Governor Signs SB 276 Into Law

Legislation Closes the Fake Medical Exemption Loophole

September 9, 2019

SACRAMENTO, CA – Dr. Richard Pan, Assemblywoman Lorena Gonzalez and a broad coalition of doctors, health care providers, public health officials, family and child advocates and parents celebrated the signing of Senate Bill 276 into law today, which will prevent fake medical exemptions and require oversight of the medial exemption process.

“I thank Senate President pro Tem Atkins, Assembly Speaker Rendon and my legislative colleagues that have stood in support of children who truly require a medical exemption to protect them against vaccine-preventable diseases. I thank the Governor for standing with science, and once again making California a leader in safeguarding children and communities from diseases that threaten our public health. It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable because a few unscrupulous doctors are undermining community immunity by selling inappropriate medical exemptions,” said Dr. Richard Pan, pediatrician and State Senator representing the Sacramento area.

“As a mom, there's nothing more important to me than making sure our kids are kept safe. Since we passed SB 277 in 2015, we have seen a few doctors get around the law by loosely issuing medical exemptions when families are willing to pay. The science is clear that vaccines work. SB 276 is critical to protecting those children who truly need medical exemptions,” said Assemblywoman Lorena Gonzalez, D-San Diego, principal co-author and Assembly floor manager for SB 276.

Senate Bill 276 will require physicians to submit information to California Department of Public Health (CDPH), including the physician’s name and license number and the reason for the exemption, which CDPH will check to ensure they are consistent with the Center for Disease Control’s guidelines or stand of care. The physician must also certify that they have examined the patient in person.

Additionally, CDPH will create and maintain a database of medical exemptions. CDPH will have the authority to revoke medical exemptions granted by licensed physicians if they are found to be fraudulent or inconsistent with standard of care. This authority will give the state public health officer the tools necessary to contain and prevent further outbreaks.

“SB 276 makes California’s existing vaccination law stronger and will protect community immunity. This important legislation makes clear that California will not tolerate physicians who are practicing outside the accepted standard of care and will prioritize public health and protections for children,” said CMA President David H. Aizuss, MD.

After working with the Governor’s office, Dr. Pan agreed to amendments that are contained in a separate measure, Senate Bill 714.

“Pediatricians across California have been deeply concerned that bogus for-profit medical exemptions to vaccines were putting the health of California children and communities at risk. We are extremely grateful to Senator Richard Pan and Assemblymember Lorena Gonzalez for their leadership in enacting SB 276 and to Governor Newsom for his signature on the bill today, reflecting his priorities as a pro-children and families and pro-science governor,” said Kris Calvin CEO American Academy of Pediatrics, California.

“On behalf of thousands of Vaccinate California members, we are thankful to Dr. Pan and Assemblymember Lorena Gonzalez for their leadership in prioritizing science over fear to protect California children by ending fraudulent medical exemptions to school vaccinations,” said Leah Russin, founder of Vaccinate California, a parent advocacy group working to improve public health in California by raising vaccination rate.

Following a measles outbreak in Disneyland in 2014, California legislators passed Senate Bill 277, authored by Dr. Pan, which eliminated all non-medical exemptions to the required vaccines for school entry. As a result of the implementation of Senate Bill 277, overall vaccination rates have increased sharply statewide since 2015. Figures from earlier this year show that immunization rates remain high, but have decreased slightly over the last two years. The report shows that 94.8 percent of kindergarteners in 2018-2019 have been vaccinated, a 0.3 percent decrease from the 2017-2018 school year.

However, California has also experienced a dramatic increase in the number of medical exemptions. Last year it had tripled (from 0.2 percent in 2015-16 to 0.7 percent in 2017-18).  Data from this year shows the percentage has quadrupled to 0.9 percent. Low vaccination rates in certain pockets of the state have put children and communities at risk. More than 100 schools have a medical exemption rate over 10 percent, far beyond what should be expected, putting children and communities at risk.

The vaccine schedule prevents measles and other types of diseases, including pertussis, (also known as whooping cough), which is marked by severe coughing attacks that can last for months. Infants too young for vaccination are at greatest risk for life-threatening cases of pertussis.

When measles spreads in a community with immunization rates below 94 percent, the protection provided by ‘community immunity’ is lost. This means that many people, are at risk of becoming infected, including those who cannot be immunized, infants, chemotherapy patients and people with HIV or other conditions.

The hesitation to vaccinate on the part of a growing number of parents stems from misinformation such as the now retracted 1998 study that falsified data to purport a link between autism and the measles vaccine.  The study was authored by Andrew Wakefield who was later found to be lying. Also, numerous subsequent studies worldwide involving hundreds of thousands of children have proved that vaccines are safe and do not cause autism.

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Dr. Richard Pan is a parent, small business owner, former UC Davis educator and pediatrician who represents Sacramento, West Sacramento, Elk Grove and unincorporated areas of Sacramento County in the state legislature and is the Chair of the Senate Health Committee. As a legislator, Dr. Pan continues to practice medicine at WellSpace Health Oak Park Community Clinic, pursuing his passion for working with families to build healthier communities.