Saving lives together

Not so long ago, childhood diseases like whooping cough, chicken pox, measles, mumps and rubella claimed the lives of thousands of American children every year. Many children who survived were left with scars or chronic health problems.

Anti-vax politics vs saving lives

Universal vaccination has been one of the most successful medical interventions in human history. By ensuring that all children are vaccinated, these terrible diseases became rare — the stuff of history lessons, not daily news.

As schools get started each year, safety is on the agenda. Part of keeping kids safe involves an important bit of paperwork: ensuring that each student has been properly immunized. The beneficial impact of this policy has been massive. According to the Centers for Disease Control (CDC), “Among children born during 1994–2023, routine childhood vaccinations will have prevented approximately 508 million cases of illness, 32 million hospitalizations, and 1,129,000 deaths, resulting in direct savings of $540 billion and societal savings of $2.7 trillion.”

Students in California must be vaccinated to attend school.

The dangerous "anti-vax" movement

Despite this success, or perhaps because of it, it's easy to assume that "old" diseases are no longer a threat. Some public figures (notably Robert F. Kennedy Jr.) have made themselves famous, or infamous, by sowing doubt about whether vaccinations are safe or necessary. Doubt causes hesitation, and vaccination rates have declined in some places. Until 2016 it was legal for parents in California to enroll unvaccinated children in public school simply by registering a personal belief statement. An outbreak of measles in 2015 served as an important reminder: these diseases are still a deadly reality.

They will come back if allowed to do so.

To protect children and the general public, in California each child must be immunized unless there is a specific, medically valid reason to leave them vulnerable, adding to the risk for them and the community. Prior to 2016, families could “exempt” their children from vaccination on the basis of “personal belief.” Unfortunately, doubt is itself contagious. The personal belief exemptions spread, creating unsafe pockets where outbreaks could occur. In 2016 the California Legislature tightened the rules, allowing students to be unprotected only based on "physical condition or medical circumstances." Some physicians abused their power to interpret the meaning of medical necessity, but immunization rates improved in most communities.

According to the California Department of Health, which tracks the use of medical exemptions, vaccine coverage improved after the law went into effect, significantly improving public safety from outbreaks.

Each School Counts

According to the California Department of Public Health, to prevent transmission of disease in a community at least 95% of children at each school must be immunized. At most schools, the vaccination rate is safely above this level, but the rate varies significantly from school to school.

Outbreaks are most likely in school communities where anti-vaccination beliefs take root. If groups of parents take measures to “exempt” their children from protection, diseases are more likely to spread.

There are patterns. Historically, the schools where children are most at risk of an outbreak tend to be charter schools or private schools. Schools audited for low vaccination rates tend to have higher shares of low-income, Black, and Native American students.

Former California Senator Richard Pan led efforts to address these pockets of vulnerability by putting an end to "personal belief" exemptions and tightening the standards for medical exemptions. Cracking down on unscrupulous doctors who issue medically unnecessary exemptions was an important part of the plan, too.

Check your school's immunization rate

Is your school among those susceptible to an outbreak? A helpful (but dated) map from the California Department of Public highlights schools with low vaccination rates. EdSource created a focused version of the map in 2023, highlighting about 500 schools where communities were at greatest risk.

What about Covid and flu vaccinations?

While Covid and the flu can both be fatal, school vaccinations for these diseases are not required in California. No states require school Covid vaccinations and only a few require flu vaccination.

Does that mean students shouldn't get vaccinated? Far from it. The United States Center for Disease Control (CDC) recommends that children be vaccinated every year.

Which vaccinations are required in California?

Required immunizations vary by age.

What do other states require?

Vaccines work through herd immunity. To work, they have to be widely used, and the US Supreme Court ruled in 1905 that states have the authority to require them. Even so, such mandates always been controversial. According to the National Academy for State Health Policy, state legislatures in Florida, Texas, and 19 other states have banned schools from requiring vaccination against Covid.

If you find that your school community has a lot of unvaccinated children or faculty members, be thoughtful about how you approach the problem. Changing someone's mind can be difficult. A clumsy confrontation can make it even harder. A podcast episode from Hidden Brain, Facts Aren't Enough, might be of use.

Updated November 2024.