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More Santa Barbara County Kids Receiving Vaccinations After New Law, Outreach Efforts

A ban on personal-belief exemptions and revamped messaging helped raise local student vaccination rate 1.5 percent over the last year to over 96 percent

Santa Barbara Cottage Hospital’s Dr. Steven Barkley, a neonatologist, says Senate Bill 277 and outreach efforts have counteracted misplaced beliefs about vaccinations and the shortness of our “cultural memory.” Click to view larger
Santa Barbara Cottage Hospital’s Dr. Steven Barkley, a neonatologist, says Senate Bill 277 and outreach efforts have counteracted misplaced beliefs about vaccinations and the shortness of our “cultural memory.” (Sam Goldman / Noozhawk photo)

Reversing a recent trend, vaccination rates in California have quickly climbed again, a trend medical and school officials credit to new community outreach efforts and a recent state law barring personal-belief exemptions.

In Santa Barbara County, the number of kindergarten students receiving all their shots rose 1.5 percent over the last year to 96.4 percent for the 2016-17 school year, according to the California Public Health Department.

Following a 2014 measles outbreak that started at Disneyland, state legislators passed and Gov. Jerry Brown signed into law Senate Bill 277, which mandates that all public or private school children receive the required vaccines before starting kindergarten or advancing to seventh grade. The law also applies to child-care centers and nursery schools. 

Though valid medical exemptions are allowed, personal-belief and religious-belief exemptions are no longer permitted.

Senate Bill 277 went into effect last July, making California the third state behind West Virginia and Mississippi to prohibit personal-belief exemptions.

State Public Health officials posited that the law, public awareness after the measles outbreak, and outreach efforts by local public health departments, schools and medical providers were behind the jump in immunizations.

Over the last two years, the state’s overall rate rose 5.2 percent to 95.6 percent.

Santa Barbara County’s kindergarten vaccine rate currently ranks around 18th out of California’s 58 counties, not all of which have full data available.

Students with personal-belief exemptions in the county peaked at 3 percent during the 2013-14 year, but now the number is below 1 percent, according to state data.

Another 0.6 percent of students are reportedly exempt for specific medical reasons.

The law’s effects on local school districts has varied.

The transition was fairly smooth at the Santa Barbara Unified School District, which held “robust communication with families” about the changes, according to spokeswoman Lauren Bianchi Klemann.

The district's vaccination efforts were focused on parents who waited until the last minute to immunize their kids, she said.

For the 2015-16 school year, only 84 percent of Montecito Elementary School kindergarteners had received all their vaccines, according to Shots for School, a website that collects data on school vaccination and personal-belief exemption rates.

Another 11.3 percent had personal-belief exemptions on file.

“Montecito Union had an issue a few years back with parents not wanting to immunize with the personal-belief exemption,” district Superintendent Tammy Murphy said.

But in the year since, she said, “100 percent of kindergarteners are in compliance” with vaccine requirements.

Though SB 277 played an important role in the dramatic turnaround, Murphy credited school nurse Cassandra Ornelas for an all-out push to inform parents and solicit their compliance.

For the 2015-16 school year, just fewer than half of local schools had rates above 95 percent, while over three in four do now, according to Dr. Steven Barkley, a neonatologist at Santa Barbara Cottage Hospital.

The real goal of vaccines, he explained, is not necessarily to prevent the vaccinated individual from having to spend a week in bed with the flu, but to protect those with immune-system deficiencies that make catching a preventable disease a life-threatening ordeal.

This concept of “herd immunity,” where there are enough immunized people to halt the spread of a disease between susceptible individuals, generally requires at least 95 percent of people to be vaccinated and spread out at least somewhat evenly in the population, though the rate varies with each disease.

While SB 277 certainly played a critical role, he said, a dedicated public outreach effort spearheaded by Dr. Daniel Brennan, a pediatrician with Sansum Clinic, was crucial to turning the tide toward greater immunization.

“From the point of view of a practicing physician, we were concerned that many of our schools were below the herd immunity rate of 95 percent,” Brennan told Noozhawk.

Sansum, Cottage, the Santa Barbara County Education Office, local schools and the county Public Health Department quickly jumped on board his grassroots campaign, dubbed Strive for 95, which put on TV and radio ads, social media outreach and a symposium at the Lobero Theatre.

Most of the campaign revolved around “sharing the scientific data that’s available and letting people read through and feel comfortable.”

But there was also a social approach: Stickers similar to the “I Voted” ones handed out at the polls were available to parents when they took their kids in for shots.

Brennan posited that if moms and dads saw their peers at school pick-ups, PTA meetings and other outings wearing the stickers, they may feel more comfortable vaccinating their own kids

One factor in parents’ decision not to immunize was a loss of “cultural memory,” Barkley said. 

He recalled that his mother had made him wait in line in the sun for two hours to receive his polio shot when the existential threat the crippling disease posed was still a fresh memory.

Society’s improved health has diluted the perception of the dangers even rare diseases still pose, he said.

At the root of many personal-belief exemptions is a discredited 1998 study by a British doctor who claimed a link between the measles, mumps and rubella vaccine and the onset of autism.

Despite all the time, money and effort put into thoroughly debunking the idea, a significant quirk of psychology means that skeptical parents become even more doubtful of vaccines even when presented with irrefutable data showing their safety and efficacy.

Chastising them for their erroneous beliefs has been shown to only strengthen their skepticism, Barkley said.

“You don’t need too many people convinced that the behavioral change in their child was temporarily related to their immunizations to really scare a lot of people,” Barkley said.

Rather than focus on the potentially disastrous consequences of opposing vaccination, he explained, a more effective approach is the “take one for the team” mentality of protecting the vulnerable — communicated on a more personal level.

Though lawmakers and health professionals have cheered SB 277’s effectiveness, it quickly prompted a local lawsuit filed by 17 parents and four nonprofit organizations representing parents who say they were affected by the law.

The plaintiffs sued then-Santa Barbara County Public Health director Dr. Takashi Wada; Public Health Officer Dr. Charity Dean; the state Department of Education; its superintendent, Tom Torlakson; the state Board of Education; the state Department of Public Health; and its director, Dr. Karen Smith.

Though the plaintiffs argued that the law denied children access to school and violated parents’ right to bring up their children in accordance with their personal beliefs, they voluntarily dismissed their lawsuit soon after, in August.

Five days before that decision, a U.S. District Court judge for the Southern District of California denied the plaintiffs' motion for a preliminary injunction that would have barred the state from enforcing the law.

“Maintaining a high vaccination rate among children in our community is the most effective way to protect them against vaccine-preventable disease,” Dean said in a statement. “And, it also protects the most vulnerable community members.”

Noozhawk staff writer Sam Goldman can be reached at .(JavaScript must be enabled to view this email address). Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.

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