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Preschools a microcosm of debate on measles vaccinations

Some preschools take a hard line on measles vaccinations for children while others leave it up to the parents

For 19 years, the director of the Laguna Parent Participation Preschool has worked alongside mothers and fathers to decide such questions as what children should eat during snack breaks and what type of field trips they should take.

But when the current measles outbreak prompted the school to review its vaccination policy, the south Orange County co-operative found itself confronting questions normally left to politicians and public health officials.

"We're a microcosm of what everyone is coming up against," said Barbara Crowley, the school's director. "Do parents have a right to decide to vaccinate their children or not?"

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Kindergarten classrooms and preschools have been pushed to the front lines as measles cases continue to roll in and the national debate over vaccines grows more heated.

At first, Crowley considered whether the co-op, which operates from a church in Mission Viejo, should toughen its stance on allowing parents to opt their children out of vaccines. More than 25% of the students at the school were not fully immunized — well below the recommended level.

"My parents are so wonderful about raising all the children and caring about all the children and teaching all the children, so why does it not extend to the vaccinations?" Crowley wondered.

But changing the policy would mean potentially alienating a quarter of the parents at a school that counted on them to be shareholders in the preschool's success.

"For us to say that we know better?" Crowley posed. Not a chance.

Look up vaccination rates at California child-care centers

After what Crowley described as thoughtful and measured discussion, the school decided against deviating from state law, which gives parents the choice of whether to immunize their children.

While physicians continue to sign exemptions for school-age children and politicians push for tougher laws, schools in California have gone in different directions since the rapid spread of the disease following the initial exposure at Disneyland during the holidays. There have now been 131 confirmed cases in California linked to the outbreak.

The University of California announced in February that by 2017, all incoming students would need five vaccines, plus TB screening. The Santa Monica-Malibu Unified School District, which had two measles cases at a high school and affiliated child- care center, directed its nursing staff to talk with parents of unvaccinated students.

Among the nearly 200 schools registered with the California Council of Parent Participation Nursery Schools, including Laguna Parent Participation Preschool, responses range from continuing to mandate vaccines to supporting parents no matter their choice.

At the YWCA Family Cooperative Preschool in Santa Monica, the executive director of its parent organization wrote a letter to current and prospective families, encouraging them to "protect their children and prevent measles" by getting vaccinated.

The school's vaccination rate had been as low as 51% in October, according to state figures. But as the school collected tardy paperwork and parents had their children vaccinated, the immunization rate grew to 82%, Julia Miele explained in the message.

Board members are also evaluating whether the state guidelines were "sufficient given the local incidents of measles," Miele said in a phone interview.

Julie Schneider, whose twin daughters attend the preschool, said she felt comfortable with the school's policy of following the state vaccination law.

"There are other things to worry about," said Schneider, explaining that vaccination rates weren't on her "list of questions to ask" when she was preschool shopping. She said she was more concerned about lead poisoning than the measles.

At Sand Tots, a co-operative preschool in Redondo Beach, admission remains contingent on up-to-date vaccinations.

"You don't have to immunize," Director Sandra Rojas tells parents, "you just can't come here."

Rojas said she makes exceptions only for children with medical restrictions and considers it the school's responsibility to the community to make sure students are vaccinated. Parents volunteering in the classroom may have infants with them, she said, and others bring along newborns when they pick up and drop off preschoolers.

Megan Haldeman, who has two children at the preschool, said the zero-tolerance vaccine policy makes sense.

"These kids get sick from everything," she said. "Cold and flu are bad enough."

As the number of measles cases multiplied, Haldeman said, she felt the school was doing its part to put up a wall of resistance to the disease and that other schools should do the same.

"I don't think it is something you can responsibly ignore," she said.

Still, parents have no more right to force a school to tighten its vaccine policy than they would in forcing neighbors to remove guns from their house, noted Alexander Capron, USC professor of law and medicine.

Parents visiting Sand Tots, however, said they appreciate the school's zero-tolerance vaccination requirement, with some saying they would enroll their children because of it, Rojas said.

After all, while Haldeman wiped off tables and swept the floor of a classroom Tuesday, delighted children put their hands on everything in sight. They shook bells, turned pages of books and tugged on costumes.

Haldeman's son Ben added loops to a paper chain, singing: "La, la, la, la, everything is awesome!"

Ben had received a round of shots last week. They hurt, he said, but the pain went away quickly. And after that?

He shrugged, a shy smile inching across his face.

emily.foxhall@latimes.com

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