Shawn Hubler

An Rx to undercut public health

Los Angeles pediatrician Charles Goodman vaccinates 1-year-old Cameron Fierro with the measles-mumps-rubella vaccine. Assembly Bill 2638 would block any liability or discipline for doctors who, based on their medical judgment, allow their patients to opt out of vaccinations.
Los Angeles pediatrician Charles Goodman vaccinates 1-year-old Cameron Fierro with the measles-mumps-rubella vaccine. Assembly Bill 2638 would block any liability or discipline for doctors who, based on their medical judgment, allow their patients to opt out of vaccinations. Associated Press file

To be a parent of grown children is to have talked to a lot of pediatricians. I was thinking about this the other day, after our youngest turned 21, finally.

So little time, so many Tweety Bird Band-Aids. We’ve known cool L.A. pediatricians and brisk HMO pediatricians, pediatricians who murmured endearments as the nurse prepped the syringe and pediatricians who were businesslike as they slipped in the needle. One doc, in San Francisco, wore a candy-striped jacket instead of a white coat, like the host of a kids’ show. Another, in Laguna Beach, was freckled and sometimes wore sandals.

All had one thing in common, though: They never minced words when it came to our children’s health, or seemed in the least bit inclined to. That’s why the rationale behind a bill to supposedly clarify California’s new vaccine law, which has supposedly intimidated California’s pediatricians, seems, to me, hard to believe.

At issue are the new mandates on childhood vaccinations, passed last year in the wake of the Disneyland measles outbreak. Senate Bill 277, which takes effect this year, eliminated the overly broad exemption for “personal belief” that had eroded California’s so-called herd immunity.

Infectious diseases that had been thought to be contained were making a comeback, largely because quacks peddling misinformation online were persuading credulous parents not to immunize their children. So state lawmakers, led by Sen. Richard Pan, D-Sacramento, himself a pediatrician, and Sen. Ben Allen, D-Santa Monica, tightened the law to require a battery of standard vaccinations for all children entering school or day care.

Starting this year, the only opt-out allowed in California will be for medical reasons, and a licensed physician will be required to sign off and explain the condition. Families who don’t comply can home-school their children if they don’t want to fulfill their social obligation to help keep the public safe.

If doctors need extra protection from the big, bad medical board, Pan asks, why single out vaccinations? “Why not disability cases?” the pediatrician asked. “Or opioid prescriptions?”

To me, this makes perfect sense. Who would want anyone’s baby to contract a disease that, a generation ago, killed and crippled American children? My husband vividly remembers being treated for polio. I’ll never forget the excruciating headaches and terrifying fever dreams that accompanied my own bouts with the mumps and measles.

The pediatricians I know regard immunization as one of the great advances in modern civilization. But Assemblyman Mike Gatto, D-Los Angeles, told me last week that the pediatricians he knows aren’t so sanguine about vaccinations, and that the new vaccine law has left them worried about being stripped of their medical licenses or sued if they sign any exemption whatsoever.

Gatto’s Assembly Bill 2638 would block any liability or discipline for doctors who, based on their medical judgment, allow their patients to opt out of vaccinations. Gatto says it just underscores existing law, but to me it sounds like a prescription for restoring the old personal belief exemption.

“This is so sensitive, it’s almost a witch hunt,” said Gatto, who feels SB 277 was a constitutional overreach and voted against it. “Anyone who questions anything is lumped into this ‘you’re-a-crazy-anti-vaxxer’ camp. The existing law is new, and it needs to be buttressed because doctors don’t feel safe.”

Pan, who emphatically does feel safe now that his SB 277 is a state statute, says Gatto’s bill would hobble enforcement by the state medical board and effectively clear the way for all the Dr. Feelgood enablers who prospered before by peddling baloney to parents, telling them that their kids were “purer” without “toxins” from vaccinations.

Pan says doctors are amply protected from malicious enforcement. I’d add that some might say that’s an understatement; if anything, the state medical board tends to give the benefit of the doubt too often to physicians.

If doctors need extra protection from the big, bad medical board, Pan asks, why single out vaccinations? “Why not disability cases?” the pediatrician asked. “Or opioid prescriptions? Why not give everything doctors do that extra protection?”

Pan says the requirements for medical exemptions are actually less stringent than before, because the law now explicitly lets doctors consider family history, which could include heredity and even siblings’ reactions to vaccines.

So the problem isn’t that the criteria for medical exemptions are too tight, or that doctors don’t understand them. It’s just that parents can no longer, based on a mere hunch, send their unvaccinated kids out to spread diseases to infants, the elderly, cancer patients and others who are vulnerable, aka the rest of us.

I don’t doubt that Gatto is sincere, and none of the many doctors I know are in his district. But his bill sure seems to be yet another attempt to undercut SB 277.

A proposed referendum failed, as did an effort to recall Pan and threats to recall any legislator who backed him. Another bill, carried by Assemblyman Travis Allen, R-Huntington Beach, would require state health websites to prominently link to a vaccine injury site that Pan says is already on the literature every pediatrician gives parents when a child comes in for an immunization.

More will surely follow, at least in the short term. And that’s too bad, because to be a parent of grown children is also to know that vaccines are the least of your worries. Life has challenges enough; you don’t need to create them, believe me. And I can recommend a pediatrician or two to talk to if you don’t.

  Comments