Tag: California

Update on Vaccine Exemption Rates in California

Vaccination rates in California are dropping.

Wait, what?

Didn’t they recently pass a vaccine law that removed non-medical exemptions? How could vaccination rates be dropping?

Update on Vaccine Exemption Rates in California

While SB 277 did indeed remove all non-medical exemptions to getting vaccinated, some folks found a way around it. Since 2015, when it passed, some doctors are giving kids fake or unnecessary medical exemptions. These extra medical exemptions are likely making up for their previous personal belief vaccine exemptions.

The result?

It isn’t fewer exemptions since 2015.

Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?
Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?

While personal belief exemptions are certainly down, medical exemptions keep going up.

In addition to the 0.9% of medical exemptions, another 1.5% of kids, also up as a percentage, are unvaccinated “for other reasons specified under SB 277.”

There are also about 1.7% of kids in kindergarten who enroll as conditional entrants.

Why is that important? Among those conditional entrants are kids with temporary medical exemptions.

And how many kids aren’t vaccinated simply because they are “receiving IEP services?”

So it is not only wrong, it is unethical to try and say that only 0.9% of kids have vaccine exemptions in California this year.

Update on Vaccine Exemption Rates in California’s Clusters

Still, the big story continues to be what’s going on in the clusters of intentionally unvaccinated kids in California and other parts of the United States.

Are they getting vaccinated and protected under SB 277?

Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!
Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!

Some actually are!

The MMR rate at the Waldorf school in San Diego was just 44% back in 2014, as a whopping 56% of kids had a personal belief exemption. As sad as it sounds, even though it is still below herd immunity levels of protection, their current MMR vaccination rate of 68% is a big improvement!

Unfortunately, there are many schools with even lower immunization rates. And of course, that means even more students with “medical exemptions” at those schools.

SchoolPMEs
Marin Waldorf School31%
Yuba River Charter64%
Westside Waldorf School37%
Sebastopol Independent Charter45%
Muse Charter50%
Live Oak Charter41%
Nevada City School of Arts31%
Sunridge Charter47%
Santa Cruz Waldorf School34%
Cedar Springs Waldorf School30%
Journey33%
Waldorf School of Orange County33%
Coastal Grove Charter36%
Mariposa School of Global Ed31%
Waldorf School of the Peninsula36%
Maple Village Waldorf School30%

In addition to these permanent medical exemptions (PMEs), some schools also have high rates of temporary medical exemptions.

Medical Exemptions for Vaccines in California are Unusually High

What’s the usual rate of medical exemptions?

As there are few reasons to skip or delay a child’s vaccines, it is lower than those rates.

A lot lower.

In one recent report, Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School Year, the median rate of medical exemptions in the U.S. was just 0.2%, with a range of <0.1 to 1.5%.

Also unusual is that in some cases, many of those exemptions are written by just a few doctors. In fact, families often go to these doctors just to get their kids their medical exemptions!

“…the removal of nonmedical exemptions in California was initially effective in increasing vaccination rates, but the substitution between exemption types may render the repeal partially ineffective in improving immunization coverage and preventing VPDs over time.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

How do we fix this and get more kids vaccinated and protected?

“Beyond fostering compliance, tightening the requirements around medical waivers will also aid in promoting public policies that protect public health.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

In addition to closing the loopholes that allow some doctors to abuse medical exemptions, it will be important to help parents be more skeptical and see through the anti-vaccine propaganda that other doctors use to scare parents away from vaccinating and protecting their kids.

Vaccines are safe, with few risks, and are obviously necessary.

More on Vaccine Exemption Rates in California

Why Should Medical Exemptions Be Based on CDC Contraindications?

Getting a medical exemption for vaccines isn’t controversial.

Or at least it shouldn’t be.

Why Should Medical Exemptions Be Based on CDC Contraindications?

As many people know though, some people have been taking advantage of the fact that medical exemptions weren’t clearly defined in California’s vaccine law.

Who are the doctors handing out fake medical exemptions in California?
Who are the doctors handing out fake medical exemptions in California?

Are there just a few doctors taking advantage of the California law?

“But at 105 schools in the state, 10% or more of kindergartners had a medical exemption in the school year that ended last month, according to a Los Angeles Times analysis of state data.”

Pushback against immunization laws leaves some California schools vulnerable to outbreaks

Is 10% a lot?

In one recent report, Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School Year, the median rate of medical exemptions in the US was just 0.2%, with a range of <0.1 to 1.5%.

In West Virginia and Mississippi, states that don’t allow non-medical exemptions and where criteria for medical exemptions are fairly strict, the rates were 0.1 and 0.3% respectively.

And that’s about what you would expect, as there are very few true contraindications or precautions to getting vaccinated.

So yes, 10% is an awful lot and that’s a good sign that it is more than just a few doctors taking advantage of the law.

“If a child has a medical exemption to immunization, a physician licensed to practice medicine in New York State must certify that the immunization is detrimental to the child’s health. The medical exemption should specify which immunization is detrimental to the child’s health, provide information as to why the immunization is contraindicated based on current accepted medical practice, and specify the length of time the immunization is medically contraindicated, if known.”

Dear Colleague letter regarding guidelines for use of immunization exemptions

Why do most other states have so few medical exemptions?

Mostly because there are very few true medical reasons to skip or delay a child’s vaccines!

They include, but aren’t limited to, the contraindications and precautions listed in the package insert for each vaccine (the contraindications and warnings sections…) and by the Advisory Committee on Immunization Practices.

They don’t include many other things that are “incorrectly perceived as contraindications to vaccination,” such as things in the family medical history of the child, eczema (unless they are getting the smallpox vaccine), colic, sleep apnea, or being a picky eater.

Is everything a vaccine injury?
Is everything a vaccine injury?

It should be obvious.

Medical exemptions for vaccines should be based on CDC criteria because some folks think that everything is a vaccine injury.

More on Medical Exemptions