On Tuesday night, the 2024 San Francisco Unified School District (SFUSD) independent audit will disclose that the school district is out of compliance with state requirements mandating immunization of all students against measles, chicken pox, and other illnesses. According to the audit, just 71 percent of students sampled were fully vaccinated, far below the 95 percent level needed for herd immunity or the 93 percent national average. While the school district has been out of compliance before, the percentage of students it reports as fully vaccinated is lower than previous years — even lower than the 82 percent immunization rate found in the West Texas community currently facing a measles outbreak.
Requiring school children to be vaccinated against measles, chicken pox, tetanus, diphtheria, and pertussis (whooping cough) to enroll in kindergarten has long been the law in every state. Since 2021, over the objections of Robert F. Kennedy, Jr., now the U.S. Secretary for Health and Human Services, California limits vaccine exemptions to medical, as opposed to religious or personal belief, reasons. The audit report concludes that the rise in unvaccinated students is caused by SFUSD “administrative oversight.”
During the 2023–24 academic year, auditors examined what they described as “a representative sample” of 120 student records. Among those records, 35 students, or 29 percent, did not have the required vaccination documentation. School officials are permitted to enroll such students on a conditional basis for just 30 days before parents are required to provide vaccination documentation or remove them from school.
This is the third consecutive audit that contains a finding of school district noncompliance with state law requiring vaccinations.
This is the third consecutive audit that contains a finding of school district noncompliance with state law requiring vaccinations. This time, auditors examined 10 times more student records than in previous years and found higher levels of noncompliance. Although the San Francisco Department of Public Health reported last Friday in its Measles Health Advisory that over 97 percent of kindergarten students newly enrolled last fall in San Francisco were fully immunized, it is not clear where the school district stands on other continuing or transfer students and on the other required immunizations.
In the Audit Report, the school district states it “is committed to making improvements to the immunization process across the District” and will “assign a dedicated individual responsible for ensuring compliance and providing supporting documentation to the auditors.” It made a similar commitment in response to the 2023 Audit Report. In response to the 2022 Audit Report also finding the school district out of compliance, it noted that “routine medical care did not occur during COVID,” and that it needed to redesign the immunization program to review records, inform parents, connect them to resources, and exclude children not up to date on immunizations. The redesign started in January 2022 and was to be implemented in August 2022.
In response to a request for comment and more detailed information, Laura Dudnick SFUSD’s executive director of communications and external affairs stated, “Some of the actions we have taken in recent years include School District Nurses and Health Workers working closely with families through outreach (i.e. in-person, emails, calls) to inform and encourage immunization compliance; adding a reminder and exclusion letters for students who are out of vaccination compliance; and working with community clinics to provide pop-up vaccine clinics.” Nurses, health workers, and community clinics may fall victim to school district and city budget cuts after June. Their efforts have not produced the results needed for parents and children to feel and be safe or the school district to meet the legal standard.
Now, after three years of audit findings and school district promises to appoint staff and hold them accountable only to result in worsening outcomes the subsequent year, parents want more to be done right away. S.F. Parent Coalition Executive Director Meredith Dotson told The Voice, “How are we able to provide the best educational environment if we cannot commit to ensuring a basic level of safety and health for our students? This requires an immediate plan of action.”
Measles outbreaks are highly preventable but dangerous when they occur. A Harvard study in 2019, the last time there was a significant measles outbreak, concluded that the measles virus could wipe out three quarters of the antibodies protecting children from other diseases to which they were previously immune. Beyond the clear health implications, the auditors note that school districts typically are not entitled to state funding for students who are enrolled in violation of the vaccine requirement. While the school district uses a different funding formula and is not at risk of losing funds, without urgent action it risks losing the trust and faith of San Francisco parents and giving them an additional reason to enroll their children someplace else.