Capitol Alert

Who gets to skip vaccines? California plan would put the state – not doctors – in charge

Richard Pan explains reason for vaccine bill

The Democratic state senator from Sacramento on June 26, 2015 recounted why he introduced Senate Bill 277, a hugely controversial bill requiring vaccinations for California school children.
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The Democratic state senator from Sacramento on June 26, 2015 recounted why he introduced Senate Bill 277, a hugely controversial bill requiring vaccinations for California school children.

Dr. Richard Pan has fought the vaccine fight before.

First, as a pediatrician in Philadelphia during a deadly measles outbreak. Then, four years ago, as a doctor-turned-lawmaker who battled death threats and a coalition of parents enraged over Pan’s 2015 legislation. The proposal — Senate Bill 277 — cut the personal belief exemption from a list of approved reasons not to immunize a child.

The new law dealt a major blow to anti-vaccine advocates who relied on religion or philosophical convictions to avoid vaccinations. California parents who wanted to send their children to school now had to vaccinate their kids.

Now Pan is taking his defense of California’s vaccination system a step further with a measure that would put the decision to grant any exemptions in the hands of a state public health official.

His idea has an alliance of 1,000 family members, doctors, alternative healthcare practitioners and members of parental rights and religious groups headed to the Capitol in advance of a Wednesday hearing to oppose legislation they consider an “overreaching bill.”

“Doctors are the only ones who know their patients well enough to make medical decisions such as which vaccines a child should or shouldn’t receive,” said Dr. Shannon Kroner, an educational therapist and co-organizer for the rally. “It should never be up to a third party to make that type of medical decision.”

Kroner, who is not authorized to administer medical exemptions, will join representatives from across the anti-vaccine spectrum. They include families who distrust pharmaceutical companies, those who doubt the “government bureaucrats” in the public health department and many who believe vaccines cause irreversible medical injuries.

Two doctors will be testifying against the bill, the rally’s spokesperson Dawna Shuman said. The organizers also have scheduled a demonstration following the hearing.

But Pan is prepared, he said, to close what he considers a loophole that SB 277 inadvertently created.

Current law dictates that parents can file a physician’s statement that explains how an immunization puts a child at risk. The documented exemption must include the specifics of the case, like the child’s condition and his or her family history. The Centers for Disease Control and Prevention say medical exemptions should be reserved for children with severe health concerns, like cancer, autoimmune disorders or allergic reactions to vaccinations.

But in the past few years, Pan says doctors have often faked, exaggerated — or in some instances, sold — medical exemptions to vaccine-skeptical and denying parents.

“I have dedicated my career to keeping children and our communities safe and healthy,” Pan said, whose statement on the issue says some doctors are “monetizing their exemption-granting authority and profiting from the sale of medical exemptions.”

Since SB 277 passed, medical exemptions are rising in California. The rate of medically exempt kindergarteners rose from 0.5 percent to 0.7 percent in the 2017-2018 school year, and now equals 4,111 kindergarteners. There are nearly 30,000 kindergarteners who are not fully vaccinated, including more than 1,000 attending school in Sacramento.

Doctors are leveraging conditions like “asthma, eczema, food allergies, speech delays, a family history of a variety of things including autism,” said Dean A. Blumberg, associate professor and chief of the Pediatric Infectious Diseases department at the University of California, Davis.

“Parents are basically doctor-shopping,” Blumberg explained. “They are going to physicians that have reportedly been giving exemptions that are far, far outside of routine medical practice guidelines for what traditional, conventional medical doctors would consider as a reasonable underlying condition that should result in a medical exemption.”

Under Pan’s measure, Senate Bill 276, the State Department of Public Health would create a standard form doctors would fill out to seek a medical exemption for students to allow them to enroll in school. The physician would have to send the document to the department to be approved or denied by the state public health officer. The measure also would establish a database to track doctors who are filing for exemptions, and for what reasons.

The California Medical Association, which represents 44,000 doctors statewide, and parents of some of the state’s sickest children support the measure.

Among them is Siobhan Kelley, whose son Miles Page, 4, lives with a congenital heart disease and hypertrophic cardiomyopathy, a condition that compromises heart functioning.

Although Miles is fully vaccinated now, Kelley told The Bee, there were several times his vaccinations were delayed due to surgeries and illness.

During that time, Kelley said she’d have to take diligent care that Miles was not exposed to any communicable disease that could risk his life.

That meant avoiding Santa’s lap during Christmas time. It meant forgoing family dinners at restaurants during flu season and fearing that someone near Miles had “made a choice that is going to cost my kid their health, and potentially their life,” Kelley said.

“That’s just the reality of life for a lot of families that have kids with special medical conditions,” Kelley said. “These are the kinds of restrictions on everyday life that we live with.”

She said she’d come to the Capitol in defense of the bill herself, if she could. But Miles, who had part of his skull removed after he recently fell due to complications from a stroke, has a procedure scheduled on Tuesday.

I don’t have the luxury of rejecting science and medicine. I just want my kid to be able to go to school,” she said. ”To see people buy fraudulent (exemptions) as a way of deliberately not vaccinating a child who could be vaccinated...I think if they had gone through what families like mine have gone through, they would make a different choice.”

Cleveland Clinic explains how measles comes on, develops, can get complicated and how to prevent the infectious disease.

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Hannah Wiley joined The Bee as a legislative reporter in 2019. She produces the morning newsletter for Capitol Alert and previously reported on immigration, education and criminal justice. She’s a Chicago-area native and a graduate of Saint Louis University and Northwestern.
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