It was back to classes Wednesday for almost all 669 students sent home earlier this week by South Bay school officials because they lacked proof of measles immunization.
Of the returning students, some received free measles vaccinations at a special county-sponsored immunization clinic, while others were immunized by their family physicians or brought in proof of the exact date of vaccination, school officials said.
The vast majority of the students kept out of class had been immunized, but they were excluded because a county Department of Health Services audit showed that their records lacked the exact date of immunization or proof that the student had had the disease, school and health officials said.
County health officials audited the records at the 15 South Bay schools in December after an outbreak of measles in November at South High School in Torrance. The audit of 15,853 student immunization records showed that 669 students lacked proof of immunization and that 54 students were exempt.
School officials said that almost all of the errors were technical, such as records missing exact immunization dates or not containing a letter from a physician that a student had had measles.
The audit included 15 middle and high schools, 12 in the Torrance Unified School District, two in the Palos Verdes Peninsula Unified School District and the private Bishop Montgomery High School in Torrance. The greatest incidence of non-compliance was at Bishop Montgomery, where 369 students were sent home on Monday.
All 46 of the measles cases reported since late November have been at South High School, county health officials said Wednesday.
Typical of the situation in the area, according to school officials, was the experience of Pat Beaulieu, whose 14-year-old daughter, Cindy, is a freshman at Bishop Montgomery.
Cindy was among the hundreds of students--almost all seniors--whose names were called during a school assembly on Monday and who were sent home after school officials contacted their parents.
The Beaulieus went to the Torrance Health Center on Wednesday where Cindy received the free vaccine, although her mother said Cindy was immunized when she was about a year old. Her daughter's school record lacked the date she was vaccinated.
"I called our family doctor's office, and the nurse said it would be wise to get the shot again," Beaulieu said, referring to the fact that the vaccine is most effective when given to infants after they are 15 months old.
County health officials have recommended revaccination for students who received the shot before the age of 15 months. Medical experts have also concluded that the vaccine does not provide 100% protection, said Dr. Steve Waterman, chief of communicable disease control for the county Health Department.
Paul Mackey, administrator of special services for the Torrance Unified School District, said less than 3% of the records that were audited in the district were out of compliance with the state immunization law, which requires that children enrolling in schools show proof of immunization--by regulation that includes the date--or certification that they have had measles. Medical reasons or religious beliefs are the only exemptions.
"For the most part, these students had been inoculated, but the records show something was missing," Mackey said. "They were either inoculated at 12 months, or the record didn't show the day and month. . . . We had no reason to believe that some of these students had been inoculated improperly."
Officials in the Torrance Unified District and at Bishop Montgomery said most of the students with incomplete records were seniors who were enrolled before the state required the date in vaccination records.
One possible reason for measles outbreaks like the one at South High--and a more widespread outbreak in Kern County in 1986, in which more than 500 people contracted measles over a seven-month period--is the large number of undocumented workers in California who may not be immunized but are afraid to go to public health clinics to get the vaccine, said Brad Prescott, administrative assistant for the county's immunization program.
Prescott said a reason that schools may not pay as much attention to the specific requirements of the immunization regulations is that there is no penalty for schools that allow students to enroll with incomplete immunization records.
The most recently reported measles case in the South Bay was on Jan. 1, but that case had not yet been confirmed, Prescott said.
Audits were also being done at the private Advanced Education Elementary School in Lomita and at one school Los Angeles Unified School District, Park Western Elementary School in San Pedro, after reports of rashes at those schools, Prescott said. Results are pending.
In the South High outbreak, for example, some students who had been inoculated against measles caught the disease anyway.
"What's happening is youngsters who are getting measles were immunized appropriately, but the immunization is not effective any longer," said South High school nurse Sherry Ruffell.
One student who had received the vaccine but who nevertheless contracted measles was Jason Kelley, 16, an 11th-grade South High student who said he was vaccinated against measles when he was 5 years old.
In mid-December, Kelley said, he developed what appeared to be cold symptoms. Kelley's stepfather, Robert Romo, said the family took Kelley to the family doctor, who diagnosed a cold. But when Kelley began developing a skin rash the next day, his mother, a nurse, recognized his symptoms as measles, Romo said.
The vaccine is still available at the Torrance Health Center during regular immunization hours, from 8:30 a.m. to 10:30 a.m. on Monday, Tuesday and Wednesday, and from 1 p.m. to 3 p.m. on Tuesday, Wednesday and Thursday. For more information, call the center at (213) 533-6571.