BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 614|
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UNFINISHED BUSINESS
Bill No: SB 614
Author: Kehoe (D)
Amended: 7/12/11
Vote: 27 - Urgency
PRIOR SENATE VOTES NOT RELEVANT
ASSEMBLY FLOOR : Not available
SUBJECT : Childhood immunization
SOURCE : California Association of School Business
Officials
California Association of Suburban School
Districts
Riverside County School Superintendents
Association
San Diego Unified School District
DIGEST : This bill allows a pupil in grades 7 through 12,
to conditionally attend school for up to 30 calendar days
beyond the pupils first day of attendance for the 2011-12
school year, if that pupil has not been fully immunized
with all pertussis boosters appropriate for the pupil's age
if specified conditions are met.
Assembly Amendments delete the prior version of the bill
regarding child care and safety awareness training, and
implement the current language regarding childhood
immunization.
CONTINUED
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ANALYSIS :
Existing law:
1. Prohibits the governing authority of a school or other
institution from
unconditionally admitting any person as a pupil of any
private or public elementary or secondary school, child
care center, day nursery, nursery school, family day
care home, or development center unless prior to his/her
first admission to that institution, he/she has been
fully immunized against the following diseases:
diphtheria; haemophilus influenza type b; measles;
mumps; pertussis; poliomyelitis; rubella; tetanus;
hepatitis B; varicella (chickenpox); and any other
disease deemed appropriate by the Department of Public
Health (DPH), taking into consideration the
recommendations of the Advisory Committee on
Immunization Practices of the United States Department
of Health and Human Services, the American Academy of
Pediatrics, and the American Academy of Family
Physicians (AAFP).
2. Prohibits from July 1, 2011, until June 30, 2012, a
governing authority from unconditionally admitting or
advancing any pupil to the 7 through 12 grade levels of
any private or public elementary or secondary school
unless the pupil has been fully immunized against
pertussis, including all pertussis boosters appropriate
for the pupil's age.
3. Waives the requirements described above for medical
reasons or if the parent, guardian, or adult who has
assumed responsibility for the pupil files a letter or
affidavit with the school governing authority stating
that the immunization is contrary to his/her beliefs.
4. Allows a pupil who has had an immunization requirement
waived, whenever there is good cause to believe that the
person has been exposed to one of specified communicable
diseases, to be temporarily excluded from the school or
institution until the local health officer is satisfied
that the pupil is no longer at risk of developing the
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disease.
5. Requires county health officers to organize and maintain
a program to make immunizations available to all persons
required to be immunized and specifies that counties
shall pay costs that are not recovered from persons
immunized.
This bill:
1. Allows a pupil, advancing to or enrolling in any of
grades 7 through 12, to conditionally attend school for
up to 30 calendar days beyond the pupil's first day of
attendance for the 2011-12 school year, if that pupil
has not been fully immunized with all pertussis boosters
appropriate for the pupil's age, and if all of the
following conditions are met:
A. The pupil was enrolled in the county office of
education or school district in the prior year, and
is continuing in the same or advancing to the next
grade level.
B. The pupil's first day of attendance in 2011-12
school year for that county office of education or
school district occurs on or before the sixth Friday
following the first day on which classes are offered
at the school in which the pupil is enrolled.
C. The county office of education or school district
work with the pupil's parent or legal guardian so
that the pupil receives all immunizations or boosters
necessary for continued attendance.
2. Sunsets the provisions of this section on January 1,
2013.
Background
Pertussis . According to the United States Centers for
Disease Control and Prevention (CDC), pertussis (also known
as whooping cough), is a highly contagious respiratory
disease that is known for uncontrollable, violent coughing
which often makes it hard to breathe. After fits of many
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coughs, someone with pertussis often needs to take deep
breaths which result in a "whooping" sound. Pertussis most
commonly affects infants and young children and can be
fatal, especially in babies less than one year of age. In
infants younger than one year of age who get pertussis,
more than half must be hospitalized. Of those infants who
are hospitalized with pertussis, about 1 in 5 get
pneumonia, half will have apnea (slowed or stopped
breathing), 1 in 300 will have encephalopathy (disease of
the brain); and 1 in 100 will die.
According to the CDC, the incidence of pertussis is
cyclical, with peaks occurring every three to five years in
the United States. The last peak was in 2005, when
approximately 25,000 cases were reported nationally and
approximately 3,000 cases in California, including eight
deaths in infants under three months of age.
According to DPH, peak seasons for pertussis in California
and the United States are typically summer and fall and it
does not know yet how severe the peak seasons will be in
2011.
California outbreak . In 2010, DPH saw a substantial
increase in the number of pertussis cases reported.
