After a measles outbreak in 2013, California lawmakers passed a series of new laws that put restrictions on the number of children who could be exempted from vaccinations. They also launched an education campaign among staff at kindergartens.
Those efforts appear to have worked - in part.
A new study released today by the Journal of the American Medical Association shows that California’s efforts dramatically reduced the rate of kindergartners without their required vaccinations. The share of students without up-to-date vaccines decreased from nearly 10 percent in 2013 to nearly 5 percent in 2017 after three legislative interventions in California, researchers found.
The JAMA study is of particular relevance now as the U.S. sees measles cases rise to levels not seen in more than a decade. California now is confronting the rapid rise of potentially fraudulent medical exemptions that have allowed some children to escape vaccinations.
Meanwhile, the state is not done clamping down on parents who don’t vaccinate their children. Gov. Gavin Newsom is expected to sign a bill soon that would tighten rules again, requiring stricter monitoring of doctors who approve high numbers of medical exemptions — the fourth major legislative effort to increase the numbers of vaccinated children.
In 2014, the state required parents to submit proof they had discussed the risks of not vaccinating their children with a doctor before obtaining an exemption. A year later, the California Department of Public Health began a campaign to educate school staff about “conditional admission” of kindergarten students, which effectively gave parents more time to catch up on vaccinations. And in 2016, the state banned all personal belief exemptions.
Now, the new offers a unique window into those past efforts in California.
“We felt it was important to take a systematic look at these interventions and examine if public health initiatives such as these are working to improve vaccination rates,” said Cassandra Pingali, who was the report’s lead author and a fellow with the Centers for Disease Control and Prevention in Atlanta. “How vaccine-hesitant parents will react to new interventions to increase vaccine uptake is not a foregone conclusion.”
Researchers examined school-level vaccination data for kindergartners collected between 2000 and 2017. During that time, more than 9 million children started school and more than 720,000 entered school without required vaccinations.
About 2 percent of the kindergartners who entered school in 2017 without up to date immunization records were conditionally admitted, according to the study.
They also conducted an analysis to identify clusters of children without current vaccinations. Many of the schools were in Northern California, researchers found.
The state’s success in improving vaccination rates after an outbreak at Disneyland six years ago has been widely lauded. However, five years after the personal belief exemption was repealed the state has seen a remarkable uptick in the number of medical exemptions granted leading some to call out doctors for alleged fraud.
State Sen. Dr. Richard Pan, D-Sacramento, faults opportunistic physicians who are “preying on parents’ fears and anxiety” and the wealth of “misinformation” questioning the safety of vaccines. “Legislation is an import element but it can’t be the only thing we do,” said state Sen. Richard Pan.
“The reason people are seeking doctors is because there is information that leads them to do it.” Pan, who authored the latest bill, SB 276, said the state also needs to combat false narratives with more outreach, too.