Santa Cruz County, California Childhood Immunization Profile

All Kids by Two (AKT) Immunization Coalition of Santa Cruz County was established in mid 1996 to raise the immunization rates of infants and toddlers. The Coalition is comprised of public and private agency representatives, health care providers, and concerned members who have agreed to combine their human and material resources to achieve a common goal that they would be unable to bring about independently. The goal of AKT is to raise the immunization levels of infants and toddlers to meet the national objective of 90% of two year olds fully immunized and protected against vaccine preventable diseases. Furthermore, when children are not immunized and becomes ill, it affects not only the child and their family, it affects the whole community. Immunizations prevent suffering and anguish. Therefore, it is essential for the health of our children and our communities to ensure that immunization rates increase to acceptable levels.

The United States, by 1996, had been experiencing a recurrence in vaccine-preventable childhood diseases due to low immunization rates. The measles epidemic of 1989-1991 resulted in 55,000 cases nationwide. In California there were 17,000 cases, 3,400 hospitalizations and 70 deaths. Fifty of those deaths were to children age four and under. A major cause of the measles epidemic was the failure to vaccinate children on time by 12-15 months of age (California Coalition for Childhood immunizations, 1996). All 50 states and the District of Columbia had immunization requirements for children entering child care and school; there were no such laws assuring that children were up to date on their shots by age 2 (CDC,1996). California had also experienced a continued increase in pertussis through the 1980's and 1990's with the highest case count in 1996 in almost 30 years with 724 cases. Fourteen deaths due to pertussis infection had occurred between 1988 and 1998 to children age four and under.

In accordance, Santa Cruz had reported increased cases of vaccine-preventable diseases. During the measles epidemic, 23 cases were reported during 1989-1991, eight of which infected children age four or under. That was not much different from the 1989-1991  in which Santa Cruz County had a total of 20 cases.  Fortunately, no deaths resulted from any of the 43 cases. The pertussis incidence, in 1993, 25 cases (4%) of the state's 619 cases occurred were in Santa Cruz County.  The number of cases dropped in 1994 but rose again in 1995, 1996 and 1997. In 1997 Santa Cruz County had 7% of total California reported cases while accounting for less than 1% of the state population. The immunization rate in Santa Cruz County was 43.6%, compared to the state level of 67.9% up to date by the age two, and much lower that the national objective of 90% by Year 2000. (DHS,  1996) At approximately 8000 children under two in the County and 43.3% of two year olds fully immunized, 4500 children were lacking at least one of the required doses according to the immunization schedule of the American Academy of Pediatrics (APA).  The ethnic breakdown of children under two in the County according to the 1995 and 1996 Birth Certificate summaries by ethnicity of birth mothers were 44% White, 50.5% Hispanic, 0.7% African-American, 3.1% Asian/Pacific Islander, 1.8% Other/Unknown. (Birth Certificate Summary, 1995-1996)  In the 1996 Expanded Kindergarten Retrospective, immunization rates were only available for Whites and Hispanics which showed Whites had a rate of 59.1% fully immunized by age two and Hispanics had a rate of 65.6%. (DHS,1996)