California lawmakers dropped this year’s most controversial public health bill into Gov. Gavin Newsom’s lap on Wednesday, but it’s not clear whether he will sign the measure, which would tighten the rules for exempting children from routine vaccinations.
The state Senate voted 28-11 to approve SB-276 by state Sen. Richard Pan (D-Sacramento), prompting protesters who were watching from the gallery to chant, “You are not representing California for all!” All Senate Republicans voted against the measure and all Democrats voted in favor, except for one who didn’t vote.
Another protest from opponents as @DrPanMD’s SB276, which tightens the rules for vaccine medical exemptions, passed the Senate and heads to the governor’s desk: “Welcome to Calabama, y’all” pic.twitter.com/iNNDJEZauq
— Alexei Koseff (@akoseff) September 4, 2019
Newsom, a Democrat, said in June he would sign the bill after it had been amended at his request. But on Tuesday, a tweet from his office announced that he wants more changes.
Pan said he’s open to working with Newsom, but “this is the bill that the Governor’s office agreed to and said that they would commit to sign.”
The Governor appreciates the work the Legislature has done to amend #SB276. There are a few pending technical – but important – changes to the bill that clarify the exemption and appeal process that have broad support. (1/2)
— Office of the Governor of California (@CAgovernor) September 3, 2019
As passed, the bill would give public health officials the authority to review vaccination exemptions issued by doctors and revoke any they deemed “inappropriate” or “invalid.” It is intended to curb what has been described by public health experts as a dangerous increase in questionable medical exemptions.
Previous amendments requested by the governor broadened the eligibility for children’s medical exemptions from vaccines and narrowed the circumstances under which state public health officials could review those exemptions.
Under that version of the legislation — the one passed by lawmakers Wednesday — the state Department of Public Health would automatically review exemptions for children at schools where more than 5% of students weren’t immunized, and from doctors who had written more than five medical exemptions in a calendar year.
Parents would be able to appeal rejected exemptions to an independent panel appointed by the secretary of California’s Health and Human Services Agency.
The changes Newsom now wants to make include clarifying that a doctor’s previous medical exemptions wouldn’t be considered by state officials; the state wouldn’t start counting them until the bill takes effect Jan. 1, his office said.
Newsom also wants to remove a provision that would require doctors to certify under penalty of perjury that their exemptions are accurate. And he is requesting that, in order to protect patients’ medical information, the legislation specify that exemption forms would not be accessible through the Public Records Act.
Additional amendments would be made in separate legislation that would have to be approved by the legislature before its Sept. 13 end-of-session deadline.
Vaccines have become an explosive topic in the legislature and around the country, even as numerous studies show they are safe and effective and complications are rare.
The debate over vaccines comes amid the biggest measles outbreak since 1992: More than 1,230 people have contracted measles nationally so far this year, including 67 confirmed cases in California.
Opposition to Pan’s bill has engendered raucous rallies outside the Capitol, aggressive and coordinated social media campaigns and disruptions of committee hearings by chanting and crying vaccine skeptics. Last month, Pan, who has faced numerous threats for carrying the bill, was pushed from behind by a man who confronted him about the ingredients in vaccines.
“Anti-vaxxers have attempted to dehumanize me and other public health advocates on social media while making death threats,” Pan said in a statement after the incident.
Vaccine skeptics argue that the bill is a form of government overreach and that the state’s ability to revoke medical exemptions would disrupt the patient-doctor relationship.
California already has some of the strictest vaccine laws in the country under a measure implemented in 2016 that banned vaccine exemptions based on religious and personal beliefs. Under that law, children can be exempted only on medical grounds, and those who don’t have their shots or a doctor’s exemption are barred from attending schools.
Since the law took effect, the number of medical exemptions has jumped, and they are clustered in many of the same parts of the state that previously had high rates of religious or personal belief exemptions, according to state data. Around the state, 117 schools reported that 10% or more of their kindergartners had been granted medical exemptions in the 2018-19 school year.
Exemptions should be rare, according to the Centers for Disease Control and Prevention. They are typically reserved for children with severely compromised immune systems, such as those being treated for cancer or those who are allergic to a vaccine component or have previously had a severe reaction to a vaccine.