Monday, June 27, 2011

Assembly Bill 354: Recent Vaccination Law for California

California’s Assembly Bill 354 states that beginning July 1, 2011, all seventh through twelfth grade students must have had the pertussis shot with all appropriate boosters. The Centers for Disease Control (CDC) has decided that the original series of pertussis shots loose potency between five and ten years after being administered; therefore, a booster is necessary. According to this bill, in 2005 a pertussis booster was licensed in the U.S. in the form of a Tdap vaccination specifically intended for teens and adults. Not only were threatening flyers sent to the parents of at least one LAUSD school warning them to give the booster to their tweens and teens or else, but the whole bill seems to be an attempt to manipulate parents because there is a lack of proof of the booster’s efficacy during an actual pertussis outbreak.

The memo that went out to all public and private school’s administrators from the California Department of Public Health (CDPH) indicates that if children received the Tdap vaccine after their seventh birthday, they would not need a booster. Administrators also were asked to post information from the CDPH’s memo for families to read and to become informed. The information asked to be sent to families was as follows:

Pertussis is widespread. If your child is 10 years and older has not yet receivedthe ‘Tdap’ pertussis booster shot, please contact your doctor or health department. Getting a booster shot now will protect your child against the ongoing threat of pertussis and meet a new school requirement that begins in the 2011-2012 school year (California law ─ Assembly Bill 354). Adults are also advised to get a pertussis booster shot, if they haven’t already, to protect themselves, their families, and their students.

The information memo sent to administrators from the CDPH also states, after the first paragraph, that parents can exempt their children from taking the booster “for verified medical conditions or personal beliefs.” Despite the offering of an exemption, at least one middle school in LAUSD sent the information about the new requirements in a very threatening manner. In no place, not even in the most minute print, did this flyer sent to parents state that a waiver for exemption would be accepted. This flyer says, “For the 2011-12 school year all students entering or advancing to 7th through 12th grade will need proof of the Tdap (tetanus, diphtheria, pertussis) booster shot before entering school,” followed by information on where to obtain a shot. The flyer then states, “You must present written evidence to the school from your physician or clinic that your child has received the Tdap booster before THE FIRST DAY OF THE 2011-12 SCHOOL YEAR or your child will be EXCLUDED FROM SCHOOL ATTENDANCE.” The CDPH had made all the information about the new law of September 30, 2010, Assembly Bill 354, available to the administrators, yet this school never mentioned the law by name in the flyer that went out to parents. From the parent’s point of view, this could have been simply a school requirement. These parents also were not informed about their right to refuse the vaccination, as was clearly stated on the CDPH’s memo to the school’s administrators. Please be aware that certain states do allow parents to sign a waiver refusing vaccinations for children due to the beliefs of the parents. Get informed. Do not be bullied by administrators and school nurses.

The California Department of Public Health wants every child in California to dose up with Tdap, asserting all the while that the shot “will protect your child against the ongoing threat of pertussis.” This recommendation is made despite the last sentence in “Chapter 10: Pertussis” of the Vaccine-Preventable Diseases (VPD) Surveillance Manual 4th Edition which states, “The efficacy of Tdap vaccination in controlling school or institutional outbreaks has not been evaluated.” This Tdap booster shot was manufactured in 2005. For its part, the CDC uses an information collection form to document vaccination history, doses, dates of doses, etc., of all patients identified as having pertussis, as mentioned in the VPD Surveillance Manual 4th Edition. Consequently, the CDC does have all the facts as to whether this booster has worked so far or not because right in front of their eyes they can see if this child had the booster and when. If the booster has in fact not been given to any suffers of pertussis, the CDC are easily privy to that information and can state that the reason they cannot evaluate the efficacy of the booster is because all the sufferers had not had the shot. If the truth is there were some tweens and teens with pertussis who had received the booster, then it would be understood why they would wish to keep that quiet; nevertheless, the CDC could still evaluate the booster’s efficacy. If all the kids who have had the booster did not get pertussis when others in their school did, that too could lend credibility to the booster’s efficacy. The information could very easily have been gathered by various school nurses where at least one child was reported as suffering from pertussis. Surely, after six years, some report on the actual effectiveness of the pertussis booster is available for the CDC and the public to evaluate. If not, why has the use of something not thoroughly evaluated for its effectiveness been made into a law?

The CDC’s National Notifiable Disease Surveillance System states that since the 1980’s, pertussis cases have been slowly increasing amongst teens. They further state that possibilities for the increase could be due to more cases of pertussis, or quite possibly to better detecting and reporting of the disease. Nevertheless, the CDC feels the booster is important.

According to a CDC article titled “Outbreaks,” ten infant deaths occurred in California in 2010 from pertussis, and 9 out of 10 of the infants were of Latin background. Details from an investigation surrounding these 10 would be very interesting, especially in regard to the people around the infants and their vaccination histories. One of the babies had the first dose of the pertussis vaccination just 15 days before he died of pertussis, and most of these babies were younger than 3 months. Because of the recent outbreak, the CDC recommends an accelerated immunization schedule for infants, and the CDC encourages the booster shot for individuals who are around babies. The updated regulations state that the first pertussis shot is to be given when the baby is just six weeks old, with one shot to follow every four weeks until five have been given.

The 2004 outbreak of pertussis was not nearly as widespread as the 2010-2011 outbreak. Looking at one group of children who were documented as having pertussis from October 2003 through December 2004, we can see that there really was not much difference between the numbers in the not vaccinated group, the not vaccinated sufficiently group, and the vaccinated sufficiently group, using 2004 criteria of three doses. Of the 115 children documented on a chart, 10 had no known vaccination history. Looking at the 105 remaining, 23 were unvaccinated, 37 were not vaccinated sufficiently, and 45 were vaccinated sufficiently. The surveillance paper states, “Cases among infants younger than six months of age are not preventable by vaccination because these infants are too young to have received three doses of pertussis vaccine, the minimum needed to confer protection.” Of these 105 children, 31 with a known vaccination history were infants, all with insufficient vaccination histories due to their age. The CDC has since increased the required number of shots to five, plus the booster around 10-11 years of age. By the way, 12 of these kids had received five doses. Perhaps the CDC could look for the vulnerability of diseases elsewhere, such as consumption of too much junk food, extreme stress levels,insufficient sleep…and too many vaccinations.

Interestingly, the Immunization Branch of the Communicable Disease Control states that to satisfy this new law, tweens and teens only need to have the pertussis shot, even though a vaccine just for pertussis (without being in cocktail form) is not available in the U.S. In short, by making pertussis vaccination a requirement, this age group is forced to receive the tetanus and diphtheria vaccinations as well.

Parents are cautioned to research the issue and CDC findings, so they can make an informed decision on this matter.

For more information, Please read Dr. Allsup’s article, “Alert-Assembly Bill 354 Passes” at (May 26) and visit


Notification “Tdap Immunization Due” flyer on file with author from a CA LAUSD school. sen_floor.html, #41, #42 14-2010%20- %20For%20Release.pdf

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