BILL ANALYSIS �
SB 614
Page 1
SENATE THIRD READING
SB 614 (Kehoe)
As Amended July 12, 2011
2/3 vote. Urgency
SENATE VOTE :Vote not relevant
HEALTH 17-0
--------------------------------
|Ayes:|Monning, Logue, Ammiano, |
| |Atkins, Bonilla, Eng, |
| |Garrick, Gordon, Hayashi, |
| |Roger Hern�ndez, |
| |Bonnie Lowenthal, |
| |Mansoor, Nestande, Pan, |
| |V. Manuel P�rez, Silva, |
| |Williams |
| | |
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SUMMARY : Permits a county office of education, the governing
board of a school district of attendance, or the governing body
of a charter school to allow a pupil, advancing to or enrolled
in grades 7 through 12, to conditionally attend school for up to
30 calendar days, as specified, if that pupil has not been fully
immunized with all pertussis boosters appropriate for the
pupil's age and if certain conditions are met. Contains an
urgency clause to ensure that the provisions of this bill go
into immediate effect upon enactment. Specifically, this bill :
1)Permits a county office of education, the governing board of a
school district of attendance, or the governing body of a
charter school to allow a pupil, advancing to or enrolled in
grades 7 through 12, to conditionally attend school for up to
30 calendar days, commencing with the pupil's first day of
attendance in the 2011-12 school year for that county office
of education or school district, if that pupil has not been
fully immunized with all pertussis boosters appropriate for
the pupil's age and if:
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;
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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; and,
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)Makes the above provisions inoperative on July 1, 2012, and
repeals those provisions as on January 1, 2013, unless a later
enacted statute that is enacted before January 1, 2013,
deletes or extends the dates on which it becomes inoperative
and is repealed.
EXISTING LAW :
1)Prohibits, effective July 1, 2011, governing authorities from
unconditionally admitting or advancing any pupil to the 7th
through 12th grades 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.
2)Waives the requirements in 1) and 2) above for medical reasons
or if the parent, guardian, or adult who has assumed
responsibility for the child files a letter or affidavit with
the school governing authority stating that the immunization
is contrary to his or her beliefs.
FISCAL EFFECT : None
COMMENTS : According to the author, dozens of school districts
have reported that pupil compliance with the July 1, 2011,
pertussis immunization requirements is alarmingly low in many
districts. The author states that districts from urban,
suburban and rural areas stand to lose substantial state funding
because high percentages of pupils in those districts have yet
to be immunized as required. The author contends that over 20
school districts will lose over $100,000 per day while San Diego
Unified School District (USD) will lose over $1 million per day
and Los Angeles USD estimates that approximately half of its
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250,000 7th through 12th graders still need the vaccination.
The district forecasts that it would amount to a $3.4 million
daily loss in revenue if all of those students were turned away.
The author states that districts are also concerned about
unknown public health and public safety impacts if students are
not allowed to attend school and must otherwise occupy their
time.
According to the U.S. 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 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 one in five get pneumonia, half will have
apnea (slowed or stopped breathing), one in 300 will have
encephalopathy (disease of the brain); and one in 100 will die.
According to the CDC, the incidence of pertussis is cyclical,
with peaks occurring every three to five years in the U.S. 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 the Department of Public Health (DPH), peak months
for pertussis in California and the U.S. are typically summer
and fall. We do not know yet how severe the peak seasons will
be in 2011.
In 2010, DPH saw a substantial increase in the number of
pertussis cases reported. According to a report from the CDC,
from January 1 to June 30, 2010, a total of 1,337 cases were
reported in California, which was a 418% increase from the 258
cases reported during the same period in 2009. From January to
June that year, the incidence of pertussis was 3.4 cases per
100,000 population. County rates ranged from zero 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% of cases
were among infants under six months, who are too young to be
fully immunized. Incidence among children aged seven to nine
years was 10.1 cases per 100,000 and for 10 to 18 years old it
was 9.3 cases per 100,000, respectively. Incidence among Latino
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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
the DPH's April 2011 Pertussis Report, disease activity in 2011
is still at relatively increased levels throughout the state
with 733 cases reported through March 2011 (23.7 cases per
100,000).
According to the CDC, the best way to prevent pertussis is to
get vaccinated. In the U.S., 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 boosters for pre-teens, teens and adults that contain
protection against tetanus, diphtheria, and pertussis. It is
recommended that pre-teens going to the doctor for their regular
check-up at age 11 or 12 years get a dose, and 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 65 years and older (grandparents, child care providers,
and healthcare providers) who have close contact with infants
should get vaccinated. According to DPH, the two manufacturers
of the U.S. Food and Drug Administration licensed pertussis
booster vaccine have stated that that they are making ample
supplies of Tdap vaccine, the booster for DTaP (as well as of
the DTaP vaccine which has been required for many years for
children entering kindergarten).
According to a survey of 68 local educational agencies conducted
by the California Association of School Business Officials,
compliance to the July 1 pertussis booster requirement varies
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fairly significantly. Rates of compliance range from lows of
20% �Las Virgenes Unified School District (USD), serving the
communities of Agoura, Agoura Hills, Calabasas, Hidden Hills,
and Westlake Village], 25% �Pajaro Valley USD in
Watsonville/Aptos], and 30% �Central Union SD, serving Lemoore,
Stratford, and the Lemoore Naval Air Station], to as high as 80%
�Brentwood Union in Contra Costa County], 85% �La Habra City
School District in northwestern Orange County and Lindsay USD in
Tulare county], and 95% �CoronaNorco USD in western Riverside
County and Farmersville USD Tulare County]. Los Angeles USD has
250,000 pupils in 7th through 12th grades, half of whom have had
the Tdap booster.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
FN: 0001663