Tighter California vaccination restrictions await Newsom, who wants changes

New state legislation aims to curb fraudulent medical exemptions for vaccines against diseases, such as measles, mumps, rubella, polio, whooping cough and chickenpox. 
Photo: Max Pixel

California’s Senate on Wednesday joined the Assembly in approving a bill that will tighten regulations on medical exemptions that allow students to attend school without having all the required vaccinations. The bill now goes to Gov. Gavin Newsom, who said he plans to seek changes through other legislation before signing it.

Opponents of the bill showed up outside and inside the Capitol in Sacramento Wednesday chanting and waving signs. Loud, raucous protests against the vaccination bill have become common at the state Capitol in recent months. Emotions have run high, prompting one protester to shove the author of the bill, Sen. Richard Pan, (D-Sacramento), when he was walking near the Capitol, according to media accounts.

“As the United States moves closer to losing our measles elimination status that we’ve had since 2000, I commend the California legislature for working to protect children and communities from measles and other vaccine-preventable diseases by passing SB 276,” Pan said in a statement. “I thank the Governor for his leadership and his commitment to sign the bill so that those children who truly need medical exemptions will be able to safety attend school.”

Senate Bill 276 calls for the California Department of Public Health to review a medical exemption if a child attends a school with an immunization rate of less than 95 percent, if the doctor who signed the exemption has written five or more during the year or if the school did not provide the department with its vaccination rates.

It requires the state Department of Public Health to develop a standardized electronic medical exemption form that will be transmitted directly to the California Immunization Registry. It prohibits a physician from charging families for filling out the form or for a physical examination related to renewing a temporary medical exemption.

The bill also establishes an appeals process for medical exemptions that are revoked and sets up an independent review panel made up of three physicians.

Newsom previously expressed support for the bill, but Tuesday indicated on Twitter that he wanted to change the bill to clarify the exemption and appeal process.

“The Governor believes it’s important to make these additional changes concurrently with the bill, so medical providers, parents and public health officials can be certain of the rules of the road once the bill becomes law,” read a tweet from the Office of the Governor of California posted Tuesday.

The changes would be made in a separate bill that would move through the Legislature before the Sept. 13 deadline to pass bills, according to the Los Angeles Times.

The Assembly approved the bill Tuesday.

Opponents of the bill voiced their outrage at the Capitol and on social media Wednesday, encouraging people to call the governor to ask him to veto the bill.

“In 2015 the state Legislature took away the personal belief vaccine exemption with a promise that licensed doctors would have the legal right to protect children from vaccine reactions by granting medical exemptions,” said Barbara Loe Fisher, president of The National Vaccine Information Center, which opposes legislation requiring vaccinations. “Four years later, legislators have broken that promise by ignoring the pleas of families with vaccine vulnerable children and passing SB 276, which sets a dangerous precedent for allowing doctors employed by government to override health care decisions made by private doctors and parents on behalf of minor children.”

Under state law, children must be immunized against 10 serious communicable diseases if they want to attend public or private schools and child care centers. Studies have linked clusters of unvaccinated children to outbreaks of measles, pertussis and chicken pox.

Vaccination numbers across the state have increased since a 2016 law was enacted banning so-called personal belief exemptions that allowed parents to opt their children out of vaccinations. At the start of the 2018 school year, nearly 95 percent of the state’s kindergartners started school with the required vaccinations, according to data from the state Department of Public Health.

Communities can guard against disease outbreaks by having a sufficient portion of residents vaccinated. The concept, referred to as herd or community immunity, also protects newborns and those with chronic illness who can’t be vaccinated. Ninety-five percent of children at a school must be immunized to prevent transmission of disease in a community, according to the state Department of Public Health.

But families can still get a medical exemption from a doctor who states that the child should not be vaccinated because of either a temporary or permanent medical condition.

Medical exemptions have gone up fivefold since 2011, to 4,812 in 2018, according to a recent EdSource analysis of hot spots with low vaccination rates. Pan said that many of the exemptions are clustered in the same schools, creating pockets of unvaccinated students who undermine the state’s overall high vaccination rates.

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