On Tuesday, June 30th, Governor Jerry Brown of California signed into law SB 277. The new law requires children attending daycare programs and public or private schools to be fully vaccinated, regardless of personal or religious beliefs [1]. More specifically, “under the law, vaccinations would be required of children first entering public school, or when they enter seventh grade” [1]. Under the bill, schools are not required to “automatically reject students who aren’t fully vaccinated – though they must work with parents to get the immunizations completed” and children currently in elementary school will have until seventh grade to be caught up with their immunizations [5]. Additionally, the law exempts students in home-based, private schools or independent study programs from needing to meet these requirements [1].
Passage of the law signifies California’s shift toward stricter legislation on vaccinations, joining only two other states, Mississippi and West Virginia, that “permit only medical exemptions as legitimate reasons to sidestep vaccinations” [1]. SB 277 is slated to begin implementation in California on July 1, 2016 [2].
It’s About Safety and Choice
Opponents of SB 277 have rallied against the bill, stating that the legislation infringes upon their parental right to choose whether or not to vaccinate their child [2]. Opponents believe that the legislation being passed is too broad. As noted in a Los Angeles Times editorial, opponents argue that children “with conditions that make vaccinations dangerous for them wouldn’t be entitled to exemptions” [5]. Prior to the passage of SB 277, some opposing parents publicly vowed to pull their children from schools. Since its passage, opponents have threatened to sue the state and to “take their case to the California voters” [3]. Additional reasons behind their opposition often revolve around vaccine efficacy and safety – in particular, concerns that thimerosal, a mercury-containing preservative, may be linked to autism and concerns regarding viral shedding [3,4]. However, there has been no convincing evidence that any harm has been caused by the low doses of thimerosal in vaccines, other than minor reactions such as swelling or redness at the site of injection [7]. Furthermore, as of July 1999, vaccine makers have moved towards thimerisol reduction and elimination as a precautionary measure [7].
Two-Thirds Say Yes
According to a recent Public Policy Institute of California poll, the passage of the bill aligns with the views and opinions of two-thirds of Californians who believe that children who are unvaccinated should not be allowed to attend public school [5]. SB 277 emerged in response to the recent measles outbreak in Disneyland, which began in December 2014 [3]. By the time the outbreak was declared over in April, there were a total of 147 total cases of measles stemming from the initial case at Disneyland, with 131 of those cases occurring in California, and nearly 20 percent of the cases requiring hospitalization [3,6].
Advocates for the legislation believe that low vaccination rates played a factor in the outbreak’s vast spread. This was noted in an earlier Disease Daily article written by Maia Majumder, reflecting on the importance of low vaccination rates and the Disneyland measles outbreak. Dr. Richard Pan, a pediatrician and a state senator from Sacramento, who spearheaded the bill, cites the rising number of parents opting for vaccination exemptions over recent years as influential in the Disneyland measles outbreak [3]. And health experts may agree — less than 0.77% of California’s kindergarteners had vaccine exemptions in 2000 – keep in mind, exemptions encompass personal belief, religious, and medical exemptions. By 2014, the total number of vaccine exemptions among California’s kindergartners had risen to 2.5% – more than tripling since 2000 and becoming equivalent to 1 in 40 children [3].
Only time will tell if SB 277 will result in fewer exemptions, and therefore greater vaccine coverage, for Californians. Improved outcomes as a result of the new law are likely to come in the form of ‘no news is good news’ – fewer vaccine-preventable disease outbreaks for all.
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Sources
[1] http://www.mercurynews.com/health/ci_28407108/gov-jerry-brown-signs-californias-new-vaccine-bill
[3] http://www.mercurynews.com/health/ci_27907241/vaccine-exemption-california-sb-277-opponents-vow-pull
[4] http://vaxtruth.org/vaccine-facts/
[5] http://www.latimes.com/opinion/editorials/la-ed-vaccine-bill-sb277-20150529-story.html
