As California imposes strict immunization requirements this year, two Sacramento County school districts say they do not know how many students have all of their required vaccines.
The problem at Sacramento City Unified and San Juan Unified school districts largely has to do with students out of compliance when they enrolled in kindergarten or seventh grade. Schools can enroll such students on a conditional basis, although they must keep checking on compliance.
Officials at Sacramento City Unified and San Juan Unified school districts told The Sacramento Bee they have not consistently tracked student vaccinations at the district level. The two large districts rely heavily on school-level staff to keep records, and they say getting an accurate count would require sifting through each student’s file at schools.
That doesn’t mean that every child without a complete record of immunization in the district system isn’t immunized, said Gabe Ross, spokesman for Sacramento City Unified, which has 46,868 students. Sometimes students get the shots, but parents don’t bring in the paperwork. In other cases, school clerks put the information into student files at campus offices instead of into the district’s computerized student information system, said officials from both districts.
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The information “is not nearly as accurate as it should or could have been,” said Dominic Covello, program manager of pupil personnel services for San Juan Unified, a district of 49,114 students. “The information is in the student information system, but not necessarily the follow-up.”
The districts instead have focused on gathering kindergarten and seventh-grade vaccination numbers, which must be reported annually to the California Department of Public Health.
“Any students who fell out of compliance between those two thresholds were typically addressed when they enrolled in seventh grade,” said Kim Minugh, San Juan Unified spokeswoman.
School districts are required to maintain immunization records and to report the immunization status of students entering kindergarten or seventh grade, but they also are required to check the record of those catching up on their immunizations at least every 30 days, according to Carlos Villatoro, a spokesman for the California Department of Public Health.
Immunizations have been required in California schools since 1962, starting with the polio vaccine, according to the California Department of Public Health. School districts were first required to track student immunizations in 1978.
Mandating vaccinations has been a hotly debated topic in recent years as vaccination rates fell statewide, but a measles outbreak tied to a case at Disneyland last year prompted lawmakers to impose stricter requirements. After months of heated debate that drew hundreds of activists to the Capitol, the Legislature passed Senate Bill 277 last year eliminating personal and religious exemptions for students who enter school after July 1.
Officials at both Elk Grove Unified and Twin Rivers Unified say they can account for the immunization status of all their students.
“I know instances when kids will be pulled because of immunizations,” said Xanthi Pinkerton, district spokeswoman for Elk Grove Unified, the area’s largest district with 62,888 students. “We monitor it regularly. Everyone is accounted for.”
Elk Grove district nurses track student vaccinations and email the parents of students who are nearing noncompliance to remind them about the looming deadline, she said.
SB 277 honors personal belief exemptions filed before 2016 until the child enters the next grade checkpoint at kindergarten or seventh grade.
“The new law is putting a spotlight on the situation and helping us to improve some practices,” said Terri Fox, Sacramento City Unified head nurse.
The district plans to train each school’s office manager to track immunizations on its student information system and to generate monthly reports, Ross said.
San Juan Unified has started training office staff at its 60 campuses to ensure they follow up on the status of students who have not completed their vaccinations, Covello said. They also will learn how to use an updated student information system to produce periodic reports about kindergarten through seventh-grade students and to track booster shots after seventh grade.
“We are trying to change years of practice,” Minugh said. “It’s a lot of work when you are talking about 40,000 students.”
Catherine Martin, director of the California Immunization Coalition, an advocacy group for vaccinations, says the problem at some schools is exacerbated by a shortage of school nurses, who usually take the lead in tracking immunizations. Nurses also counsel families about immunizations and help them find services if needed.
Currently, nurses are supposed to track students who are behind on their vaccinations to ensure they are excluded from classes if a measles or chicken pox outbreak occurs, Martin said. The new law shortens that list, she said.
Students admitted on a conditional basis often are kindergarteners with few or no shots who can’t safely take the full regimen required by the time they start school. The group also includes students given temporary exemptions because of medication they are taking, a fever or other temporary health conditions that prevented them from receiving their vaccinations.
Districts also give foster children and homeless students immediate entry to school without vaccination records, as required by state law. In those cases, district officials are supposed to follow up to ensure the students receive all required vaccinations.
Martin said some public and certain private schools have high numbers of conditional admissions, including some pockets in Sacramento.
“Public health departments are working more closely with schools to make sure conditional admissions are addressed,” she said.
In some cases, she said, public health officials have visited these schools to identify ways to increase immunization rates.
“It’s important to recognize the good work, but also to hold the schools accountable to make sure they are protecting the community,” she said.
By the numbers