IMMUNIZATIONS

This indicator reports the percent of children who received all of the doses of specific vaccines recommended by their 2nd birthday and required at kindergarten entry. Data at the 2nd birthday are based upon annual retrospective reviews of a sample of randomly selected schools’ kindergarten immunization records and therefore represent vaccination trends three years prior.

The widespread use of safe, effective childhood vaccinations has been one of the most successful and cost-effective public health interventions in the U.S. and globally. Many serious and once-common childhood infections have been dramatically reduced through routine immunizations. The success of immunization programs depends upon appropriate timing and on a high rate of vaccine acceptance, particularly among parents of young children.

Over the past decade, increasing numbers of children with delayed or refused vaccinations have led to reduced levels of vaccine coverage. Studies have found that children whose parents delay or refuse vaccines are more likely to be White and reside in well-educated, higher income areas.1 On the population level, success depends on a community achieving a threshold level of immunity, and many communities are below the protective level needed to prevent the spread of disease.2

• In 2017, 77.9% of Orange County children entering kindergarten had been adequately immunized (4:3:1 schedule) at their 2nd birthday, lower than the high of 78.9% in 2014.3

• In 2017, 95.7% of Orange County kindergartners had up-to-date immunizations, a 7.9% increase from the 10-year low at 88.7% in 2013, and exceeding the high of 95.5% in 2016. Children attending private schools in Orange County tend to have lower levels of up-to-date immunizations compared to public schools at kindergarten entry (93.0% vs. 96.2%).

• These percents and trends are similar to those among kindergartners throughout California, who were immunized at a rate of 95.1%.4

• One school district, comprised of Laguna Beach Unified public schools and private schools in the area, had 88.5% or fewer of kindergartners with up-to-date immunization levels. However, seven school district regions remain below the recommended immunization rate of 95%. This correlates with higher percentages of permanent medical exemptions and conditional enrollments.5

Effective July 1, 2016, California law now removes the personal belief exemption from statute and requires almost all schoolchildren to be fully vaccinated in order to attend public or private elementary, middle and high schools. For kindergarten entrance, children must be immunized against 10 diseases:

Diphtheria, Haemophilus Influenza Type B (Bacterial menigitus), Measles, Mumps, Pertussis (whooping cough), Polio, Rubella, Tetanus, Hepatitis B and Varicella (chicken pox). Home school students or students who do not receive classroom-based instruction are not required to be vaccinated. Students who qualify for an Individualized Educational Program cannot be prevented from accessing any special education and related services required by their IEP. The medical exemption will remain in statute.