California law: Health workers must sign for kids to skip vaccines

Declining to have a child immunized may become more difficult for Californians in 2014.

Last year Gov. Jerry Brown signed AB 2109, which requires parents and a licensed healthcare practitioner to sign a form before a child can be exempted from getting required vaccinations because of personal beliefs. On Wednesday, the state’s Department of Public Health made the new Personal Belief Exemption form available.

By completing the single-page document, a parent or guardian vouches that the the parent has received from a health practitioner information about the benefits and the risks of immunizations -- or that religious beliefs prohibit seeing an authorized practitioner. The new law applies to all public and private schools in the state, and to child-care facilities. Licensed doctors, osteopaths, nurse practitioners, physician assistants, naturopathic doctors and school nurses are all authorized to sign the form.

In past years, a parent could obtain exemption from one or more vaccinations for a child by submitting a brief note or signing a standard exemption statement on the back of the school immunization record.

But over time, there’s been a gradual increase in the number of kindergartners who are exempted from vaccines in California, said Dr. Mark Sawyer, a pediatrician and infectious disease specialist at the UCSD School of Medicine and Rady Children’s Hospital. Around the county -- and increasingly, the world -- outbreaks of preventable diseases such as measles have also been on the rise.

In many cases, Sawyer said, the decision against getting vaccinations is rooted in misconceptions about their safety. The idea behind the new law is “to make sure parents who opt not to immunize their children have access to good information,” Sawyer said. “Our observation is that parents get bad information and run with it.”

In the San Diego region, Sawyer said, parents who have chosen to exempt their kids from immunizations tended to be educated, upper-middle-class people and tended to cluster in the same schools, day cares and communities. When vaccination rates fall too low in a local pocket and herd immunity is lost, he added, infections -- including measles, which Sawyer called the “poster child” -- have an opportunity to spread rapidly.

Dr. Jonathan Fielding, director of Los Angeles County’s Department of Public Health, said he considered the rule “an important step in the right direction” because it “raises the bar and makes people take a careful look” before checking a box to opt out of immunization.

He added that his agency will monitor vaccination rates closely in the coming months to assess the new law’s effects.

The California Department of Public Health offers more information about the law at its Shots for Schools website.