Medical Exemptions Increase After California Passes Vaccine Law

CALIFORINA -- Three years after California lawmakers passed a bill removing personal belief exemptions from childhood vaccination requirements, medical exemptions have risen, according to a study published Monday.

The study, titled "Experiences With Medical Exemptions After a Change in Vaccine Exemption Policy in California" published in the journal of Pediatrics, examines how Senate Bill 277 changed the vaccination landscape in the Golden State two years after it was implemented. The law requires children to receive vaccines before entering school or day cares, only allowing for medical exmeptions.

Researchers found that vaccination rates have increased among kindergarteners from 92.8 percent in the 2015-2016 school year to 95.1 percent in the 2017-2018 school year.

"However, the rates of medical exemptions in California after the passage of SB277 increased 250% (from 0.2% in 2015–2016 to 0.7% in 2017–2018)," researchers wrote. "Counties that had high PBE
(personal belief exemption) rates before SB277 also had the largest increases in medical exemptions during the first year of SB277 implementation, leaving portions of California susceptible to vaccine-preventable outbreaks."

Researchers said the increase in medical exemptions could be because of the "underuse of medical exemptions before SB277 (when PBEs could still be obtained) and the willingness of some physicians to write medical exemptions for parents who are vaccine hesitant whose children may lack scientifically justified medical contraindications as defined by the Advisory Committee on Immunization Practices."

The study also interviewed members of the Health Officers Association of California, an organization that represents health officers in California’s local health jurisdictions, finding many frustrations among officials.

"Frustrations and concerns were commonly discussed when describing medical exemptions. Four subthemes revealed the feelings of frustration and concern: (1) frustration over the lack of authority for local health departments, (2) concern over the burden on school staff to review medical exemptions, (3) frustration with physicians who are writing problematic medical exemptions, and (4) concern about an increase in medical exemptions under SB277," the study said.

One person interviewed told researchers, “The law didn’t give the health officer any role, and I’ll tell you how ridiculous this is. In comparison to the fact that I have to review dog rabies vaccine exemption requests….”

Read the full study here.

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