Polio watch: No cases, but Santa Cruz County sees some of the lowest immunization rates in the state

A CDC scientist extracts viral RNA from samples of poliovirus genetic material for molecular testing.
(Via Centers for Disease Control and Prevention)

A polio case in New York has generated national headlines. Though it is the only known U.S. case, as the once-almost-eradicated disease pops up in 34 countries, concern is spreading. County health and schools are encouraging vaccination, especially as Santa Cruz lags behind.

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Since a case of paralytic polio was reported in New York in July — the first known case in the U.S. since 2013 — and the Centers for Disease Control and Prevention reported the disease’s circulation in the city’s wastewater, health officials have reiterated that vaccination continues to be the best way to prevent its spread.

So far, no additional cases have been reported in the U.S, according to the CDC.

Santa Cruz health and education officials say there are currently no concerning signs in the county. Their efforts are focused on encouraging families to stay up to date on all recommended and required vaccinations.

In Santa Cruz County, 89.3% of kindergarten students had received all required immunizations required to attend school (polio, diphtheria/tetanus, chickenpox, measles/mumps/rubella and hepatitis B) for 2019-20 — the most recent year with available data. Santa Cruz County’s rate is among the lowest 25% of California’s 58 counties.

A total of 92.5% of U.S. children aged 24 months have received three doses of the polio vaccine. The vaccine has been given only by a shot here since 2000.

The CDC recommends children receive four doses of the vaccine, which they start receiving at the age of 2 months. They receive their remaining doses at the ages of 4 months, 6 months through 18 months and then a final dose between the ages of 4 to 6 years.

Santa Cruz County Health Services Agency spokesperson Corinne Hyland said that there is no change in baseline data for “vaccine-preventable diseases,” meaning that there has not been an observable spike in the prevalence of diseases with available vaccines like measles, smallpox and polio.

Still, the pandemic forced many people to forgo non-emergency appointments, including immunizations. Since there’s been no observable local surge in the diseases these vaccines prevent, Hyland says the best public health tool right now is messaging.

“The pandemic definitely did not help with people getting regular vaccinations,” she said, adding that public health knows that people are behind on vaccinations based on data from the California Immunization Registry. “Right now, our message in public health is to go see your health care provider and get caught up on any vaccinations that may have been missed during the pandemic.”

“While we aren’t seeing an uptick locally, there is always the potential for vaccine-preventable disease cases to increase if there are pockets of unvaccinated individuals,” said Hyland. “Anyone who is concerned about preventable diseases such as polio should get vaccinated.”

Hyland added that outside of immunization requirements for schools, Santa Cruz County does not have a policy requiring individuals to receive certain vaccinations, including the polio jab.

What about schools?

To attend school in California, state law requires four doses of the polio vaccine — among several other required vaccines, according to the Department of Public Health.

County Office of Education spokesperson Nick Ibarra said local school officials are monitoring CDC and California Department of Public Health updates. Further, they reached out to families this summer, reminding them to catch up with vaccinations.

COE officials also have regular meetings with local education leaders, including those from some private schools that have had lower vaccination rates, according to Ibarra.

A state law that went into effect in January 2021 tightened requirements for obtaining medical exemptions from vaccines.

“There is a stricter process to seek a medical exemption that requires application through a more centralized database with more stringent standards,” Ibarra said. “We’re optimistic that some of those changes will move us in the right direction.”

To check the vaccination rates at school sites with kindergartens, sites with seventh graders and for child care centers, visit the California Department of Public Health immunization website.

For the better part of the 20th century, polio was perhaps the world’s most feared illness. Though some infected with the virus remained asymptomatic, about 1 in 200 cases led to paralysis and even the need for iron lungs to simply stay alive.

However, thanks to one of the most successful and high-profile vaccination campaigns ever, polio was eradicated in the United States by 1979. By 2015, the virus was nearly eradicated everywhere except in Afghanistan and Pakistan.

But the 2020s have been filled with curveballs so far, and a polio resurgence has health care professionals watching closely. By 2020, 34 countries had reported cases, and in recent months cases have surfaced in Ukraine and Israel, and poliovirus was detected in sewage in London in June.

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