As the summer draws to a close, Marin County public health officials are reminding parents that five vaccinations are required before their children are permitted to attend kindergarten or childcare, barring a medical exemption. Vaccination rates for Marin kindergartners have gradually risen in recent years, reaching their highest level yet last year, with 93.2 percent of students in the county’s 73 schools meeting all requirements: DTP, which fights diphtheria, tetanus and pertussis; Hepatitis B; MMR, which inoculates against measles, mumps and rubella; and varicella, the chickenpox vaccine. Beginning in 2016, Senate Bill 277 eliminated personal and religious exemptions from vaccine requirements, which county health officials say was a major factor in boosting vaccination rates. Most of West Marin’s schools have high vaccination numbers. Last year, at Inverness School, 19 of the 21 kindergarteners were up to date in their vaccinations, while 20 of 21 kindergartners at Tomales Elementary were fully inoculated. At Bolinas-Stinson School, two of 10 kindergarteners filed personal belief exemptions. Donna Henderson, an administrative assistant at Lagunitas School, which historically has been a stronghold of anti-vaxers, said the school has received a few medical exemptions for the upcoming school year. Dr. Lisa Santora, deputy health officer for Marin Health and Human Services, said the county will “engage with a school directly if the vaccination numbers begin to decline.” But obtaining a medical exemption can be difficult, said Dr. Michelle Veneziano, a Forest Knolls osteopath and mother in the district. “Most doctors are not willing to write them because they fear repercussions. The doctor must have read enough non-industry funded research that if they’re called to defend an exemption, they have solid science to back it up,” she said. Though the anti-vaccination movement has been sharply condemned by the medical community, public health officials and the media, some in West Marin are encouraging dialogue. Suzanna Goldblatt Clark, a Sonoma resident whose young children will attend school in the Shoreline Unified School District, studied the movement while she was pursuing a Ph.D. in medical anthropology. She said the public should not invalidate concerns, but reach out to skeptics to find a middle ground. “People have legitimate worries about vaccines that are not addressed by the community,” she said. “If we start the conversation there, and say those fears are legitimate, then we have a place to start without compromising the science.”