A rising number of California parents are choosing to send their children to kindergarten without routine vaccinations, putting hundreds of elementary schools in the state at risk for outbreaks of childhood diseases eradicated in the U.S. years ago.
Exemptions from vaccines -- which allow children to enroll in public and private schools without state-mandated shots -- have more than doubled since 1997, according to a Times analysis of state data obtained last week.
The rise in unvaccinated children appears to be driven by affluent parents choosing not to immunize. Many do so because they fear the shots could trigger autism, a concern widely discredited in medical research.
But with autism rates rising, some parents find that fear more worrisome than the chance that their child could contract diseases that, while now very rare in this country, can still be deadly.
Last year, a 7-year-old boy triggered a measles outbreak in San Diego after he returned, infected, from a family trip to Switzerland. His parents had chosen not to vaccinate him or his siblings.
"The more children we have in our communities that are not immunized, the more likely we are going to have massive outbreaks," said Dr. Gil Chavez, deputy director of the California Department of Public Health's Center for Infectious Diseases.
In all, more than 10,000 kindergartners started school last fall with vaccine exemptions, up from about 8,300 the previous school year. In 1997, when enrollment was higher, the number of exempted kindergartners was 4,318.
Statewide, only 2% of kindergartners had exemptions. But The Times found they were enrolled in a relatively small number of schools. Parents who sign affidavits saying vaccines are "contrary to my beliefs" are most likely to send their children to schools in affluent areas -- many of them public charter schools and non-Catholic private schools.
The Times found that 1 in 11 elementary schools statewide may be at risk of an outbreak of an infectious disease such as measles, mumps or whooping cough. It's a risk some parents are willing to take.
"As a parent, I'd rather deal with my kid dealing with measles or mumps and sit with them in a hospital . . . than taking your chances on a shot and having irreversible effects," said Kim Hart, a mother of two in San Clemente.
In California, sending a child to school without all or some of the required shots is as simple as filling out a form, a policy that's been in place for decades.
Parents' fears grow
For generations, most children went unimmunized only if their parents couldn't afford the shots, a problem now remedied through federal funds. A tiny percentage of children cannot be vaccinated for medical reasons.
But as parents' fears about vaccine safety have grown, the demographics of the unvaccinated have shifted substantially. Although fewer than 2% of kindergartners at traditional public schools and Catholic schools in California had exemptions last fall, more than 4% of kindergartners at other private schools and nearly 10% of those enrolling in charter schools were exempted.
In south Orange County, 16 of the 38 elementary schools in the Capistrano Unified School District had high enough exemption rates to be at risk, as did nearly a quarter of the 26 elementary schools in the Saddleback Valley Unified School District.
A Times analysis found other concentrations on the Westside, the Palos Verdes Peninsula and the central Orange County coast, and in the southern San Fernando Valley.
At Ocean Charter School in Del Rey, near Marina del Rey, 40% of kindergartners entering school last fall and 58% entering the previous year were exempted from vaccines, the highest rates in the Los Angeles Unified School District.
Administrators at the school said the numbers did not surprise them. The nontraditional curriculum, they said, draws well-educated parents who tend to be skeptical of mainstream beliefs.
"They question traditional knowledge and feel empowered to make their own decisions for their families, not deferring to traditional wisdom," said Assistant Director Kristy Mack-Fett.
Some parents at the school, which opened in 2004, said they struggled between what they believed was healthiest for their children and the risk that choice might create for others.
Kami Cotler, 44, delayed some vaccinations for her daughter, Callie Howard, 8. But by the time Callie went to school, she had received all of her shots.
"It seems like a social contract," Cotler said on a recent morning at the school, where parents agree to ban TV on school nights and the children create their own textbooks. "If we all stop immunizing, that has serious ramifications as far as society is concerned."
The risk to children is real, as the San Diego outbreak demonstrated.