Sonoma County school and public health officials are gearing up for a large-scale immunization campaign aimed at getting an estimated 15,000 preteen and teen students vaccinated for whooping cough.
A new immunization law that takes effect this summer requires that all incoming seventh- to 12th-grade students show proof of receiving a booster shot for whooping cough - also known as pertussis - before starting the 2011-2012 school year this fall.
In Sonoma County, 32,800 students fall into this category. While more than half have likely received the booster, all of the students will be required to update their immunization records at school.
"We have 32,800 students to check. We got to get it going," said Steve Herrington, county superintendent of schools.
The county's estimate of 15,000 students who have yet to receive the pertussis booster is based on state data and figures from Kaiser Permanente Santa Rosa Medical Center, which insures about 12,000 of the 32,800 students, said Mark Netherda, the county's deputy public health officer.
The new state requirement is a direct response to an epidemic increase in the number of cases of whooping cough in the U.S.
Cases have been increasing since the 1980s, especially among younger people, ages 10 to 19, and babies younger than 6 months. Nationally, in 2009 there were nearly 17,000 reported cases, including 14 deaths, from pertussis.
Last June, California declared a statewide pertussis epidemic after 910 cases and five infant deaths were documented within six months.
For the entire year of 2010, 8,627 confirmed, probable and suspected cases were documented, the largest number of cases in 63 years, state officials said.
"That's only the tip of an iceberg," said Dr. Robert Schechter, a pediatrician with the immunization branch of the state Department of Public Health. "There are many cases that don't get reported as well."
Schechter said while it is legal to obtain an exemption from vaccines, doing so puts both schools and the larger community at risk.
"Children who are unimmunized are at greater risk of getting pertussis and they are at greater risk of spreading pertussis," he said. "Should there be pertussis outbreak at the school, the children (with exemptions) may be excluded."
Health officials say that could last weeks.
Schechter recalled several instances where schools were temporarily shut by local public health officials after an outbreak of whooping cough.
In 2008, the 300-student East Bay Waldorf School in El Sobrante, which has a low percentage of immunized students, was closed after at least 16 children came down with whooping cough.
Pertussis, a highly contagious bacterial disease, is among the most common to occur in the U.S. In Sonoma County last year, there were 221 cases of whooping cough, with 20 of these cases being among infants.
It starts out like a cold, with runny nose or congestion and sneezing. A mild cough often becomes more severe after one to two weeks. It can cause violent, rapid and repeated coughing until the lungs are devoid of air and what follows is a loud, forced inhalation that makes the "whooping" sound.
While the cough may be mild or minimal among infants, pertussis is especially dangerous for infants. Most of the fatalities caused by pertussis have been among babies, Schechter said.
Unlike other vaccines given to children before they enter kindergarten, the protection kids get from getting a pertussis vaccine diminishes over time.
The pertussis booster is currently found in the Tdap combination vaccine, which protects children against diphtheria, tetanus and pertussis. Netherda said only the Tdap vaccine contains protection against pertussis.
The new Tdap law makes a number of changes to state vaccination requirements.
As with current vaccination rules, parents can get a waiver through a "permanent medical exemption" or a "personal belief exemption." However, the rules around such exemptions have changed, Herrington said.
Among the changes:
All students entering grades 7 through 12 must show proof of receiving the Tdap vaccine before beginning classes in the fall.
Beginning with the 2012-2013 school year and thereafter, all children entering seventh grade must receive the Tdap vaccine.
Students who begin the school year earlier because of sports, such as starting football practice in August, must get a Tdap vaccine before they hit the field.
Current exemptions based on personal belief or a medical issue are not valid for the new pertussis booster requirement. A new exemptions must be obtained.
Exemption forms cannot be taken home and filled out. The forms must be filled out in the presence of school staff.
A meeting between local school officials and public health officials is scheduled for Feb. 17 to discuss the administrative and health care implications of the new rule.
Kaiser, which cares for about 6,000 children in Sonoma County who will need the pertussis booster, is planning a two-phase outreach effort to parents in the first week in March and again in April.
"That is a significant number of kids and that's the reason we're starting outreach in March so there's not a backup of kids when school starts," Kaiser spokesman David Ebright said.
On Friday, the state health department released the latest pertussis report and found "disease activity" is slowing down across the state, although a relatively high number of cases continue to be reported each week.
Netherda said the epidemic is far from over.
"We still are fighting the worst pertussis epidemic we've seen since 1947," he said.
For a baby, the illness can be deadly.
Netherda said that "illustrates the importance of everybody getting this immunization to protect our infants, because it's the infants who die from this disease, and it's a vaccine-preventable death."
You can reach Staff Writer Martin Espinoza at 521-5213 or martin.espinoza@pressdemocrat.com.
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