Four years after California led the nation in rolling back religious exemptions for vaccines, lawmakers are pushing to tighten remaining medical exemptions after a handful of skeptic doctors helped anti-vax parents exploit a loophole that’s resulted in hundreds of schools no longer having immunity from dangerous diseases like measles.
On Friday, the bill, which would create oversight of the medical exemption process and allow investigation of exploitative doctors, faces its last committee hurdle before going to the full legislature for final votes. Gov. Gavin Newsom has said if passed, he’ll sign it into law, in spite of ferocious opposition from anti-vaccine parents and lobbying by celebrity skeptics including Robert F. Kennedy Jr. and Jessica Biel. Activists rallied on Wednesday at the California capitol in an event titled, “The Last Stand,” with other protesters also coordinating this week.
New data on the immunization of 2018-19 California kindergarteners illustrates the problem. Statewide, the immunization rate is high, but for the last two years in a row, it’s been trending downward. More than 600 schools around the state reported that their campus no longer has herd immunity protection against measles, with less than 93% of kindergartners are up-to-date on their MMR shots. More than 100 schools reported that at least 10% of their students are unvaccinated because of medical exemptions. Statistically, just 1% of kids are likely to have medical conditions that prevent them from being vaccinated, Pan said.
That adds up to a dangerous situation for children who can’t be safely vaccinated, and it’s now up to the state to step in and protect them, he added.
“They need to be able to go to school and be safe as well. All children deserve to be safe at school,” he said.
The bill aims to create that safer environment in several ways: Medical exemptions would be tracked in a state database, and public health officials would flag those that required review. That review would be done by a doctor or nurse working for the state, and it would begin whenever a school’s immunization rate drops below 95%, a school fails to report its immunization rate, or one doctor writes five or more exemptions in a year.
Decisions by the state’s health department would be appealable to an independent panel of physicians, who would consider whether the doctor who signed off on the medical exemption was acting reasonably to protect a child’s health and safety.
The bill also gives the California Medical Board new power to investigate doctors who are unethically gaming the medical exemption system. Pan pointed to doctors advertised as “vaccine friendly” online and offering medical exemptions for a fee.
“If a physician was selling handicapped placards…we’d be pretty outraged about that. Especially if you actually need a handicap placard and you can’t find a parking space,” Pan said. “In this case, we’re talking about actually putting someone at risk, not just access to something you should have.”
Those doctors are a minority, but they’re capable of doing outsize damage, Pan added. In San Diego, one doctor was responsible for a third of medical exemptions, the Voice of San Diego found. Five doctors, several of whom had been singled out on social media by parents as “vaccine flexible,” signed more than half of the medical exemptions at Bay Area schools, the Mercury News reported.
But currently, the medical board must gain permission from parents to obtain medical records that would reveal misconduct and they can refuse to participate in an investigation. That’s limited their ability to crack down on anti-vax doctors who abuse the system.
With their pathway to legally getting out of vaccines coming under threat, anti-vax parents have for months been mobilizing on social media. California has long been a center of the anti-vaccine movement in the US, with generations of hippies skipping shots in favor of alternative medicine, and Hollywood celebrities pushing false claims linking autism and vaccines into the mainstream. Outside of the state’s liberal strongholds, conservative anti-vaxxers have championed their beliefs as medical choice and balked against vaccine mandates as government overreach. Dr. Bob Sears, the author of The Vaccine Book who has promoted delayed shot schedules popular with vaccine-hesitant parents, practices medicine in Orange County.
Claudia Koerner is a reporter for BuzzFeed News and is based in Los Angeles.
Contact Claudia Koerner at [email protected].
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