The California Legislature showed great courage on Wednesday by voting to close a loophole that vaccination skeptics have been using to get around mandatory immunizations for schoolkids — a vote that protects the public against the risk of serious harm from infectious diseases.
Now we just have to hope that Gov. Gavin Newsom doesn’t undermine all this good work with last-minute meddling. For some reason, California’s otherwise rational governor is acting irrationally when it comes to SB 276, a bill written and supported by doctors to ensure that physicians grant medical exemptions only to people who really need them.
After the state stopped letting parents skip the usual course of vaccinations for their kids on religious or philosophical grounds in 2015, exemptions for medical reasons spiked implausibly. Public health officials suspect it was due to a few unscrupulous doctors making money essentially selling exemptions for kids who didn’t need them, but whose parents were influenced by anti-vaccination advocates peddling misinformation about vaccine safety. Approximately 3% of the people in any population have a legitimate reason for an exemption, such as having an allergy or a compromised immune system. Their safety relies on everyone else getting vaccinations, which would render their community essentially immune and eliminate the risk of them being infected.
But neither the medical board nor public health officials have the tools today to stop doctors who provide exemptions willy-nilly. The bill would give them the power to review and reject medical exemptions from doctors who write more than five per year. The rejection wouldn’t be automatic; for some physicians, such as oncologists, a high number of exemptions may prove to be perfectly legitimate. Public health officials would also review exemptions for students in schools that have a collective vaccination rate of less than 95%.
Although both the Assembly and Senate passed SB 276 by wide margins, the governor says he wants a companion bill that makes a set of “technical” amendments. The changes he’s seeking, however, would delay and weaken the law. The governor didn’t say what he would do if the Legislature didn’t pass the companion bill, but the implication was that he’d veto SB 276.
What’s mystifying is why Newsom would suddenly decide that the bill needs a second round of tinkering. In June, the governor asked the bill’s author, Sen. Richard Pan (D-Sacramento), to accept a set of amendments weakening the law in exchange for his support, and Pan did. We haven’t seen the actual language of the new changes yet, but the way the governor’s office describes them makes it clear they are substantial, which is inappropriate at this late stage.
One of Newsom’s proposed changes would bar scrutiny of exemptions written before 2020, raising the possibility of a run on bogus exemptions until Dec. 31. This is in direct conflict with the author’s intention that any and all exemptions written by doctors be open to scrutiny by public health officials.
Another change would remove the possibility of criminal sanctions if a physician flouts the law and writes bogus exemptions. Considering that giving out (or worse, selling) exemptions to children who don’t need them could result in serious harm or even death for those with legitimate medical exemptions, leaving open the possibility criminal prosecution for perjury seems perfectly reasonable.
It’s difficult to figure out what Newsom is trying to accomplish with these new amendments. Is he acting on behalf of doctors? The California Medical Assn. and American Academy of Pediatrics, California are co-sponsors of the bill and support it in its current form, so probably not. Is the governor hoping to assuage the angry anti-vaccination advocates who have crowded into hearing rooms by the hundreds? If so, he’s woefully misguided. Those who oppose the bill don’t want fixes; they want it dead. In fact, Newsom’s amendments seem to benefit only one group: physicians who have written bogus medical exemptions and don’t want to be held accountable for endangering public health.
It’s disappointing that a governor so strongly on the side of science and reason when it comes to climate change could stand on the other side when it comes to public health — and during the worst measles outbreak in 20 years to boot. We hope Newsom comes to his senses and drops this eleventh-hour end run around this important bill.