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.”
The anti-vaxxer movement is one of the most dangerous around. If people want to not let their kids get vaccinated, they should have to quarantine them.
” If people want to not let their kids get vaccinated, they should have to quarantine them.”
If people do not want their children vaccinated, they are idiots and/or religious fanatics and neither deserve any state recognition or indulgence. Such parents, most second amendment advocates and home-schoolers should be prosecuted for child endangerment and sent to re-education camps until they are rehabilitated.
I’m not opposed to vaccinating kids for measles. However, I do think so-called anti-vaxers have been unfairly lumped together and vilified, and summarily dismissed. Some things that give me pause:
“Big-Pharma” is seen as greedy and profit-driven in other contexts; but when it comes to measles vaccines, their motives and research results are unquestioned.
A disturbing number of FDA-approved drugs are, years later, found to be unsafe and have approval withdrawn. E.g., https://www.npr.org/sections/health-shots/2017/05/09/527575055/one-third-of-new-drugs-had-safety-problems-after-fda-approval.
Not all opponents of SB 276 are “idiots and/or religious fanatics.” A significant number of well-reputed medical professionals oppose SB 276 because it requires government intervention in the doctor-patient relationship. How many of us would be OK with a requirement that our medical treatment decisions for ourselves or our children be subject to approval by state bureaucrats as SB 276 would provide? Today, measles vaccinations. Tomorrow, what?
Just sayin’.
Today no vaccinations. Tomorrow, what?
Outbreaks of polio, mumps, diphtheria and a plethora of other preventable diseases.
There is no serious scientific debate about the efficacy of vaccination.
Efficacious does not necessarily mean safe or without risk. The issue is who should get to make treatment decisions: Patients/parents and their doctors or state bureaucrats?
Parents are generally not even remotely qualified to make informed assessments of the risk of the vaccine versus the risk of an increasing percentage of the population being unvaccinated. We have very compelling reasons for the doctors and “state bureaucrats” to be the ones making those decisions.
http://vaccine-safety-training.org/balancing-efficacy-and-safety.html
Eric has very good point. Forced medical treatment is a violation of actual human rights.
Nobody is being forced to get medical treatment. It is already mandatory that children be vaccinated before attending public school. If they aren’t, they can’t attend public school and potentially infect your children. This bill just tightens the exemption process to make sure it isn’t being abused.
You are free to not vaccinate your children, foolish as that may be. But it is worth noting that preventing epidemics and pandemics has generally been considered one of the jobs of our elected government, using the best medical information and practices available.
“Forced medical treatment is a violation of actual human rights.”
Damning children of the deluded to a lifetime of chronic illness, pain and paralysis is a violation of their rights.
Every fascist justifies their action as being “for their own good”
“Nobody is being forced to get medical treatment” That remark is so bizarre that I’m not sure how to reply. The point of the legislation is to force people to vaccinate their children. Or is it your idea that injecting vaccines are not “medical treatment”?
If you feel strongly about it, you are welcome to home school your children or enroll them in an independent study program.
Eric
When it comes to the possibility of prevention of epidemics , my answer would be bureaucrats basing their decisions on the best medical evidence available. Especially since no one is forced to have their children vaccinated. The only sanction is that if they choose not to, they cannot enroll their child in public school. I strongly believe in the right of the parent not to have their child vaccinated, as long as they make arrangements for quarantine of their child not only from school but also church, public gatherings, amusement parks or any other venue open to the public.
Corollary… who should get to decide whether their ‘choice’ as to their child, puts other children/adults at risk’?
If a parent, just on GP, decides against vaccinations for their child, perhaps they should also waive their right to having their child in a public or private school, and waive their (and their child’s) right for any treatment for any disease for which their child could be immunized against… at least not paid for by any employer/private insurance or publically funded medical coverage… as it stands now, ‘the herd’ covers the cost of immunizations, and medical (insurance, which affects all our rates) coverage for any ‘unintended consequences’.
Sidebar… when one of the kids in the neighborhood got chickenpox (before the vaccine was available) we exposed others, to get it ‘over with’. Correlation between adult shingles and CP was not generally known at the time… rare, but happens. We took responsibility for that.
Parents make a choice for their child, they should “own it”, and bear the responsibility for how it affects other children/adults.
Just saying…
That’s a pretty dismissive response. It’s analogous to responding to those who raise other rights issues with “America. Love it or leave it.” Regardless of what one feels about measles vaccines, generally, there can be legitimate concerns with the specific provisions of this particular bill.
