A controversial bill that restricts vaccine medical exemptions for students enrolling in California schools was amended on Tuesday to secure the support of Gov. Gavin Newsom’s administration two weeks after Newsom raised concerns about the measure.
Sen. Richard Pan, D-Sacramento, scrapped a major element of the bill that would have restricted medical exemptions for vaccines to only the ones endorsed by the Centers for Disease Control and Prevention. Critics considered those limitations to be too narrow.
The guidelines now include the CDC’s, as well as those under the federal Advisory Committee on Immunization Practices and the American Academy of Pediatrics.
The new language also allows parents to appeal decisions to revoke or deny medical exemptions made by state public health officials.
The changes come after Newsom raised concerns during the California Democratic Party’s convention in early June that a state agency might overstep a family’s medical decision. The Medical Board of California also expressed skepticism that the federal guidelines were not broad enough.
The amendments allow doctors to issue medical exemptions for children who need them, but hold the physicians accountable to ensure they’re not writing “improper and inappropriate exemptions that endanger the health of their patients and of the community at large,” Pan’s office said.
Pan thanked Newsom for “standing up for science and the importance of vaccination.”
“I appreciate that the governor has worked with me in crafting a California solution to halting the abuse of medical exemptions that endanger our children,” the statement read. “The governor recognizes that we need to ensure that children who truly need medical exemptions get them and they will be safe in their schools with community immunity.”
The bill would still require doctors to file a standardized form to obtain a medical exemption, and the law would hold doctors liable to perjury if the information is not “true, accurate and complete.”
But the California Department of Public Health would no longer be required to create and maintain a separate database that tracks which doctors issue exemptions and for what reasons. Instead, the bill uses the existing California Immunization Registry to track the exemptions and school vaccination rates data.
The registry would focus on schools that have vaccination rates of less than a 95 percent, the threshold considered necessary to maintain “community immunity,” or the standard by which kids who have severe medical needs and can’t get the shots are still safe to go to school.
Health department officials would also flag doctors who submit five or more medical exemptions in one year. The staff would review the records to determine if students are skipping vaccinations under “fraudulent or inconsistent” exemptions, which could then be denied or revoked by a public health officer or a doctor designated by the department.
Because medical exemptions “should be rare,” Pan’s office said, public health officers can review these exemptions to “ensure they fall under the standard of care.”
In order to keep current exemptions, parents would be required to submit their child’s medical information to the public health department. A state public health officer could revoke an exemption if it does not align with “guidelines established by designated entities.”
Parents are also allowed to appeal a denial or revocation to the state Health and Human Services Department. The department secretary would appoint a review panel of doctors to determine the legitimacy of the exemptions, and the secretary would have the final say based on those recommendations.
The vaccine debate coincides with a nationwide measles outbreak, with 52 out of 1044 cases reported in California. Pan has said that the bill is necessary to crack down on questionable exemptions that could increase the likelihood of spreading preventable diseases.
The amendments protect the doctor-patient relationship, Health and Human Services Secretary Mark Ghaly said, adding that the bill “strengthens the state’s ability to target doctors who abuse the medical exemption process and gives state public health officials the tools to identify and protect schools and communities where herd immunity is in danger.”