ROBERT SIEGEL, HOST:
The measles outbreak linked to Disneyland has grown to 114 cases in seven states. It has started a new conversation in this country about the decisions parents make when it comes to vaccinations. In states where it is easy to get a nonmedical vaccination exemption, disease rates go up, and we're going to explore that further in a few minutes.
RACHEL MARTIN, HOST:
First, the challenge school districts face in keeping track of children who are partially vaccinated. They're enrolled on the condition that they will eventually get all their shots. In Los Angeles, the school district can't even say if these under-vaccinated students ever become fully vaccinated. Rebecca Plevin of member station KPCC begins our coverage.
REBECCA PLEVIN, BYLINE: When Sara Martin's children were infants, she got them all of their vaccinations.
SARA MARTIN: And then somewhere when they became toddlers, I started to fall a little behind on the vaccinations - not intentionally, just that's kind of how it happened for me.
PLEVIN: Martin is 29 and a single mother of two. She says it was a huge chore to travel from her home in East LA to a community clinic downtown.
S. MARTIN: It not just about paying the fare for the bus, which seems pretty inexpensive, right? Like, a dollar and some change - maybe two buses there and two buses back because it was a long trip.
PLEVIN: There was also the challenge of feeding them throughout that trip while on food stamps.
S. MARTIN: I don't want to feel like these are excuses. It was just the reality. These are choices I had to make.
PLEVIN: Martin's kids, three-year-old Tzintia and 18-month-old Rick, eventually got caught up on their shots. There are a lot of kids like them who fall behind on their vaccinations simply because the logistics of life get in the way. California law says these kids must have all of their shots in order to start kindergarten. But there's flexibility. Schools enroll kids without all their shots as conditional entrants on the understanding that they will get the shots they need, says Tonya Ross of the Los Angeles School District.
TONYA ROSS: Then that information will be tracked by the school nurse, and then they'll - the parent will receive a letter saying your child is due for this immunization.
PLEVIN: By law, a family will then have 10 days to show proof of vaccination or the child will be kept out of class. But Ross admits schools don't always alert families on time.
ROSS: It's a challenge when, you know, you're busy during the school day and the days roll by and then three months later you realize you have a student who - you know, you missed notifying them and the parent forgot.
PLEVIN: And, she says, no kids were barred from class last year for falling behind on their shots. KPCC and the California Healthcare Foundation's Center for Health Reporting found in state records that in some Los Angeles kindergartens 60, 70 - even 80 percent of kids were enrolled conditionally during the 2013-2014 school year. In a written statement, and LA Schools spokeswoman said the district does not know how many children actually end up getting all their vaccinations. And, she says, no school district in the state has that information. Tonya Ross of the LA Schools says it's a resource problem.
ROSS: Immunizations - you know, if you're looking at a continuum, it's probably not high on the radar of a school that does not have a full-time school nurse or even a three-quarter-time nurse.
PLEVIN: The state is not tracking either. And under the law, schools don't risk any sanctions for not tracking conditional entrance or for failing to keep those who didn't get fully vaccinated out of school. For policymakers, the measles outbreak that started at Disneyland is a prime example of why schools and the state should do a better job of keeping track of students' immunizations. Bennett Kayser is a member of the LA school board. He says the problem should be easy to fix.
BENNETT KAYSER: It shouldn't be difficult to generate a report that says, who has needed a booster shot for the longest period of time - and sort the list of students who are still in need of boosters.
PLEVIN: The measles outbreak has brought the issue of unvaccinated kids to the attention of California lawmakers who recently proposed a bill to boost immunization rates. But nothing is in the works yet to ensure under-vaccinated kids get all of their shots. For NPR News, I'm Rebecca Plevin.
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