In light of the rising rates of measles, State Sen. Richard Pan, D-Sacramento, a pediatrician, introduced legislation that aims to curb the sale of false medical exemptions for vaccinations.
Forty cases of measles have been confirmed in California in 2019, as of May 1, compared to the 22 cases in 2018 and 15 cases in 2017, according to the California Department of Public Health.
Dr. Pan drafted Senate Bill 276 in response to increasing numbers of medical exemptions in California. SB-276 exists as a follow-up to SB-277, a law passed after 117 Californians were infected with measles due to an outbreak in Disneyland in 2015. SB-277 restricts non-medical exemptions to vaccines, such as religious and personal belief exemptions.
Anti-vaccine parents who could no longer exploit personal belief exemptions instead sought out medical exemptions, and such parents, nicknamed anti-vaxxers, tended to live in clustered communities, weakening the effect of herd immunity.
Herd immunity exists as a form of protection for those who cannot receive vaccines when the majority of the population is vaccinated, thereby preventing the spread of a disease.
The threshold is 94% of a given population, according to a press release by Dr. Pan.
“SB-277 helped raise immunization rates across the state – it was very successful in doing that – but what we found was that there were pockets across the state that remain vulnerable because doctors were selling exemptions,” said Shannan Velayas, spokesperson for Dr. Pan.
The bill would require state-level approval of all exemptions.
Information regarding the exemptions, such as the physician’s name, license number, reason for the exemption and certification of an in-person patient visit would be submitted to the California Department of Public Health.
The CDPH would ensure that the exemption complied with the Center for Disease Control’s list of contraindications. Contraindications are conditions in which a person would have a serious negative reaction to a vaccine.
SB-276 is co-sponsored by the American Academy of Pediatrics California, California Medical Association, and Vaccinate California, and is supported by a number of medical associations, including the California Immunization Coalition.
“In our view, some of these physicians are really reaching to grab something that will sound good enough and exempt these children permanently from all vaccines,” said Catherine Flores-Martin, executive director of CIC.
Flores-Martin said situations in which children have permanent, legitimate exemptions from all vaccines are extremely rare.
As for motivations behind anti-vaccine parents, Flores-Martin said their reasons vary.
Some parents cite a fraudulent study by Dr. Andrew Wakefield that linked the MMR (measles, mumps, rubella) vaccine to autism, while others claim the bill infringes on their right to personal choice.
“They’ll say, ‘I’m very concerned about my rights as a parent to control my child’s health and what goes into my child’s body,’” said Flores-Martin. “Some people extend it to, ‘I believe in an organic, pesticide free, healthy lifestyle and my children do not pose a risk to other children.’ They’re all about the freedom and control and their parental rights.”
Vaccinate California, a co-sponsor of the bill, is a parent advocacy group that encourages parents to openly discuss the benefits of vaccination.
Leah Russin, spokesperson and co-founder of Vaccinate California, said that while parents against vaccinations are rather vocal about their decisions, parents who choose to vaccinate their children tend to keep their decisions to themselves, resulting in a lop-sided conversation about vaccines among parents on social media.
Some parent members of Vaccinate California would scope out conversations occurring on Facebook anti-vaccine groups, which often serve as a hub for anti-vaccine parents to assist each other in getting medical exemptions for their children.
However, not all pro-vaccine parents monitor Facebook groups exclusively.
“We would also just see it on our feed,” Russin said. “Until recently, Facebook allowed advertisers to target people who were interested in the anti-vaccine people. And since I and many of our members do a lot of interacting regarding vaccines, I was often scooped up in somebody’s advertising targeting. So I saw sponsored, paid ads for doctors in my feed who wanted to sell me medical exemptions.”
Recent measles outbreaks in UCLA, UC Irvine and Cal State Los Angeles prompted Director of Student Health Services Cynthia Denne to send a mass email to the University of La Verne community containing information about measles symptoms, infection and prevention.
Denne said if a ULV student were to come into the health center with symptoms of measles, that student would immediately be isolated to prevent infection of other people.
Denne would ask questions such as where the student has been and with whom has the student been in contact. A medical provider would investigate the student’s case, and even take samples such as blood tests, throat swabs or urine tests to determine if it is a genuine case of measles. Then Denne would call the CDC, which would assist the University in informing relevant communities.
Such communities may involve the student’s dormitory, the student’s hometown if the student had returned home recently, or any other locations the student may have recently gone prior to showing symptoms.
As for the number of vaccinated students on campus, the University has no definitive answer.
The University highly recommends, but does not require that incoming students volunteer their medical history – and by extension, their vaccine information.
“It’s not a high percentage of medical history that we get from our undergraduates,” Denne said.
As for those who do volunteer their information, or for any student who visits the student health center during their time enrolled in the University, their information is kept on file at the health center for seven years.
Aryn Plax can be reached at firstname.lastname@example.org.