from 884 to 1,197, according to the state Department of Public Health.
That's similar to the 37 percent increase in waivers statewide over the same period.
Kasirye said fewer parents are vaccinating their children because of misinformation on adverse affects, and because disease rates are so low they don't realize there is a risk.
Large groups of unimmunized people put the community in danger of an outbreak like the recent measles outbreaks in Europe, she said.
Leaders of a growing movement against vaccination disagree. They contend that shots contain dangerous ingredients and may cause autism, Crohn's disease and cancer, among other things.
People are scared, said Michelle Gutierrez, co-director of the National Vaccine Information Center an organization skeptical of vaccines. "There are bomb blasts of all these vaccines and kids are getting sick."
Many Sacramento-area parents apparently are questioning the safety of vaccines, particularly those with students in charter and private schools.
Parents of about 4 percent of kindergartners in the four-county region exempted their children from otherwise-required vaccinations last school year by filing objections based on personal beliefs.
But at roughly 50 schools, at least triple that rate of kindergartner parents chose not to vaccinate their children, according to a Bee review of data from the state Department of Public Health.
The 50 schools are mostly located in wealthier parts of the region. Parents in Placer and El Dorado counties were twice as likely not to vaccinate their children as Sacramento County parents, according to state records. Students at these schools represent less than 10 percent of the kindergartners in the region, but roughly 50 percent of kindergartners who lack vaccinations.
The highest rates of unvaccinated kindergartners can be found at the region's mostly private Waldorf schools, where more than 40 percent of students have not been immunized.
Camellia Waldorf School, a private school in Sacramento, has the highest percentage of unvaccinated kindergartners. Seventy percent of the school's kindergartners do not have the generally required immunizations.
Waldorf schools usually take no official position on vaccination, saying it is a matter of personal choice.
Camellia Waldorf school board president Tim Takagi said he is not aware of any pressure on families not to vaccinate. He believes many of the parents at the school choose not to immunize because of literature popular among Waldorf families.
Some parents rely on "herd immunity" to protect their children, said Takagi, who is a physician. They believe their children don't need to be vaccinated because most other children are immunized.
"Lower social economic groups don't immunize because they don't have access," Takagi said. "In the high social economic groups they just don't believe the data."
"It ends up becoming part of the culture," he said.
Takagi and his wife, who is also a doctor, have immunized their children and don't believe that immunizations are dangerous.
He doesn't try to talk parents at the school into immunizing their children. "It's a personal choice, whatever they want to do," Takagi said. "The only thing I've ever asked within the community is to be respectful of what it means for people that do and those who don't."
Among public schools, the highest rates of unvaccinated students are at charter schools, including Community Outreach Academy in North Highlands, where nearly 60 percent of students lack vaccinations. The school serves a largely Eastern European population.
In 2014, it will be more more difficult for families to opt out of vaccinations. Gov. Jerry Brown in September signed AB 2109, which requires parents to first get a signed document from a doctor saying they have received information about the risks and benefits of vaccines.
The bill, which goes into effect in 2014, will exempt parents who choose not to vaccinate because of religious beliefs.
The National Vaccine Information Center is among a number of groups battling such vaccination legislation. Gutierrez complained that AB 2109 could force a parent to schedule a doctor's appointment and take time off work, with no guarantee of obtaining the required signature.
"People are scared," Gutierrez said. "Politicians are pushing these laws backed by pharmaceutical companies."
But Kasirye, the county health officer, said parents are potentially affecting more children than just their own when they choose to skip the shots. She said an unvaccinated child puts others at risk of infection. "There are certain children who aren't able to get immunized because their immune systems are compromised from diseases like cancer," Kasirye said. "The only protection these children have is the protection given by the community."
Also at risk are adults who haven't had booster shots to update immunizations. Adults actually get harsher forms of diseases that can have severe complications, she said.
If an outbreak is identified at a school, the county health department can take children out of school who aren't up to date on their shots, Kasirye said.
These children could be excluded from school until the incubation period for the disease expires, she said.
"Parents don't realize when they are signing those waivers that their students could be excluded from school for as much as a month if we get into a situation like that," she said.