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It’s a debate spreading as quickly as the infection, and local schools lead the state when it comes to vaccine exemptions.

Community Outreach Academy in North Highlands is known for its nurturing and warm environment. It’s also one of several local school under the microscope because of its high rate of unvaccinated children.

Katie Romanovich is a parent of two young boys.

“I’m sure all parents want the best for their children. And I don’t feel that, for my children, (vaccination) is the best,” Romanovich said.

Fifty-four percent of kindergarten students at COA have opted out of vaccinations; the school is a microcosm of the trend across our area.

In 2013, Placer, Yolo, Sacramento and El Dorado Counties saw the number of children starting kindergarten without vaccinations jump by 30 percent. Dr. Dean Blumberg founded a clinic at UC Davis Medical Center where parents can get counseling and have their exemptions signed.

“If it gets into one of these groups of susceptible people, it can really go through that group like wildfire,” Blumberg said.

So-called “anti-vaxxers,” health nuts or isolationists get much of the blame for the outbreak. But health experts and school administrators say something bigger is at play.

“When you do have a community that`s so close and tight knit, the word can spread from family to family quicker,” COA Assistant Superintendent Michael Gillespie said.

At COA, the vast majority of students are of Russian descent and are native Slavic speakers.

Many came to Sacramento as refugees to escape religious persecution. Health experts say clusters of immigrant groups are also where you are likely to find higher rates of children who aren`t vaccinated.

“Those who choose not to vaccinate become susceptible,” Blumberg said. “They get disease and they increase disease pressure on those who are vaccinated and those who are not vaccinated.”

And that`s why school administrators are bringing in health experts, sending home information packets and doing radio interviews.

“We don`t want parents to panic,” Gillespie said. “But at the same time we want them to be informed so they know if their child is sick. We don`t want them to be sent to school and we want them to consult their physician.”

Romanovich says it wasn`t an easy decision; neither one of her young boys are vaccinated.

“I don`t know if I’m comfortable enough giving something to my child that I don`t fully believe in,” says Romanovich. She admits that in small tight-knit communities, mis-information can spread like wildfire. But she says in her case, their decision was a personal one.

“There`s these stereotypes that we`re uneducated,” said Romanovich.  “That we haven`t done our research and that we follow this herd… and it`s absolutely false.”

Whatever the reason, Dr. Blumberg says parents are at a crossroads: principles vs. practical.

“Vaccination, immunization of children, have saved more lives in the history of mankind than any other medical intervention, than all of them put together,” he said.

A recent study from Kaiser Permenente shows a high number of under-immunization or vaccine refusal in the Sacramento area.