As we head into the fall and winter, health systems are encouraging people to get flu vaccines and updated COVID shots. High vaccination rates reduce the risk of preventable disease outbreaks, lessening the strain of flu season on individuals and medical facilities. While flu and COVID vaccines are not mandatory, state law requires that students be vaccinated against other infectious diseases, such as measles, chicken pox, and polio. Maintaining adequate school vaccination rates is essential for public health and community well-being, but many schools across the state could be vulnerable to disease outbreaks due to lower vaccination rates.
In the 2021–22 school year (the most recent year school-level data are available), about 94% of California’s kindergarten students received all required vaccines. But vaccination rates among kindergartners vary across the state. We focus on vaccination rates below 90%, which the state considers vulnerable to disease outbreaks. Out of the thirteen counties that have vaccination rates below 90% among kindergarten students, nine are in the far north, two are in the Sacramento area, and two are in the Central Valley region. We see a similar geographic pattern when looking at the share of kindergarteners in schools with vaccination rates below 90% In some of these counties, including El Dorado, Humboldt, Sutter, Tuolumne, and Yuba, more than 30% of kindergarteners attend schools that have vaccination rates below 90%.
California law changed in 2015 and 2017 (Senate Bills 276, 277, and 714) to strengthen vaccination requirements for schools and reduce the number of ways that families can request exemptions. Currently, students in special education or those who receive their education remotely, without any in-person school-related activities, are not required to be vaccinated. This school year, the financial and compliance audits of public schools include an immunization assessment component. This audit applies to about 500 California schools (out of roughly 8,000 total) with kindergarten or 7th grade classes that either failed to submit immunization assessment reports or had over 10% of students either not currently meeting vaccination requirements or overdue for one or more vaccines. Schools not complying with immunization requirements could lose state school funding for those students.
Schools on the audit list are located throughout California districts. Some of the large school districts that have a high number of schools on the audit list include Oakland Unified, Los Angeles Unified, Pomona Unified, San Francisco Unified, San Juan Unified, and Sacramento City Unified. Ninety out of the 1,289 charter schools in the state are on the audit list—24 of them in Los Angeles County alone.
When we look at student demographics, we see higher rates of enrollment in free or reduced-price meals among schools on the audit list compared to schools that are not—indicating higher student poverty in schools that are being audited for low vaccination rates. The audited schools have similar shares of Latino and white students as non-audited schools but have higher shares of Black and Native American students.
In addition to students’ routine immunizations, an updated COVID booster was recently approved for people six months and older and is now being rolled out to providers. Although the booster is recommended by medical professionals to prevent against severe illness, children are much less likely to be vaccinated against COVID than adults. As of August 2023, about 73% of Californians had received the primary series of COVID vaccines, compared to only 38% of children between ages 5 to 11. Recent survey data suggest about one-third of Californians will likely not get any additional COVID vaccines and that the share is likely higher for children and teens. A 2022 survey estimates that about 44% of children who did not complete the primary vaccine series have parents who reported being worried about the side effects.
Collaboration between local health jurisdictions, school districts, and individual schools is crucial in keeping students healthy. Schools can work with local health departments and pharmacies to organize school-located vaccine (also known as SLV) events for the COVID-19 vaccine, seasonal flu vaccine, and other routine immunizations while helping to address concerns that families may have about the vaccines. These events help in immunizing large groups of children quickly and improving vaccination access for underserved students and families.