TheBakersfieldCalifornian.com

More Kern County kindergarteners who headed to school last year were up-to-date on their vaccinations compared to the previous year, but the number of kids being opted out of their shots also edged up.

Data schools reported to the California Department of Public Health showed that 93 percent of Kern kindergarten students enrolled in schools with 10 or more kindergartners were up-to-date on their shots in the 2011-2012 school year, up from 89.7 percent the previous year.

The change from 2010 to 2011 brought Kern County back to its typical numbers.

Ann Walker, supervising public health nurse and immunization coordinator for the Kern County Public Health Services Department, said the county is usually in the 91 to 92 percent range for up-to-date children and she isn't sure why the numbers fell for the 2010-2011 school year.

If anything, you would think vaccination rates would be higher in 2010 after the whooping cough outbreak that year and that of H1N1, sometimes called swine flu, in 2009, she said.

"For it to dip down that year, I'm not sure what happened there," she said.

But while more kindergarteners were up-to-date last school year, the number who weren't because their parents signed a personal beliefs exemption rose 17.5 percent between the two years.

Walker said the opt-out numbers were still within the county's typical rate of 1 to 2 percent of students.

The new numbers come at a time when politicians and public health experts across the nation are focusing more attention on childhood immunizations, driven by a re-emergence of diseases like whooping cough. The United States is in the midst of what could be its worst year for that disease in more than five decades, with nearly 25,000 cases and 13 deaths.

Parents are allowed to forego vaccines for philosophical reasons in California and 19 other states. Of those, only Washington requires parents to consult with a physician. California parents simply sign a document to opt out. The state recommends that kindergarteners receive five vaccine progressions, including protections against polio, hepatitis B and measles.

In the Bakersfield City School District, 27 kindergarteners had personal beliefs exemptions in 2010-2011; that jumped to 42 last year, according to the state's data.

"It's becoming more and more common because the Internet is accessible to everyone and it's not always factual," said Debbie Wood, coordinator of school health at BCSD.

Wood said a growing number of parents tell her they don't want the government telling them what to do with their child. She hears it more now than she ever has during her more than 25 years as a school nurse, Wood said.

A BROADER LOOK

Vaccination opt-out rates nationwide have been creeping up since the mid-2000s, spurred in part by the belief the battery of vaccinations routinely given to infants could lead to autism.

Several major studies have discredited that idea.

The Associated Press recently took a look at California's numbers and found some other interesting trends.

The percentage of children in private schools who forego some or all vaccinations is more than two times greater than in public schools. More troubling to public health officials is that the number of children entering private schools without all of their shots jumped by 10 percent last year.

Saad Omer, a professor of global health at Emory University in Atlanta who has studied vaccine refusal in private schools, surmised more private school parents are wealthy and have the time to spread five shots over a series of years and stay home should their child get an illness like chickenpox.

Neal Halsey, a professor of pediatric infectious diseases at Johns Hopkins University, said parents who choose private schools are likely to be more skeptical of state requirements and recommendations.

Public health officials say that regardless of why parents choose not to vaccinate their children, the result is the same: an increased risk of an outbreak of whooping cough or other communicable diseases.

"We're very concerned that those schools are places where disease can spread quite rapidly through the school and into the community, should it get introduced," said Dr. Robert Schechter, medical officer with the Immunization Branch of the California Department of Public Health.

Walker said kids who aren't immunized pose a risk to themselves and other kids who aren't vaccinated, pregnant women and people who can't be vaccinated due to medical reasons.

"We don't see the diseases that vaccinations prevent against, but if we were to stop (vaccinating), the diseases would be right back in our backyard," Walker said.

Walker pointed to a 2008 measles outbreak in San Diego.

An unvaccinated 7-year-old boy, who was not vaccinated because of a personal belief exemption, returned from a family visit to Switzerland with measles, according to the Centers for Disease Control. Eleven cases of measles in "unvaccinated children in San Diego" were linked to the boy, including his two siblings, five kids at his school, and four kids who were at his pediatrician's office on the same day as the sick boy, the CDC reported.

