Should California Strengthen School Immunization Rules?

  ·  California Healthline, California Healthline   ·   Link to Article

Think Tank


Two statistics are on the rise in California:


  • The number of California kindergarteners who have not been vaccinated against childhood illnesses has increased by 16% over the past year, according to data from the state Department of Public Health.


  • Communicable diseases including measles and whooping cough are increasing in California. So far, 56 cases of measles -- the largest outbreak since 2000 -- have been reported this year. Last year, 2,300 cases of pertussis -- also known as whooping cough -- were reported in California.


Under a new state law that took effect Jan. 1 this year, parents are required to consult with a health care provider -- physician, school nurse or naturopath -- before they decide their child should forego one or more of the standard vaccinations most children receive before starting school.

Before the new law -- AB 2109 by Richard Pan (D-Sacramento) -- parents could opt out with a signature on the child's immunization card.

It's too early to tell how the new law might affect the two trends above, but some health advocates say the new regulations don't go far enough. Some suggest children should not be allowed to attend school without vaccinations.

We asked legislators, stakeholders and experts how California lawmakers and policy makers should respond.

We got responses from:


Assembly member Richard Pan (D-Sacramento) | Chair, Assembly Committee on Health

"Vaccine-Preventable Diseases Must Be Prevented

However, I remained optimistic that with the advent of vaccines that prevented meningitis and cancer, we could still protect more children.

Today, my past optimism has been replaced by concern that too many parents do not understand the dangers of vaccine-preventable diseases. Instead, many parents hesitate to vaccinate their children because of misinformed fears regarding vaccine safety. This past year, the number of California kindergarteners not receiving recommended vaccinations rose 15%. Some even claim children should catch these infections "naturally," not understanding that prior to accepted use of these vaccines, one in five children with measles were hospitalized and 450 children a year died, that 9,000 children a year died of pertussis, etc.

But we do not have to look back decades to find death from vaccine-preventable diseases. With falling vaccination rates, preventable diseases have returned to California. In 2010, more than 9,000 cases of pertussis resulted in 809 hospitalizations and 10 infant deaths, cases clustered in communities with low vaccination rates, and with another sharp increase in pertussis in 2013. Measles, declared eradicated in 2000 in the U.S., sharply increased with 58 cases already this year in California compared to a low of four cases for an entire year.

AB 2109, implemented this year, requires parents to consult a licensed health care professional before opting out their child from required immunizations. This law is modeled on a law in Washington state, which reduced school vaccine exemptions. Keeping vaccination rates high enough to prevent outbreaks is essential to protect people who cannot be vaccinated such as infants and people with poor immunity, such as chemotherapy patients. Monitoring the impact of AB 2109 on school immunization rates will be important. Public disclosure of vaccine exemption rates at each school can empower parents and community members concerned with disease outbreaks. In addition, the Affordable Care Act eliminated copayments for vaccines to reduce cost barriers for parents to get immunizations. However, if outbreaks continue to increase with low immunization rates, additional steps need to be considered to protect our communities. 

We should not wait for children to die of vaccine-preventable disease to act."


Read three other viewpoints regarding immunizations on California Healthline's website at: