Starting school with a hero strip

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 COVID-19 pandemic reminded everyone of what can be easy to forget in normal times: universal vaccinations are critical to our society. 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.

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.

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.

Despite this success, or perhaps because of it, it's easy to assume that "old" diseases are no longer a threat. 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, each child must be immunized unless there is a specific, medically valid reason to leave them unprotected. Prior to 2016, families could “exempt” their children from vaccination on the basis of “personal belief.” This created 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.

The California Department of Health, which tracks the use of medical exemptions, concludes that 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.

California Senator Richard Pan, the author of the law that put an end to "personal belief" exemptions, led efforts to address these pockets of vulnerability by 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 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.

That does not mean students should not 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?

Unless you have been sleeping under a coconut tree, you probably know that mandating vaccines is highly 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 August 2024.