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California lawmakers make big changes to vaccine exemptions bill

Melody Gutierrez, Los Angeles Times on

Published in News & Features

SACRAMENTO, Calif. -- A key California lawmaker has amended contentious legislation to tighten vaccine exemptions amid a national measles outbreak, sharpening its focus on bad doctors while easing the list of medical conditions that doctors could cite in allowing schoolchildren to skip required immunizations.

The amendments to SB 276 made public Tuesday come after Democratic Gov. Gavin Newsom raised concerns earlier this month that the bill would create an immunization bureaucracy that could interfere with the doctor-patient relationship.

The bill faces a vote in the Assembly Health Committee on Thursday, where it is expected to draw large crowds of opponents. The amendments Tuesday address many of the concerns raised by opponents, although the changes likely do not go far enough to pacify the scores of parents who have flooded the Capitol in protest.

Anti-vaccination advocate Robert F. Kennedy Jr. has been actively fighting the "draconian proposal," including by lobbying last week with actress Jessica Biel. Many public health advocates support tougher immunization requirements, and at least one poll has shown that Californians surveyed also support strong requirements. But opponents of mandatory vaccinations for schoolchildren have been more active and vocal than proponents, leading to amendments today meant to counter their arguments.

California already has some of the strictest childhood vaccination laws in the country, with the state requiring immunizations to attend public or private schools. A doctor can excuse a child from some or all vaccinations if there is a medical reason to do so, but questions have been raised on whether some doctors are improperly approving exemptions.

SB 276 by Sen. Richard Pan, D-Sacramento, would make it more difficult for doctors to exempt children from shots required to attend school by granting the state Department of Public Health oversight authority. A doctor would have to certify, under penalty of perjury, that the medical exemption is "true, accurate and complete."

The bill originally allowed for the health department to review and potentially reject any child's medical exemption approved by a doctor. SB 276 would now allow for such reviews only at schools with immunization rates of less than 95% or for doctors who grant five or more medical exemptions in a year.

The bill is also less prescriptive on what medical conditions qualify for an exemption, including consideration of family medical history. The bill now requires that an exemption "fall under the standard of care." In applying for a medical exemption, parents and doctors would have to agree to turn over a child's medical record to prove skipping all or some shots is warranted.

Any medical exemption rejected by the state would have to be reviewed by a doctor in the state health department, a change meant to address other concerns with the bill surrounding the qualifications of those overseeing physicians' orders.

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Pan, a medical doctor, has said the bill is needed in order to target "unscrupulous physicians" who are profiting off granting unneeded exemptions from vaccines. SB 276 would not allow a doctor to charge patients for filling out a medical exemption under Tuesday's amendments.

"The first goal of the bill is to try to keep our schools safe," Pan said in an interview last week. "We know the root of the problem are these physicians."

Under the bill, the state would have the authority to bar certain doctors from writing medical exemptions for up to two years if the health department determines they pose a risk to public health. Doctors with a pending investigation by the Medical Board of California or Osteopathic Medical Board of California related to vaccines would also not be allowed to write new exemptions until it is resolved.

The state would track all rejected medical exemptions and share that information with the licensing boards.

(c)2019 Los Angeles Times

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