Like what?
I haven’t payed that close attention to this controversy, but, for example:
The Association of American Physicians and Surgeons opposition is here: https://aapsonline.org/re-sb-276-the-elimination-of-physicians-right-to-determine-medical-exemptions-for-vaccines/
Some have questioned the adequacy of the CDC guidelines, on which the bill would rely as criteria.
The bill would allow a public health officer or designee to require vaccination when the child’s treating physician believes it is contraindicated. Personally, I’m generally wary of efforts to bypass the requirement of informed consent and interfere with the doctor-patient relationship by putting medical treatment decisions in the hands of state bureaucrats.
As I noted earlier, research on the safety and risks of vaccines is largely conducted by the pharmaceutical industry, which has an obvious profit motive.
So let’s not summarily disrespect and dismiss parents and medical professionals who have concerns with SB 276 by telling them to “love it or leave it.”
I didn’t say that. You implied I said it. And now you’re responding as though I did. There’s some kind of rhetorical fallacy at work there, but I can’t remember what it’s called.
Eric
I do not see this as a dismissive response. At least no more dismissive than saying to the parents of the child who cannot be immunized for true medical reasons, your child’s life and well being is less important than the life and health of the child whose parents will not immunize him.
Thank you, Tia, for weighing in… suspect you and/or your co-workers have seen ‘both sides’ of the issue…
According to Robert F. Kennedy Jr. “All four companies that manufacture all 72 of the current vaccines that are now mandated for American Children, all four companies are convicted felons” For example Merck the current company that makes the MMR II vaccine is responsible for killing 60,000 to 139,000 people with their Vioxx pills which were sold as “safe and effective”. So are we to believe that they now found Jesus and making safe vaccine products? They are making vaccines that have no liability and are not tested against a placebo controlled study. With each vaccine they make mandatory by buying politicians, doctors, TV news, newspapers, CDC and web sites makes them about one billion dollars. We need to demand honest science with placebo controlled studies. We need to demand mandatory reporting of injuries. The vaccine manufactures need to be held liable for the vaccine injuries and deaths they are creating.
“all four companies are convicted felons”
If the felonies involved the immunizations in question, you would have a point. However, that is not the case. However, it is the case that the purported linkage of immunization to autism was a hoax based on faked data as admitted by the perpetrator. Being convicted of false statements in the case of an unrelated drug does not change the proven efficacy of vaccines, both for the individual and for the community.
The Journal of Clinical Microbiology (2017) reported: “During the measles outbreak in California in 2015, a large number of suspected cases occurred in recent vaccinees. Of the 194 measles virus sequences obtained in the United States in 2015, 73 were identified as vaccine sequences (R. J. McNall, unpublished data).” Rebecca J. McNall, a co-author of the published report, is a CDC official in the Division of Viral Diseases, who had the data proving that the measles outbreak was in part caused by the vaccine. It is evidence of the vaccine’s failure to provide immunity. But this crucial information has been concealed, and continues to be withheld from the public. So as much as 38% of people with measles got it from the vaccine and also spread it to others.. It explains why some hospitals do not allow you inside if you have been recently vaccinated by a live virus vaccine for up to 30 days since vaccinees are shedding the virus and infecting others.
“So as much as 38% of people with measles got it from the vaccine and also spread it to others..”
This is an inaccurate conclusion from the data presented. It takes the measles vaccine approximately 10-14 days to take effect. If the individual has been exposed to the measles during that time interval, they are susceptible to the symptoms of the measles and are contagious. This effect may inadvertently be perceived incorrectly as the vaccine causing the measles or as the vaccination not being effective. While it is true that no vaccination is perfect, the measles vaccine is 95% effective.
If vaccines are so safe, why are the vaccine makers free from liability? All you have to do is read the vaccine label or insert to find out all the possible side effects to the toxic ingredients. The MMR II product insert acknowledges that death is a potential side effect from the vaccine, along with a long list of other potential permanent injuries. Are vaccine injuries or death rare? Are vaccine injuries or death one in a million? Just go to the U.S. CDC’s VAERS Database where you will find for 2018 in the U.S.:
60,544 Reports of Injuries including:
443 Deaths
267 Permanent Disabilities
4,414 Hospitalizations
According to a Harvard study payed for by the CDC, less than 1 % of injuries and deaths are reported to VAERS. So the projected actual numbers are:
44,300 Deaths
26,700 Permanent Disabilities
441,400 Hospitalizations.
