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California

Three doctors face medical discipline for vaccine exemptions, and more could be on the way

Dr. Tara Zandvliet
The complaint against Dr. Tara Zandvliet says she has granted 1,000 exemptions since 2016.
(Alejandro Tamayo / The San Diego Union-Tribune)

A San Diego doctor is among three California physicians accused by the Medical Board of California of granting inappropriate childhood vaccination exemptions, but many more doctors across the state may be in for similar scrutiny.

Earlier this week, the board released a formal charge of negligence against Dr. Tara Zandvliet for writing a vaccination exemption for a local girl based on inadequate documentation of an adverse medical history that would make inoculation too risky.

The complaint, which is the first step in a formal hearing process that could result in license revocation or suspension, says that Zandvliet, who did not respond to requests for comment, has granted 1,000 exemptions since 2016.

On Wednesday, a medical board representative said the regulatory body has filed three accusations, including Zandvliet’s, around inappropriate vaccination exemptions. Of the three, Zandvliet’s lists the largest total number of exemptions by far.

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But more may be on the way.

According to an email from the medical board, the regulatory body has received 192 complaints regarding inappropriately granted vaccine exemptions since 2016, including 99 so far this year. Given that the average investigation and legal processing times for complaints range from one to nearly two years, it’s likely that many of the cases, especially the 135 made in 2018 and 2019, could still generate additional accusations.

Board officials declined to discuss whether additional filings are in the offing or to identify who filed the complaints made so far. By law, the identities of complainants are kept confidential.

Medical exemptions were traditionally given only to those who experienced severe allergic reactions during or soon after getting a shot or for those with severely compromised immune systems.

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But that changed in 2016 when a new law made it impossible for parents to exempt their children from school vaccination requirements by simply saying that vaccination was against their personal beliefs.

The new law has produced a drastic change statewide.

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During the 2014-2015 school year, records show that Californians filed 13,592 personal belief exemptions and 1,034 medical exemptions for kindergartners statewide. With personal belief exemptions off the table, 4,812 medical exemptions were granted by doctors during the 2018-2019 school year, a nearly five-fold increase over the number filed four years ago.

It’s the same picture for San Diego County, which saw the number of medical exemptions for kindergartners jump from 97 to 599 during the same span.

It is unclear whether Zandvliet’s 1,000 alleged exemptions means she granted the most in the state. A representative of the San Diego County Office of Education said the agency does not log which doctors are granting exemptions because that information is communicated directly to the California Department of Public Health from individual doctors.

When asked for a list of all exemptions granted by a doctor, the CDPH said in an email that no state records fit that description: “Schools report to CDPH the number of exemptions at each school but do not report the names of the physicians who granted the exemptions.”

While the state is not keeping a tally of how many exemptions are granted by each doctor, the San Diego Unified School District has been ahead of the curve in this regard. Since personal belief exemptions were banned, the district has logged medical exemptions by doctor. The list, which was unavailable Wednesday due to a glitch in the district’s online public records request system, indicated that Zandvliet had signed off on about one-third of all requests in San Diego Unified schools since 2016.

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The other two doctors facing medical board accusations related to their vaccine exemption practices include:

  • Dr. Robert W. Sears of Capistrano Beach. An amended accusation filed against Sears, who is a well-known critic of childhood vaccination practices, lists the cases of five children. According to the document, Sears granted vaccine exemptions to four of the five without enough evidence of severe reactions. The board also questions Sears’ medical record-keeping practices for a fifth patient seen in 2017. The evidence used to grant an exemption to a 7-year-old boy involved psoriasis while medical evidence for his sister’s exemption letter included a bee sting. Sears’ medical license was suspended for 35 months in 2018 after a preliminary accusation was filed in 2016.
  • Dr. Kenneth P. Stoller of Santa Rosa. An accusation dated July 29 lists 10 patients that the medical board says were granted exemptions without adequate medical evidence of severe vaccination risk. In some cases, the board accuses the physician of relying on genetic testing results even though such results are not recognized by the U.S. Centers for Disease Control and Prevention as valid “medical contraindications to vaccination.”

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