According to a report from the CDC, from January 1, 2010,
to June 30, 2010, a total of 1,337 cases were reported in
California, which was a 418 percent increase from the 258
cases reported during the same period in 2009. From
January to June of 2010, the incidence of pertussis was 3.4
cases per 100,000 persons. County rates ranged from 0 to
76.9 cases per 100,000. By age group, incidence was
highest (38.5 cases per 100,000) among infants aged less
than one year; 89 percent of cases were among infants under
6 months, who are too young to be fully immunized.
Incidence among children aged 7 to 9 years was 10.1 cases
per 100,000, and for children 10 to 18 years old it was 9.3
cases per 100,000. Incidence among Latino infants (49.8
cases per 100,000) was higher than among other
racial/ethnic populations. According to DPH, there were 10
deaths resulting from pertussis infection in 2010.
According to DPH's June 2011 Pertussis Report, disease
activity in 2011 is still at relatively increased levels
throughout the state with 1,428 cases reported (7.8 cases
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per 100,000). This includes 326 new cases being reported
since the last update in May 2011.
Pertussis vaccine . According to the CDC, the best way to
prevent pertussis is to get vaccinated. In the United
States, the recommended pertussis vaccine for infants and
children is called DTaP, which is a combination vaccine
that protects against three diseases: diphtheria; tetanus;
and pertussis. For maximum protection against pertussis,
children need five DTaP shots. The first three shots are
given at two, four, and six months of age. The fourth shot
is given between 15 and 18 months of age, and a fifth shot
is given before a child enters school, at four to six years
of age. Parents can also help protect infants by keeping
them away as much as possible from anyone who has cold
symptoms or is coughing. Vaccine protection for pertussis,
tetanus, and diphtheria fades with time. Before 2005, the
only booster available contained protection against tetanus
and diphtheria, and was recommended for teens and adults
once every 10 years. There are currently boosters for
pre-teens, teens and adults that contain protection against
tetanus, diphtheria, and pertussis. Current guidelines
recommend that pre-teens going to the doctor for their
regular check-up at age 11 or 12 years get a dose, and that
teens who did not get this vaccine at the 11- or
12-year-old check-up get vaccinated at their next visit.
Adults who did not get the booster as a pre-teen or teen
should get a dose. Pregnant women who had not previously
received the booster shot should get one postpartum before
leaving the hospital or birthing center. Adults age 65
years and older, as well as parents, grandparents, child
care providers, and health care providers who have close
contact with infants should also get vaccinated.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 7/13/11)
California Association of School Business Officials
(co-source)
California Association of Suburban School Districts
(co-source)
Riverside County School Superintendents' Association
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(co-source)
San Diego Unified School District (co-source)
Adolescent Health Collaborative
Alvord Unified School District
American Academy of Pediatrics - California
Association of California School Administrators
Attendance Works
Beaumont Unified School District
California Association of Family Physicians
California County Superintendents Educational Services
Association
California Immunization Coalition
California Medical Association
California School Boards Association
California School Health Centers Association
California School Nurses Organization
California State PTA
Central Valley Education Coalition
Children Now
Clovis Unified School District
Corona-Norco Unified School District
El Dorado County Superintendent of Schools
Elk Grove Unified School District
Elsie Allen Health Center
Fresno Unified School District
Hemet Unified School District
Irvine Unified School District
Jurupa Unified School District
Long Beach Unified School District
Los Angeles County Office of Education
Los Angeles Unified School District
Menifee Union School District
Monterey County Office of Education
Newport-Mesa Unified School District
Oakland Unified School District
Rialto Unified School District
Riverside School District
Roseland Children's Health Center
Sacramento Unified School District
San Jacinto Unified School District
Santa Cruz City Schools
Santa Rosa Community Health Centers
Small School Districts Association
Temecula Valley Unified School District
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Tulare City School District
ARGUMENTS IN SUPPORT : Numerous school districts write in
support that despite extensive district outreach over the
past six months, including public education campaigns,
parent contacts, and school -sponsored clinics, it is now
clear that a significant number of 2011-12 year's incoming
grade 7 through 12 students are not yet immunized. These
school districts state that with summer vacation now
underway, their ability to reach families of non-immunized
students is severely diminished. The San Diego Unified
School District (SDUSD), one of the bill's sponsors, writes
that since schools receive state funding based on
attendance, turning away students will result in the loss
of up to $1 million per day in funding for SDUSD schools.
SDUSD states that this loss of funds would severely set
back their ability to deliver educational programs to
students, and may result in serious mid-year cuts.
Further, SDUSD writes that the unattainable current
deadline may also have negative health impact as some
families who find it difficult to get their students
immunized quickly may sign personal belief waivers just to
keep their students in school - which could undermine the
very purpose of the pertussis immunization requirement.
Other supporters write that an extension is in the best
interest of students because a more realistic time frame
will allow schools, providers, and local public health
entities to work together to ensure complete immunization
and students will be less likely to be excluded from
school. Supporters are concerned that the current time
frame will cause parents to seek waivers and possibly never
have their children immunized.
CTW:mw 7/13/11 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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