Those numbers are not 1 in a million. How many lives must be sacrificed for the mythical herd immunity? The only emergency is that people need to wake up sooner to Big Pharma’s fraud.
Ms. Wolf’s comments go against all the evidence from public health experts. Just citing the number of deaths/injuries due to a treatment doesn’t tell us much. NOT vaccinating increases the risks of mortality and morbidity from the illnesses in question. When compared to the risk of mortality and morbidity associated with vaccination I would rather take the vaccination. Ms. Wolf also provides no citation for the study that she says was done at Harvard. Please provide a citation. Robert Kennedy’s claims have been debunked by a number of others. His own family has distanced itself from his remarks.
The notion that we are “forcing medical treatment” when we require vaccination is a confusion. It’s similar to saying that we are “forcing” people to take chemicals when we chlorinate drinking water. Or any number of other public health measures that protect the public. Doctors don’t complain about being required to report communicable diseases like syphilis or tuberculosis.
For goodness sake. We’ve had public health measures that protect millions of people for almost two hundred years. This nonsense from the anti-vaccination people is just more of the anti-scientific attitudes that have plague us today (no pun intended).
Is anyone going to respond to XW?
Looks like folk are now “weighing in”… appropriately… there is no 100% ‘immunity’ to risk… ultimately it is an issue of informed “risk management”, and dis-information does not help that… it is divisive, and IMHO, stupid…
Unfortunately, I inadvertently blocked Tia a few weeks ago and, despite two requests, have not had her comments unblocked. I’m sure she had valuable comments on this topic.
I don’t know how to unblock people. Here are Tia’s replies so far.
Eric
When it comes to the possibility of prevention of epidemics , my answer would be bureaucrats basing their decisions on the best medical evidence available. Especially since no one is forced to have their children vaccinated. The only sanction is that if they choose not to, they cannot enroll their child in public school. I strongly believe in the right of the parent not to have their child vaccinated, as long as they make arrangements for quarantine of their child not only from school but also church, public gatherings, amusement parks or any other venue open to the public.
Eric
I do not see this as a dismissive response. At least no more dismissive than saying to the parents of the child who cannot be immunized for true medical reasons, your child’s life and well being is less important than the life and health of the child whose parents will not immunize him.
In reply to Xavier Wolf.
“all four companies are convicted felons”
If the felonies involved the immunizations in question, you would have a point. However, that is not the case. However, it is the case that the purported linkage of immunization to autism was a hoax based on faked data as admitted by the perpetrator. Being convicted of false statements in the case of an unrelated drug does not change the proven efficacy of vaccines, both for the individual and for the community.
In reply to Xavier Wolf.
“So as much as 38% of people with measles got it from the vaccine and also spread it to others..”
This is an inaccurate conclusion from the data presented. It takes the measles vaccine approximately 10-14 days to take effect. If the individual has been exposed to the measles during that time interval, they are susceptible to the symptoms of the measles and are contagious. This effect may inadvertently be perceived incorrectly as the vaccine causing the measles or as the vaccination not being effective. While it is true that no vaccination is perfect, the measles vaccine is 95% effective.
She has… you can see them if you are not “logged in”… at least I thought they valuable to the discussion…
Tia said:
Under the same reasoning, would you also quarantine those kids who meet the criteria for a medical exemption under SB 276? Denying access to a public education and other community activities to these kids due to a medical condition seems pretty harsh (and would likely violate federal anti-discrimination law).
As I’ve noted, personally, I’m in favor of measles vaccination measures; but I also don’t dismiss the concerns of those parents and medical professionals who reasonably believe SB 276 is not the answer. As the article notes, the vaccination rate increased after enactment of SB 277 in 2016 to 95.6%, and is now above the 94% rate necessary to achieve community immunity and prevent the occurrence of a measles outbreak. So, the current law seems to be working. Perhaps it’s premature to be imposing even more restrictive requirements.
Eric,
This vaccination rate of 94% may apply to our community, but there are many in which it does not apply. And there are pockets within our own community in which it does not apply, the Waldorf school being one of them. The problem with epidemic prevention is that with current ease of travel if this percentage is not widely maintained, the risk of a life-threatening resurgence becomes a possibility.
I am a very strong believer in medical autonomy….when it is only the health and well being of the individual at stake. When the well being of the entire community is at stake, I believe that community has the right to protect itself.