"Overall, approximately 70 children exposed to children with measles in the school, a day care center, the pediatrician's office, and other community settings were placed under voluntary home quarantine because their parents either declined measles vaccination or they were too young to be vaccinated," the CDC said.

A LEGISLATIVE BOOSTER SHOT?

Recently, the California Legislature approved a bill requiring parents to discuss vaccinations with a pediatrician or school nurse before they can opt-out. Gov. Jerry Brown has until the end of September to sign or veto it.

State Assemblyman Richard Pan, a pediatrician who sponsored the bill, said he believes private school parents are more apt to mistakenly believe that the vaccinations could be more dangerous than the diseases.

"In private school, these are people who have money, who are upper-middle class, and they are going on the Internet and seeing information and misinformation," said Pan, D-Sacramento.

Increasing immunization rates for this population is critical to controlling the outbreak of diseases, he said.

"Have you ever seen a child cough themselves to death? It's not pleasant," he said.

Melissa Vega, program coordinator for San Joaquin Community Hospital's mobile immunization clinic, which provides free vaccinations to children, thinks the law would be a good requirement for parents considering opting out.

"They need to learn about (vaccinations), they need to be educated about it before they just choose not to," she said. "To be honest with you, I'm going to say that a lot of parents opt out of vaccines because they're lazy and they do not want to wait in line at the health department to get their kindergartener immunized because they waited until the last minute."

Those who choose not to vaccinate their children see the legislation as meddlesome and unnecessary.

"It's making an extra appointment and paying extra money to go in there and essentially get permission to do what I feel is right for my family," said Dawn Kelly, who sends her unvaccinated 5-year-old son and partially vaccinated 9-year-old son to Monarch Christian School in the Los Angeles area.

Kelly worries her children's immune system could be overwhelmed by getting too many vaccines at once.

PARENTS VOLLEY ON VACCINES

Erica Pumphrey, a licensed vocational nurse at San Joaquin Community Hospital's mobile immunization clinic, said parents who visit the clinic may be concerned about the side effects of immunizations but usually change their mind after they talk to clinic staff.

"A lot of people are still concerned if autism's a factor in getting vaccinated or not," Pumphrey said.

Vega said questions about a purported link between vaccines and autism are rarer now than they were three or four years ago.

"I've noticed that more kids are coming (for vaccines) and it just depends on what California has, what they have cookin' as far as requirements for school entry," she said.

While walking her son home from school Wednesday afternoon, Alisha Miller of Bakersfield said immunizations are a high priority for her and her seven kids.

"I don't want (my children) to catch something that could have been prevented by a shot, something simple," she said. "That's why I tell my kids when they go, 'The shot hurts but it hurts more if you get sick.'"

Still, Miller said her 5-year-old son, Tyrese Miller, started school a week late this year because he needed several shots and other medical exams before he could attend class at William Penn Elementary School. Miller took him to the health department for his shot, a trip she said took about three hours.

"I really don't understand why (parents) would want to take the chance of getting somebody else sick or taking the chance of (their child) getting sick," she said. "To me it's always just been what you're supposed to do, so I can't really see other people's reasoning for not doing it."

For other parents, the decision doesn't seem so clear cut.

Juliet Abney, mother to 13-month-old Olive Dewitt, decided to vaccinate her daughter for polio and whooping cough but not any other disease. Abney said after doing some online research she felt that Americans over-vaccinate and that the push to immunize children is profit-driven.

"I feel like (Americans) take too much medicine," she said. "I feel like we should go back to our roots and focus on natural remedies."

Abney's decision became a point of friction with her family.

"They thought that it was ridiculous and they felt that I was putting (my daughter) in harm by not vaccinating her," Abney said. "I really feel like it's unnecessary."

Abney said she would probably sign a waiver when her daughter reached school age and that while she has heard the argument that diseases could resurge if children aren't vaccinated, that's not something she anticipates.

"Anything's possible but I personally don't think that's going to happen," she said.