California has a new vaccine law, which will streamline the process through which doctors provide medical exemptions for vaccinations.
In California, children need to have vaccinations or medical exemptions from a doctor to attend school – exemptions for personal beliefs were outlawed in 2016. The goal of the law is to lower the rate of unnecessary medical exemptions issued by doctors.
Medical exemptions for vaccinations allow children to not receive immunizations because of a legitimate medical condition such as family medical history, severe allergies or a weakened immune system.
With the new law, Senate Bill 276, the California Department of Public Health can review and have final say over medical exemptions for vaccinations in a few, but not all circumstances: if school immunization rates fall below 95 percent, if a doctor issues more than five exemptions per year and if a school fails to report their vaccination rates.
That 95 percent immunization rate is the level needed to maintain community immunity, according to the California Health and Human Services Agency, which means 95 percent or greater of a population needs to be vaccinated to stop infectious diseases from spreading.
Marysville Unified School District Superintendent Gary Cena said the district works to enforce vaccinations and medical exemptions by sending home letters with families of preschool age children before they start kindergarten.
“We’re really proactive in obtaining the proper vaccination documentation and then making sure that all medical exemptions -- our nurses go through them with a fine-tooth comb -- making sure they’re acceptable,” Cena said.
That process, Cena said, is to verify the medical exemptions are specific to a medical condition, and written by a licensed physician.
According to the State Health and Immunization Board, medical exemptions have seen a slight uptick in the last few years, citing 4,812 students who entered kindergarten in 2018 with medical exemptions for vaccinations, compared to 931 in 2015.
Cena said the school district works with students who are not up to date on their vaccinations for a variety of personal circumstances.
“Exemptions, like people whose immune systems are compromised, homeless or foster students,” Cena said. “We enroll them immediately and work with them to connect them with services.”
Charter and private schools must also report the vaccination records for their students, but unlike public schools, students who are homeschooled or participate in independent study programs outside of a classroom don’t need to comply with the vaccination requirements, according to state law.
Heather Marshall, director of Sutter Peak Charter Academy, said the school does not have a physical location and offers classes for students in any of the six counties bordering Sutter county. She said the nature of the non site-based school allows those who cannot be vaccinated to receive and education tailored to their needs.
“A lot of times we will get kiddos that have a cancer diagnosis, we’ve had several children who are chronically ill,” Marshall said. “They choose to work from home.”
She said the school works to keep records of all its students vaccination levels, medical exemption or otherwise. She said she’s curious how the new laws will be interpreted and whether non site-based schools like Sutter Peak will be expected to comply with the 95 percent vaccination rate.
“If that’s (the laws) interpreted to include everybody, then that would have a fairly dramatic effect on us,” Marshall said.
She said if legislators interpret the new law to include all schools, both site-based and non site-based she said the school would work with the students and families who could be affected.
“Because we’re publicly funded like all charter schools are...we take a look at the population and go ‘OK who’s this going to impact,’” Marshall said. “We would certainly want to help them transition or help finding free clinics.”
Marshall said while the school will work to comply with the new state laws, she said she wonders about access to vaccinations for students in rural communities.
“I think it’s a bigger issue in finding out people are not being vaccinated because they truly don’t want to be, or is it access to care,” Marshall said.
Opponents of the law, which will go into effect Jan 1, 2020, raise concerns about government overreach in the medical industry. For schools, the impact of the new law is still unknown.
“We’ll just have to wait and see once the law comes into play and once it’s interpreted at the state level,” Marshall said.