California Close to Eliminating Personal Belief Exemptions for Vaccines

California Law Would End Vaccine Exemptions
"The science is clear: Vaccines are safe and efficacious." Lucy Nicholson/Files/Reuters

California's Senate on Thursday passed a bill that would prohibit parents from seeking vaccine exemptions for their children due to religious and philosophical reasons. Senate Bill 277, written by Senator Ben Allen (D-Santa Monica) and Senator Richard Pan (D-Sacramento), passed 25-10 and will now head to the State Assembly for review.

If the bill is signed into law, it would make California only the third state in the U.S. to abolish a personal belief exemption and require all school-age children to receive vaccines based on U.S. Centers for Disease Control and Prevention (CDC) guidelines. These vaccines protect against a number of serious and sometimes deadly viruses, including those causing measles, mumps, rubella, chickenpox, hepatitis B, poliovirus and diphtheria.

"Vaccines are necessary to protect us. That protection has been eroding," said Pan, who is also a pediatrician, before Thursday's vote. "The science is clear: Vaccines are safe and efficacious."

The legislation only addresses families that will soon enroll their children in school. Under the proposed law, children who aren't currently immunized are not required to get vaccinated until seventh grade. The law still allows families to opt out due to medical reasons, such as a history of allergies to vaccines and inherited or acquired immune disorders or deficiencies.

Many public health experts say California has been largely responsible for the reemergence of measles in the U.S. Its virus was all but eradicated in 2000, after ongoing public health campaigns provided the vaccine to millions of children in the country.

Earlier this year, worried federal and state health officials and irate parents urged California lawmakers to take up the issue, spurred on by a measles outbreak in Orange County that began in December 2014 and then spread to a number of states, including Massachusetts, New Jersey, New York, Nevada, South Dakota, Texas and Utah. Health officials traced the source of that outbreak to California after an investigation indicated that 40 people who visited Disneyland during the busy holiday season had contracted measles. Most were not vaccinated for the virus.

According to the CDC, there have been a total of 169 cases of measles in 20 states and the District of Columbia so far this year. Federal health officials say 70 percent of these documented cases were a result of California's outbreak, which most likely emerged when an ill child visited the amusement park from outside the country while still in the virus' infectious stage. In mid-April, health officials reported that the outbreak had ended after there were no reported cases of the virus in two back-to-back cycles of 21-day incubation periods.

Measles is a contagious disease that first begins with flu-like symptoms, as well as skin rashes and conjunctivitis. In more severe cases, a child may develop encephalitis, a serious and often fatal infection of the brain. Despite the effectiveness of vaccines, measles is still a common childhood illness in many parts of the world, including Europe, Africa and Asia. This is a result of a number of factors, such as religious beliefs, poverty, limited vaccine supplies and lack of access to basic preventive health care.

Some experts say the worldwide anti-vaxxer movement is contributing to an opportunity for viruses like the one causing measles to potentially return at epidemic levels. Many parents who have joined the anti-vaxxer movement believe that legal measures enforced by the state would infringe upon personal liberties and that the choice to vaccinate should remain up to the child's caregiver. Other parents, who do not vaccinate their children, still hold fast to research that links vaccines to a higher risk for autism, which resulted from a study that was published in 1998 but was later found to be falsified and eventually retracted.

Senator Bob Huff is one of a handful of California state lawmakers who oppose the bill. "My family and I all get vaccinated, so it's not about whether I believe in it or not," said Huff on Thursday. "It comes down to what to we as a society, as a legislature, trade when we mandate that somebody has to do this to protect somebody else. And I don't believe that the crisis we have seen with the measles epidemic raises to that level to give up the personal freedoms that we enjoy in a free society."

Dr. Mark Sawyer, a member of the committee on infectious diseases for the American Academy of Pediatrics and a professor of pediatric infectious diseases at the University of California, San Diego, says it's wrong to blame California for bringing measles back to the U.S.

"I think that's a coincidence that we had this outbreak at Disneyland," he says. "This trend of increasing numbers of children not being immunized is occurring everywhere."

Sawyer added that too many parents have started to rely on "herd immunity" to keep their children safe. The size of that herd may be diminishing to the point of ineffectualness: Research has shown that approximately 95 percent of a population must receive the measles/mumps/rubella vaccine in order to prevent serious outbreaks.

"Measles is the poster child of this issue for two reasons: It's incredibly contagious and the vaccine is highly effective," says Sawyer. "I think we're generally getting very concerned that we're reaching a tipping point—if our rates drop more we're going to see really large outbreaks of diseases."