Vaccine Exemption Bill Wins Approval From California’s Medical Board

The Medical Board of California announced its support Thursday for a state bill that would more strictly regulate which children can skip vaccines for medical reasons. This is the first time the government agency has fully backed efforts to crack down on doctors who grant excess exemptions.

The bill would require the state health department to review exemption forms issued by doctors who grant more than five medical exemptions in a year, or in school districts with low immunization rates. Supporters say more regulation is crucial to make sure vaccination rates remain stable. 

Opponents have rallied against the bill at multiple hearings during this legislative session, including one where hundreds of parents packed the halls of the Capitol. Some parents feel the guidelines for medical exemptions are too narrow and that increased oversight violates the doctor/patient relationship. 

Only certain children, such as those who have HIV or are undergoing chemotherapy, are medically exempt from vaccines under federal guidelines. Some California lawmakers say doctors are writing false medical exemptions for children who should be getting their shots. 

In California, families can no longer opt out for personal reasons. Since those exemptions were banned in 2016, the rate of kindergartners with medical exemptions has quadrupled, according to the California Department of Public Health. 

The medical board agrees that these exemptions should be subject to stricter review. But some members initially felt the federal guidelines for who can skip shots were too narrow. 

In June the board sent a letter to bill author Sen. Richard Pan announcing that they supported the bill “in concept,” which drew criticism from members of the public who thought the physicians should back the bill more firmly. 

In the same letter, the board noted that the bill could make it easier to investigate doctors accused of writing fraudulent vaccine exemptions by allowing board members to receive medical records related to these cases. 

Since 2015, the medical board has received 186 complaints regarding “inappropriate vaccine exemptions”. There have been 89 this year alone, up from 41 in 2018 and 43 in 2017, according to the medical board. The board has disciplined one physician, who is currently on probation, and filed one accusation. Another 107 cases are pending, and 77 are closed. 

Both supporters and opponents attended Thursday’s hearing in San Francisco to try to sway the board’s vote. The bill now continues moving through the legislative process. 

An earlier version of the proposal would have required state health officials to approve all medical exemptions. The bill underwent significant changes in June after Gov. Gavin Newsom voiced concern about a state “bureaucrat” handling the forms. 

The current bill bans doctors from accepting payment for filling out a medical exemption form or conducting a medical exam, and allows parents to appeal denied exemptions to an independent panel of doctors. It also requires the state to review medical exemptions issued in schools with vaccination rates of less than 95 percent.