"...children in child care and schools are well protected against vaccine-preventable disease.

(Currently) The implementation of statewide requirements has been effective in maintaining 92% immunization coverage among children in licensed child care facilities and kindergartens."

94.4% of K Students Have All Shots Single Vaccine Rates are Higher, 95.7%+ There is No Problem!

SELECTIVE REVIEW CALIFORNIA, 2011

Current Vaccination Rates with the Exemption in Place Easily Exceed the 90% Healthy People 2010/2020 Goal!

Table 1: Kindergarten Immunization Coverage*, Comparison of Fall 2010 Assessment and Spring 2011 Selective Review All Schools Public Schools Private Schools blue boxed and The n = 286 n = 205 n = 81 highlighted text is the Fall 2010 Assessment Total Enrollment All Required Immunizations Conditional Entrants Permanent Medical Exemptions Personal Belief Exemptions DTaP (4+)1 Polio (3+)2 MMR (2+)3 Hep B (3+)4 Var (1+)5 17,089 + 1.5% + 1.42% + 0.07% + 0.49% + 1.1% + 1.1% + 1.1% + 0.6% + 0.6% Spring 2011 Selective Review 16,899 + 0.8% + 0.66% + 0.05% + 0.52% + 0.7% + 0.6% + 0.6% + 0.5% + 0.5% Fall 2010 Assessment 15,486 + 1.5% + 1.51% + 0.07% + 0.45% + 1.1% + 1.0% + 1.1% + 0.5% + 0.5% Spring 2011 Selective Review 15,316 + 0.8% + 0.68% + 0.05% + 0.50% + 0.6% + 0.6% + 0.6% + 0.5% + 0.5% Fall 2010 Assessment 1,603 + 5.4% + 4.32% + 0.18% + 2.99% + 5.0% + 5.0% + 5.4% + 3.1% + 3.1%

admission Spring 2011 that some number of the Selective Review Personal

Belief Exemption's are for 1,583 only a single vaccine or 91.6% 94.4% 92.2% 95.2% 86.4% 86.8% + 4.0% dose- Few 6.19% 3.03% 5.95% 2.56% 8.55% 7.58% + 2.72% children exempt from 0.08% 0.12% 0.07% 0.12% 0.13% + 0.18% all vaccines. 0.12% 2.08% 2.48% 1.78% 2.17% 4.93% 5.50% + 2.90% This is evidenced by the 93.7% 95.7% 94.2% 96.3% 88.9% 90.1%rising when Chicken rate + 3.7% 94.2% 96.0% 94.8% 96.6% 88.5% 89.4% + 3.8% added as a Pox was 94.1% 96.0% 94.7% 96.6% 88.0% 90.3% + 3.5% requirement. Many 96.7% 96.8% 97.0% 97.1% 94.2% 93.5% + 3.0% remember parents who 97.1% 97.0% 97.3% 97.3% 94.4% 94.0% + 2.9% Chicken Pox being a routine childhood illness, * Immunization coverage for individual antigens is unavailable for students with Personal Beliefs Exemptions and therefore may be underestimated; and perhaps desiring the Anecdotal evidence suggests a small percentage of students may have some but not all required immunizations. lifelong immunity 1. Four or more doses of any diphtheria and tetanus toxoids and pertussis vaccines including diphtheria and tetanus toxoids, and any acellular pertussis vaccine 2. Three or more doses of any poliovirus vaccine conferred with natural 3. Two or more doses of measles, mumps, and rubella vaccines, separately or combined on or after the 1st birthday infection, opt out of 4. Three or more doses of hepatitis B vaccine Chicken Pox but willingly 5. One or more doses of varicella vaccine, adjusted for history of varicella disease comply with the rest of the Due to "underestimation" actual individual vaccine rates are even higher than the 95.7% + plus documented schedule.

What Public Health Objective is not met with 95.7% + vaccination rates?
Any epidemic risk is long past with this coverage. Any outbreaks at these rates are due to vaccine failure, not inadequate coverage. From a practical standpoint, how likely is it that any appreciable number of the small group of exemption holders documented here does so casually, and could be easily converted, and at what effort? Even if half of the exemptions were eliminated, what has been gained in real terms? An increase from a 96% vaccination rate to 97%? Prepared by the California Department of Public Health, Immunization Branch EXEMPTIONS ARE NO THREAT TO PUBLIC HEALTH
http://www.cdph.ca.gov/programs/immunize/Documents/2011SelectiveReviewResults.pdf

This Powerpoint was presented at The 10th National Conference on Immunization and Health Coalitions - May 23-25, 2012, New Orleans
Summarizing the Results of WA SB5005 Vaccination Exemption Rule Changes Health Care Providers are Refusing to Sign Exemption Forms
CA AB 2109 IS NOT INDENTICAL to WA SB 5005 and has been misrepresented to the CA Legislature and Public. SB5005 contains a Religious Exemption not requiring HCP signature, as well as Personal and Philosophical Exemptions. All Current Exemptions Grandfathered and Unaffected & No Annual Renewal Requirement.

Is SB5005 working? Dozens of complaints in the first 8 weeks to DOH about HCP's refusing to sign Exemption Forms. Overall (K-12) Exemption use reduced only 3/10's of 1%(00.3%). Vaccination Rates Dropped for 4 of 8 Vaccines.

100%

DTaP/Td
95%

Polio Measles

90%

Mumps & Rubella

85%

Hep B Varicella (chicken pox)

80%

75% 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11

School Year

Within mere weeks of SB5005's implementation the DOH had received Dozens of Complaints about Providers refusing to sign. Assembly Member Pan stated at both the Assembly Health and Senate Health hearings that the DOH hotline in WA State had received less than a dozen calls . THIS IS INACCURATE! Choice advocates correctly predicted that some Providers would refuse to sign. If AB2109 is enacted it will cause many more complaints.

Vaccine Hesitancy Trends

Aug 2011 Reuters/NPR Survey Pediatrics Oct 3, 2011

21.4% said they believe vaccines cause autism 26.6% report they were concerned about value and safety of vaccines
47% had concerns about long-term impact on health 46% had concerns about side effects

1 in 5 parents following recommendations agreed that delaying vaccine doses was safer 1 in 4 disagreed that the best vaccine schedule was the one recommended by experts 1 in 3 parents using alternative schedules had initially followed the recommended schedule

23.5% said their opinions had changed in the past five years
59% said their opinion had become less favorable

Percent of Students with Exemptions to School-Entry Vaccination Requirements, School Years 2002-03 through 2011-12