Taking the medicine

When it comes to a state law mandating that a large segment of its student population get the whooping-cough booster, Chico Unified School District is getting an A-minus. Just 10 percent of the district’s 6,000 seventh- through 12th-graders are still in need of the vaccine.

But CUSD nevertheless is in violation of the law by continuing to allow those remaining 600 students to attend classes.

“We’re not yanking kids yet because 90 percent of our students have been vaccinated and we have plans to cover the rest,” said Dave Scott, director of pupil personnel services at CUSD. “We wanted to be more positive and don’t want the unvaccinated kids to miss their education.”

Some districts aren’t taking any chances.

In San Francisco, 2,000 unvaccinated students were sent home on Sept. 15. On Sept. 14, Elk Grove Unified School District told 200 of its students they would be prevented from attending classes until they got vaccinated.

But other districts in California, like CUSD, are breaking the directive by keeping kids in classrooms, with some out of compliance by as much as a 25 percent. That is why state lawmakers are considering yet another, more stringent law for the next school year to force compliance, though it’s too early to know the particulars of how it might work.

Scott believes this is the wrong approach.

“I don’t think we need laws with more penalties, but more resources to facilitate access to the vaccine,” he said.

The initial law, passed last year, was in response to a huge outbreak of whooping-cough cases in 2010 that resulted in more than 9,000 new California infections that led to 10 infant deaths. It specified that all seventh- through 12th-grade students receive the booster vaccination known as Tdap—for tetanus, diphtheria and pertussis—within 30 days of the start of the 2011-12 school year. (The booster supplements the original vaccination required of all children by the time they enter kindergarten.)

In the years to follow, only incoming seventh-graders will need to get the vaccination. Exceptions are made for those whose parents refuse for health or personal reasons, such as religious belief or fear of severe side effects.

Dr. Mark Lundberg, health officer for the Butte County Public Health Department, said the greatest health risk is for children younger than two months, with a mortality rate of 1 percent for those infected. The booster helps to protect these vulnerable infants who are likely to contract the illness from their school-age siblings.

For the students themselves, Lundberg noted that half of those who catch the infection get a persistent cough that lasts more than 10 weeks. “For school kids, that means a lot of lost school, exercise and vacations,” he said.

No deaths in Butte County were reported during last year’s epidemic. However, several school-age children were infected so severely that they had to be transported out of county for more specialized treatment, he noted.

As for CUSD’s percentages, Lundberg said there’s work ahead.

“It’s pretty safe if you’ve got 90 percent of your students vaccinated, but I’d still like to see 100 percent compliance, since pertussis, or whooping cough, is pretty serious,” he said.

CUSD has made strong efforts to have all its students vaccinated since last March, Scott said. Automated phone messages have been sent to student households, along with emails and letters urging vaccination. The vast majority of students have acquired vaccinations from family doctors or for approximately $50 through local pharmacies.

The district has given out free vaccinations at clinics for those who couldn’t afford them.

Butte County Public Health Department also has chipped in with several low- or no-cost clinics, and the district has three more free clinics planned at local high schools in October.

Scott said the law has been challenging financially to the district as well, since the politicians who passed the directive didn’t provide funding for the vaccines.

He said that the district may begin pulling students from classes if they refuse to comply without a good reason. But for now there is no deadline set for the remaining students, and he wants to stay constructive and optimistic. Scott said that schools are caught between a rock and a hard place.

“The whooping-cough law says that we have to get all eligible students vaccinated, yet another law says we have to educate all the children,” he said.