California’s vaccine laws aren’t likely to have a dramatic effect, study says
California’s legal efforts to increase vaccination rates among school children could have a weaker impact than lawmakers hoped for, according to a new study that analyzed the state’s two laws that restrict when families can skip vaccines.
The two mandates, Senate Bills 277 and 276 passed in 2015 and 2019, respectively. The first eliminated personal beliefs as a valid reason to skip the shots, and the second increased oversight of doctors issuing medical exemptions to children who should otherwise be vaccinated before heading to school.
But because both bills left loopholes for families to avoid the requirements, usually by homeschooling children or putting them in non-classroom learning environments, the percentage of exemptions is unlikely to drop dramatically, according to a report this week out of the Annals of Internal Medicine.
Before the 2015 law went into effect, 2.59 percent of students had exemptions, the report said. If current trends persist, that number would likely dropped to 1.87 percent by 2027, which the researchers called a “modest decrease.”
With the latest crackdown, the percentage is likely to dip to 1.41 percent by 2027, down from 2.19 percent in 2018.
Paul Delamater, a study co-author and a professor at the University of North Carolina at Chapel Hill, said he wasn’t completely surprised by the estimated numbers, given last-minute efforts in the Capitol this year to limit the state’s oversight of doctors and the exemptions they’ve already administered.
“The last-minute changes actually took the teeth out of the (2019) bill,” Delamater said. “I don’t think the medical exemptions will drop as low as they could have given those last-minute changes.”
Though the new law authorized an increase in state oversight of physicians who write medical slips for students, last-minute negotiations appeared to weaken certain provisions of the legislation, allowing more time to comply with the law and reducing punishment for doctors who issue questionable exemptions.
State Sen. Richard Pan, the Sacramento Democrat who wrote both laws, disagreed with the study’s conclusion, saying that the Legislature acted in 2015 when it noticed exemptions start to rise, not decrease. He pointed to a 2014 measles outbreak at Disneyland as evidence of the problem.
Pan went a step further in a legislative crackdown on vaccine avoidance this year after he noticed a surge in the number of medical exemptions since his 2015 effort. The 2019 legislation was also introduced amid another measles outbreak, which has increased to 1,250 this year.
“We had the largest measles outbreak in over a quarter of a century,” he said. “It’s not because things were staying the same, it’s because things were getting worse. Why do they think (exemptions) would suddenly stop increasing if we didn’t do anything? You think (the law) was just spontaneous?”
The pediatrician-turned-lawmaker said the increase was due to what he called “unscrupulous” physicians. He said they issue bogus exemptions to students who don’t need them and imperil children with weakened immune systems who can’t risk catching an otherwise preventable disease.
The legislation prompted a wave of opposition from families who said strict federal guidelines on exemptions might be too narrow to include their children. They also likened Pan to a dictator who wanted to strip California families of their “medical freedoms.”
Gov. Gavin Newsom signed the law in September amid protests and arrests at the Capitol in efforts to halt the legislation’s progression.
Delamater said it’s unclear whether the laws were a fight worth winning, given the loopholes left behind and the deluge of protests and political discord that clogged the Capitol on a near-daily basis during hearings and floor votes.
“All of the attention that gets drawn to these fights, is that even worth it?” Delamater said. “Sen. Pan should be commended for how hard he’s pushed to get these through, but with that being said, how effective are they actually going to be in the end? I don’t know.”
Pan said the legislative battles were not only worth it, but will change the landscape of public health and school safety throughout the state.
“We can tip over into community immunity,” in which enough people are vaccinated to protect those who are not, he said.
“When you’re right there and tip over it, that makes a huge difference in public health. That’s the difference between an outbreak and no outbreak,” Pan said. “That’s not modest, that’s important.”
This story was originally published November 7, 2019 at 5:00 AM.