Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines (generally, but sometimes moving to other areas of medicine), social policy and the law. Her articles usually unwind the complexities of legal issues with vaccinations and legal policies, such as mandatory vaccination and exemptions, with facts and citations.
Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.
[pullquote]Wake up, and speak for protecting your children from the risk of disease a minority has been allowed to choose for the rest of us.[/pullquote]
Two bills are currently proposed in California that may dramatically affect vaccination rates. Anti-vaccine activists have mobilized against them. We, the majority of vaccinating parents, need to do the same, speak up and make our preferences known. Say clearly that we will no longer have a preventable risk of disease forced on our children, ourselves, and other family members and friends by a minority. And we can.
The more salient bill, at least so far, is California SB 277 vaccine legislation, which abolishes the personal belief exemption. The bill would leave intact the medical exemption: it makes no changes to it. But it would mean that if passed as written, parents would not be able to send children to, public and private, or daycares, also public and private, without the required immunizations unless they are medically exempt.
Contrary to anti-vaccine claims, the bill does not remove informed consent and is not equivalent to forcing vaccines on parents. A doctor is still not allowed to vaccinate without parental consent or a court order. But a parent will not be able to impose on the other children in a daycare or school the risk they choose for their own child by denying her vaccines.
Under current law, even with the requirement to get a health provider’s signature that a parent had the risks and benefits of immunization explained, getting an exemption is very, very easy. A parent needs to fill a form, get a doctor, nurse, or qualified naturopath to sign that they got an explanation about risks and benefits (with or without actually giving that explanation) and get the exemption. Or check the religious exemption box on the form and get the exemption.
Some schools have very, very high exemption rates.
There is abundant evidence that higher exemption rates increase the risk of outbreaks (pdf). Those exemption rates directly put children at risk of disease. Yes, the children left unvaccinated are at higher risk. But they can infect the too young (for example in daycares), children with medical problems that prevent vaccinating, other unvaccinated children, or the few that suffer vaccine failure. By reducing herd immunity, they make the school a hotspot for outbreaks – decreasing its safety for everyone. They violate the rights of other parents to choose a disease-free, safe school for their children, and the right of children that are not theirs to health.
There’s not really a good way around it. Easy to get exemptions make schools more disease vulnerable and less safe. SB277 would make schools and daycares safer for the children in them – children of the majority that supports vaccinating, following the data and expert opinion.
What are the choices facing parents? Currently, parents who insist on denying their children vaccines have one choice only: homeschooling by using an accredited tutor – hiring one or getting accredited themselves (California Education Code § 48224). Yes, it’s costly. But who says that being exempt from the legal requirements that apply to everyone else should be easy? And again: the cost of high rates of exemptions is making schools less safe for other children and their families. That is not justified.
I hope and expect that the bill will be changed to clarify that all home schoolers are exempt from vaccination requirements, leaving an out. That’s because I worry, as I said in the past, about the response of the extreme minority to a mandate without an opt-out – I worry they will resort to extreme measures like faking records or using untested, dangerous methods to “detox” their children.
Home schooling would still not be an easy choice for some families. But the fact that avoiding the requirement is hard is not a good reason to allow these parents to impose the costs of their error on other children and society at large. It’s bad enough that their own children have to pay the price of not being protected against disease. Other children have the right not to have that preventable risk forced on them. And hopefully, the bill will create a situation where herd immunity will protect vaccine-deprived children in the community from disease as well.
This bill, California Senate Bill 792 (SB 792) (pdf), would forbid daycares – both home daycares and institutional ones – from employing people not immunized against influenza, pertussis and measles. This bill fills a much needed gap: currently, children going to daycares are subject to immunization requirements – but workers are not, and a worker can easily transmit a disease to a child. It may be a good idea to extend the requirements to teachers, and to carefully consider, with expert input, the appropriate list of vaccines. But the idea – that childcare workers should be vaccinated as well – is a good one.
The majority of people support vaccines. The vocal anti-vaccine minority is exactly that: a minority. But because the benefits of vaccination are so obvious, many people don’t see a need to speak up, leaving the stage to a vocal, misinformed minority – possibly creating an impression the minority has more support than it does. What people need to do is speak up.
Don’t let a tiny extreme group continue to impose a risk you have not chosen on your children and yourself.
How can you make a difference?
- Join VaccinateCalifornia.org – so they can send you notifications of events and how to help (this list only reflects the current events).
- Consider liking the relevant Facebook pages – Vaccinate California and Californians for SB277.
- Call, email or visit senators – contact your State Senator directly.
- Fax committees regarding your support for SB 277 – Health, Education and Judiciary.
- Attend, if possible, the legislative hearings in Sacramento, in the Senate:
- health committee, 4/8 at 1:30 pm
- education committee, 4/15 at 9 am
- judiciary committee, 4/21 at 1:00 pm
- Speak up in every forum – online and in media. Don’t leave the stage to the anti-vaccine minority. Wake up, and speak for protecting your children from the risk of disease a minority has been allowed to choose for the rest of us.
- Glanz JM, Newcomer SR, Narwaney KJ, Hambidge SJ, Daley MF, Wagner NM, McClure DL, Xu S, Rowhani-Rahbar A, Lee GM, Nelson JC, Donahue JG, Naleway AL, Nordin JD, Lugg MM, Weintraub ES. A population-based cohort study of undervaccination in 8 managed care organizations across the United States. JAMA Pediatr. 2013 Mar 1;167(3):274-81. doi: 10.1001/jamapediatrics.2013.502. PubMed PMID: 23338829.
- Glanz JM, McClure DL, Magid DJ, Daley MF, France EK, Salmon DA, Hambidge SJ. Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. Pediatrics. 2009 Jun;123(6):1446-51. doi: 10.1542/peds.2008-2150. PubMed PMID: 19482753.
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