In 2000, the disease measles was declared to have been largely eradicated thanks to expanded vaccination. At the peak of measles before vaccinations began, more than four hundred people died from it each year. Its elimination was a literal life-saving victory for medicine and public health.
However, years later, measles is making a comeback. Starting in 2018, 372 measles cases were reported. In 2019, 764 were reported after only May, the most since measles was declared gone in 2000.
This upsurge is the result of growing skepticism about vaccines. A poll taken in 2018 found that only 71 percent of parents believe it is important to have their children vaccinated. This may seem like a lot, but in 2008 that number was at 82 percent. Vaccine skeptics are not distributed evenly; some communities are much more skeptical of vaccinations than others. Even a small proportion of unvaccinated people can allow outbreaks to spread, and in many communities the proportion of people who are unvaccinated is much more than small.
After a previous surge in measles cases, the California State Legislature enacted a law requiring children to be vaccinated in order to attend public schools, even if their parents have a religious or philosophical objection to vaccination. The only excuse for not vaccinating was if your doctor felt vaccination would be a health risk. This exception is important because vaccinations are healthy for most children, but those with extremely weak immune systems or other health problems would be very endangered by vaccination.
As important as this exemption is, it also contains a massive loophole. The ability to grant exemptions is completely in the hands of doctors, who can easily exempt children for less-than-legitimate reasons, which is exactly what has become a pattern. Doctors have advertised their ability to exempt children for conditions that do not in any way cause an adverse reaction to vaccines, such as asthma. In San Diego’s Unified School District, a single doctor provided one out of every three exemptions.
In order to close this loophole, Senate Bill (SB) 276 was introduced. SB 276 requires medical exemptions to be approved by the state health department, based on federal standards for when vaccines are harmful, which is a necessary step in stopping doctors from making unnecessary exemptions.
Skeptics would say this bill would cause necessary exemptions to be bogged down in a large bureaucracy which does not have the resources to manage them. However, the amount of medical exemptions granted in California numbers in the hundreds yearly; easily manageable for an agency like the California Department of Public Health with a multibillion dollar budget. The extra layer of bureaucracy added by this bill is unfortunate, but not extremely complex or difficult to navigate.
To claim this bill is a panacea would be false. Many children lack vaccinations for reasons unrelated to medical exemptions, and this bill won’t affect those. It doesn’t solve undervaccination in California, but it closes a harmful loophole, and does so for a relatively low cost.