In 2000, the United States eliminated measles from our country, a disease that killed 500 people a year before vaccination. Measles could still be caught in another country by an unvaccinated person and brought back home, but vaccination rates were high enough in most communities to prevent further spread of the disease.
With safe and effective vaccines, families gained the freedom to go about their neighborhood without worrying their children would catch serious diseases. As memories of these diseases faded, charlatans spread misinformation about vaccines and some parents were duped into becoming more anxious about vaccines than the diseases. Vaccination rates slowly fell and neighborhoods in the U.S. began losing their herd community, or community immunity, the protection achieved when over 94 percent of children are vaccinated against measles.
In 2014, a measles outbreak began in Disneyland and spread across California and the country mainly by unvaccinated children. Parents were worried about the safety of their babies who were too young to be vaccinated, and their school children who had cancer or transplants, who could not protected by vaccination.
Thousands of parents across California demanded state government restore community immunity to keep their children safe.
In 2015, Senator Ben Allen and I authored legislation to abolish all non-medical exemptions to legally required vaccines for school enrollment. The law was a success: vaccination rates rose above 95 percent for each entering kindergarten class since implementation, thereby restoring community immunity.
Unfortunately, a troubling new trend occurred.
By law, children for whom a vaccine is ineffective or unsafe would receive a medical exemption for school from their physician, which is estimated to be less than one percent of children. However, there were schools reporting that over 20 percent and even 50 percent of their students received medical exemptions. And these exemptions did not come from the children's regular doctor, but from a few doctors who granted many of the exemptions. An investigation of medical exemptions in the San Diego Unified School District showed almost a third were written by a single physician.
A few unethical physicians are selling fake medical exemptions; many advertising to anxious parents how they could pay cash and obtain an exemption. They were monetizing their medical license and putting our children in danger in order to make a quick buck.
Parents are again demanding that state act to keep their children and families safe.
With the support of physicians, I introduced legislation to restore integrity to medical exemptions and maintain community immunity. The bill stops unethical physicians by requiring oversight over medical exemptions by the California Department of Public Health. State and county health officials will have the authority to review and invalidate inappropriate medical exemptions that compromise the safety of vulnerable school children. The ability to track information on exemptions will also allow public health officers to identify unvaccinated children during outbreaks to halt disease. Finally, data on inappropriate medical exemptions will help the state Medical Board in investigations of unethical physicians.
Low vaccination rates are endangering the health and safety of children. This year, the State of Washington and Rockland County, New York have declared emergencies to combat measles outbreaks affecting hundreds of people. In California, unvaccinated travelers have brought measles to the Golden State including an outbreak where two unvaccinated children with suspect medical exemptions were infected.
We fought to win back our community immunity in 2015, and we need to keep it to protect the most vulnerable: babies, people with cancer, transplant recipients, and the two percent of children for whom the vaccine does not confer immunity. They will be the victims of fake medical exemptions.
Who will act on their behalf?
The primary role of government is to protect the public. We will act again to keep people safe.
We cannot allow a small number of unethical physicians to put our children back at risk for infection. It is time to stop fake medical exemptions and the doctors who are selling them.
Dr. Richard Pan is a pediatrician, former educator at the University California, Davis and a California State Senator representing the Sacramento region. He was elected to the State Assembly in 2010 and later elected to the State Senate in 2014 and 2018. California has some of the toughest vaccine laws in the nation because of Dr. Pan's authorship of SB 277 in 2015, which abolished the personal belief exemption in California.
The views expressed in this article are the author's own.
Uncommon Knowledge
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