By Dr. David Gonzalez
For more than a half century vaccines have been a safe and important tool in the fight to prevent death or disabilities caused by measles, whooping cough, diphtheria, polio and other childhood diseases. However, despite their success, a troubling minority of parents and guardians believe vaccinations pose more risks than benefits to their children.
In the past, parents could opt their children out of vaccinations by utilizing the personal belief exemption. However, legislation signed into law by Governor Jerry Brown in 2019 repealed that option. Now, the only way a parent can prevent their child from being vaccinated and attend school is by receiving a “medical exemption” from a licensed medical doctor.
In response to the growing number medical exemptions, non-profit organization Vaccinate California and others have sponsored Senate Bill 276 to create a government form for medical exemptions and a statewide exemptions database. The bill also requires the California Department of Public Health (CDPH) to develop a process state government employees would use to approve or deny medical exemption requests.
Carried by Democrat State Senator Richard Pan, SB 276 would create a system where untrained non-medical government employees may be empowered to evaluate vaccination exemptions. The legislation also requires CDPH to establish a database of medical exemption requests. This would place a significant burden on CDPH to decide in a timely manner whether a medical exemption is valid.
For example, if the 7,000 medical exemptions issued in 2017-18 were sent to CDPH the month before school starts, state or local officials would have to review 233 requests per day to meet the school start date—quite a challenge for agencies with many other responsibilities and limited staff and resources.
The process may also neglect or even overrule the opinion of a child’s personal physician and surgeon, and replace it with that of a far-away government worker who likely has no medical training and likely has never examined the child. This also begs the question will the state eventually receive the power to evaluate your child? This legislation could unintentionally lead to a massive increase in government power.
In addition, every physician issuing a medical exemption could be subject to state examination of medical competence and ethics without evidence that either has been violated.
While the development of a standardized medical exemption form and a database would increase information about medical exemptions, how will the forms and information be stored or secured, and what type of personal medical information would those files contain?
A more reasonable option would be to use the new database to flag physicians who have issued a higher than expected number of medical exemptions and turn that information over to the state medical board, which currently evaluates medical competence and ethics.
This solution would reduce concerns about non-medical professionals deciding if a medical exemption is based on valid health concerns and avoid costly duplication of physician oversight.
Dr. David Gonzalez is an assistant professor of public administration and organizational leadership with Brandman University’s School of Business & Professional Studies.