I see the allowed attendance at public schools of those who genuinely cannot be immunized as a separate issue with two relevant points. 1) If the immunization rate can be guaranteed at > 95%, they are not at increased risk of contracting or spreading the disease. This is the benefit of “herd” immunity, which is a statistical reality, not a myth. 2) Their exemption is a matter of medical necessity, not their parent’s whims. While you may not make this distinction, I most assuredly do.
“If vaccines are so safe, why are the vaccine makers free from liability?”
While I do not believe that vaccine makers should be free from liability if there is a production error, this is not a valid association of ideas. Vaccine makers are not alone in their exemption. Gun manufacturers also are free from liability even when a gun discharges under unanticipated circumstances. The answer in my mind is not to vilify either vaccines or their manufacturers, but to create legal consistency in holding companies liable for the products from which they profit regardless of the identity of the product.
Tia:
The history of the vaccine liability exclusion is here:
https://en.wikipedia.org/wiki/National_Childhood_Vaccine_Injury_Act
I think it is extremely relevant to the current debate, as it was entirely instigated by false assertions about the safety of a particular vaccine:
Anti-vaccine activism is a real threat to public health.
Oh… had measles as a child… before measles vaccines…I have a permanent hearing loss due to that… fortunately it manifested only in the higher frequency ranges… so I have always been able to buy lower cost stereos… am OK with that… in mid-60’s, overall hearing is quite good… but have mostly used hearing protection on construction sites & music concerts where decibels are high…
Prevention is good…
I find this whole discussion amusing. For the record I did vaccinate my own children however that is not a choice I would force on others, unlike some of the authoritarian folks on this thread.
To level-set:
“In 2017, 38,739 people received an HIV diagnosis in the U.S.” Unless they die of something else first, which is increasingly common, they will die of AIDs.
“There were an estimated 687,000 Healthcare-Associated Infections (HAIs) in U.S. acute care hospitals in 2015. About 72,000 hospital patients with HAIs died during their hospitalizations.” Healthcare providers transmitting disease are predominantly physicians as repeated studies have shown MDs have worse hand hygiene than other people.
Neither of these inspire mass efforts to deprive people of their civil rights yet both HIV and HAIs are entirely preventable.
So far as I know, neither of the examples you cite can be spread by a stranger sneezing on you in public.
It is an extraordinary luxury to live in a time and place where one could consider allowing the spread of small pox, polio, measles, rubella, diphtheria, etc., to be matters of civil rights.
I can think of numerous examples where we accept limitations on our purported freedoms in order to prevent health or safety risks, and even severe economic harm, by adopting practices based on evidence and agreed upon by our elected officials.
Today I had to tell a guy from Red Bluff that I couldn’t sell him a citrus tree because we are in different quarantine zones for the Asian citrus psyllid; the Ag department has established zones to prevent the spread of the psyllid, which vectors citrus greening disease (HLB). I guess we are violating his civil right to buy a citrus tree wherever he wants, even though the HLB disease would devastate the state’s citrus industry and put everyone else’s trees at risk.
For a less mundane example, spraying for mosquitoes that vector West Nile virus has continued each summer locally, despite vigorous opposition at the time the virus arrived in California.
And I seem to recall that there are several vaccinations required for international travel. Should that be voluntary?
So shall we just leave it to an informed public to make these risk assessment decisions, regardless of the possible impact on the general population, based on what they read on the internet? What could go wrong?
Jim
Well, we share one point of view. We find each other’s comments “amusing”. While both AIDS and MD handwashing are important issues that we should be steadily working on, and indeed many groups are, neither has anything at all to do with the risk/benefit ration of measles vaccination. It is the equivalent of saying we should not promote gun safety because….after all…..cars exist.
“So far as I know, neither of the examples you cite can be spread by a stranger sneezing on you in public.”
Don’t be too sure. I was an outbreak analysis workshop by the LA County department of health. They traced 14 surgical site infections (SSIs) back to one orthopedic surgeon. Mortality from SSIs is about 3%, significantly higher than measles. The LACPH physician went to meet with the orthropod who had a cast to his knuckles. When asked how he scrubbed in before surgery he just said he wrapped it with some kind of film which of course violates every surgical infection control procedure but hey, he has a mortgage.
So what happened to this MD who infected 14 people we know of? Any guesses?
https://psnet.ahrq.gov/primers/primer/45/Surgical-Site-Infections