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New Requirement for Vaccine Exemption Passed by Senate

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Baby cries after receiving a vaccine. (Dan Hatton: Flickr)
Baby cries after receiving a vaccine. (Dan Hatton: Flickr)

Update: Gov. Jerry Brown signed this bill into law on Sept. 30, 2012. 

California has one of the more lenient approaches for parents who wish to opt out of vaccinations for their school-age children. While state law requires that children must be vaccinated against various illnesses (think polio, measles, tetanus) to enroll in school, California parents can opt out of vaccines simply by filing a short statement stating that immunizations are contrary to their beliefs. It's known as a personal belief exemption.

This week in Sacramento, the Senate passed AB 2109, a bill to make this exemption a little tougher. Under the bill, parents who don't wish to have their children vaccinated must meet with a health care provider to talk about risks and benefits of vaccines. The provider can be a doctor, nurse practitioner, physician assistant, osteopathic physician, naturopathic doctor or a credentialed school nurse. The provider must sign a form and the parent must still provide a written statement.

Assemblyman Richard Pan of Sacramento, a pediatrician himself, sponsored the bill. He pointed to misinformation as a driver of parents opting out of vaccines. "Parents become uncertain. They're not sure what they should do," he told me today in an interview. "They’re being told their children should be immunized but at the same time, they’re seeing scary stuff out on the internet."

Pan noted that the bill does not mandate vaccination of all children. "This bill does not take away the parent’s right to make a decision about whether to get their child immunized or not. We just want to make sure it’s an informed decision."


Critics counter that parents who opt out are already informed. They say that this bill adds to health care costs by requiring extra medical appointments to discuss vaccines.

A similar bill passed 18 months ago in Washington state. After it took effect, the opt-out rate there dropped by about 25 percent. So at least some people are making a different decision after meeting with a health care provider. Public health officials expect the opt out rate will go down further this year.

The personal belief exemption rate in California is much lower than Washington's -- 2.3 percent for the 2010-2011 school year. But it's not an even distribution statewide. In Los Angeles county, for example, the rate is 1.58 percent. But several counties in northern California -- Trinity, Nevada, Siskiyou -- have opt-out rates exceeding 12 percent. Public health officials say when more than 10 percent of children are not vaccinated, it puts a community at risk. Of special concern are people with weakened immune systems, such as cancer patients or people with HIV. Another group at strong risk are newborn babies.

Babies cannot be vaccinated against some illnesses until they are six months old. In 2010, California had a whooping cough epidemic. There were 9.000 reported cases and 10 babies died.

AB 2109 heads back to the Assembly for a final vote, which must happen before the end of the legislative session next Friday. From there, the governor will have 30 days to sign or veto the bill.

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