One of the biggest health crises in the nation has been the reemergence of measles. In 2000, the disease was declared eradicated in the U.S. However, due to the anti-vaccination movement, it is making a comeback with 45 confirmed cases in 2019, up from 21 confirmed cases in all of 2018.
SB 276 cracks down on medical exemptions for mandatory vaccines by targeting “unscrupulous physicians” who Senator Richard Pan, the bill’s author and a pediatrician, says are administering “fake” medical exemptions for children who should be vaccinated.
The bill, co-authored by Assemblymember Lorena Gonzalez, passed the Senate by a 24-10 vote.
“Medical exemptions for required vaccines have more than tripled since the passage of SB 277, putting kids and communities at risk,” said Dr. Richard Pan. “SB 276 assures students who truly need medical exemptions will receive them and that the schools they attend maintain community immunity to keep them safe. Through passage of SB 276, we are taking a preventive approach to keep schools safe for all students by applying a model successfully used in West Virginia, which has not experienced measles in a decade.”
To combat the proliferation of fake medical exemptions, Senate Bill 276 will strengthen oversight of the medial exemption process, which some doctors in the state are abusing by selling medical exemptions to parents.
Senate Bill 276 is co-sponsored by the California Medical Association, the American Academy of Pediatrics, California and Vaccinate California.
“As physicians, we know the importance of community immunity, and the role we play in protecting our patients and the public at large. SB 276 will ensure that public health comes first, that no physician is able to act outside the accepted standard of care, and that medical exemptions will be reserved for those rare cases where they are actually needed,” said CMA President David H. Aizuss, MD.
“We applaud California’s Senators for their leadership in protecting our children’s safety and public health,” said Leah Russin, a mother from Palo Alto and co-founder of Vaccinate California. “With new cases of measles still being reported weekly in California, SB276 is the right science-based policy.”
According to a release, under SB 276, physicians will submit information to California Department of Public Health (CDPH), including the physician’s name and license number and the reason for the exemption, which CDPH will check to ensure they are consistent with the Center for Disease Control’s contraindications to vaccination. The physician must also certify that they have examined the patient in person.
Additionally, under SB 276, CDPH will create and maintain a database of medical exemptions. CDPH and County Health Officers will have the authority to revoke medical exemptions granted by licensed physicians if they are found to be fraudulent or inconsistent with contraindications to vaccination per CDC guidelines. This authority will give state and county health officers the tools necessary to contain and prevent further outbreaks.
As a result of the implementation of Senate Bill 277, which abolished the personal belief exemption in California, overall vaccination rates increased sharply to more than 95 percent statewide. That is greater than the 94 percent vaccination rate necessary to achieve community immunity to prevent the spread of a measles outbreak.
The increase followed the dramatic increase from 92.9 percent in the 2015-16 school year to 95.6 percent in the 2016-17 school year after implementation of SB 277 in 2016 and a vaccination rate of only 90.7 percent in 2010-11 when Dr. Pan entered the legislature and authored AB 2109. AB 2109 required parents to be counseled before they opted out of legally mandated vaccines.
Despite the success of SB 277 in increasing the overall immunization rate of kindergarten students, California has also experienced a dramatic increase in the number of medical exemptions. Since the passage of SB 277, the rate of medical exemptions has more than tripled (from 0.2% in 2015-16 to 0.7% in 2017-18). Low vaccination rates in certain pockets of the state have put children and communities at risk.
A very small percentage of the population, less than 1 percent, suffers from qualifying medical condition, such as a severe allergic reaction to a vaccine component that would lead to the granting of medical exemption.
Those people can still get medical exemptions, Senator Pan said.
“SB 276 assures students who truly need medical exemptions will receive them and that the schools they attend maintain community immunity to keep them safe,” he said.
The number of confirmed measles cases has soared in recent years, but measles is not the only concern.
The vaccine schedule prevents other types of diseases as well, including pertussis, (also known as whooping cough), which is marked by severe coughing attacks that can last for months. Infants too young for vaccination are at greatest risk for life-threatening cases of pertussis, and a baby in Orange County died from the disease last week.
“When measles spreads in a community with immunization rates below 94 percent, the protection provided by ‘community immunity’ is lost,” Senator Pan’s release noted. “This means many people are at risk of becoming infected, including people who cannot be immunized, including infants, chemotherapy patients and those with HIV or other conditions.
“The hesitation to vaccinate on the part of a growing number of parents stems from misinformation such as the now retracted 1998 study that falsified data to purport a link between autism and the measles vaccine,” the release continues. “The study was authored by Andrew Wakefield who was later found to be lying. Also, numerous subsequent studies worldwide involving hundreds of thousands of children have proved that vaccines are safe and do not cause autism.”
“Vaccinating our patients is one of the most important tools pediatricians have to prevent illness and death,” said Kris Calvin of the American Academy of Pediatrics, California. “It is the rare physician who does not take this responsibility to heart, but they put all of us, our children and our communities, at risk. By ensuring medical exemptions to vaccines are reviewed and valid, this bill will protect the health of California’s children and of our larger communities. It is a reasonable and urgently needed measure.”