“Balancing considerations regarding the unpredictability of timing of onset of the influenza season and concerns that vaccine-induced immunity might wane over the course of a season, it is recommended that vaccination should be offered by the end of October.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season
Not surprisingly, folks are pushing misinformation in trying to get support in their efforts to oppose SB276, the California bill that will help stop doctors from writing fraudulent medical exemptions.
Are There 6 Reasons to Oppose SB276?
It also shouldn’t be a surprise that none of their “reasons” hold water.
And it is only the doctors writing excessive medical exemptions that will trigger an investigation.
What about the Medical Board of California?
While the system that they have in place has allowed them to investigate some doctors, it has mostly failed. While they do have the authority to investigate physicians, for some reason, they can’t get medical records unless a parent cooperates.
“Ms. Simoes provided background on Senate Bill (SB) 277, which passed in 2015, eliminating the personal belief exemption from the requirement that children receive specific vaccinations for certain infectious diseases prior to being admitted to any school or daycare center. She explained that after the passage of SB 277, the Board has had a difficult time investigating complaints related to medical exemptions since an authorization of medical records needs to be signed and many parents or guardians do not want to sign the authorization since it would identify the doctor that provided the medical exemption. She explained that this causes a barrier to investigation since most medical exemption cases cannot be subpoenaed and medical records are needed to conduct an investigation.”
Discussion and Possible Action on SB 276 (Pan) Immunizations: Medical Exemptions
And the Medical Board of California supports SB276.
In addition to the Governor of California, supporters include the AAP, California Medical Association, California State PTA, Children’s Defense Fund of California, County of Los Angeles, Infectious Disease Association of California, and the March of Dimes.
“Treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals. Also called best practice, standard medical care, and standard therapy.”
NCI Dictionary of Cancer Terms
Just because a few doctors do something a certain way, that doesn’t make it the proper way for it to be done.
And that’s why a doctor making up their own rules for what counts as a vaccine medical exemption, especially when it goes against published guidelines and advice, isn’t standard of care.
Some want very broad guidelines and are confused about how doctors determine who should get a medical exemption.
Does the CDC Determine Medical Exemptions for Vaccines?
Bob Sears even thinks he has a bombshell revelation that clears everything up.
An email from the CDC!
The thing is, no one has ever said that ACIP contraindications and precautions to vaccination are the one and only factor that should determine whether or not a child should get a medical exemption.
“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
So no one should really be surprised by an email that says the CDC does not determine medical exemptions.
What Qualifies as a Vaccine Medical Exemption?
What are the other big factors, in addition to ACIP contraindications and precautions?
“A medical exemption is allowed when a child has a medical condition that prevents them from receiving a vaccine.”
“Medical exemptions are intended to prevent adverse events in children who are at increased risk of adverse events because of underlying conditions. Many of these underlying conditions also place children at increased risk of complications from infectious diseases. Children with valid medical exemptions need to be protected from exposure to vaccine-preventable diseases by insuring high coverage rates among the rest of the population. Granting medical exemptions for invalid medical contraindications may promote unfounded vaccine safety concerns. Although states may wish to allow parents who make decisions based on poor science or perceptions to withhold vaccines from their children, these exemptions should be distinguished from valid medical exemptions.”
Salmon et al on Keeping the M in Medical Exemptions: Protecting Our Most Vulnerable Children
For example, in addition to kids who may have had a severe allergic reaction to a vaccine, there are often children with immune system problems or who have a moderate or severe illness who can’t get one or more vaccines, at least temporarily.
Medical exemptions for vaccines should not be based on anecdotes or simply because a vaccine-friendly doctor has scared a parent away from vaccinating and protecting their kids.
In general, they should rarely be given, as the AAP states in their policy statement, Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance, “only a very small proportion of children have medical conditions prohibiting specific immunizations…”
That’s why rates of medical exemptions should be low.
“Between the 2009-2010 and 2016-2017 school years, the national median prevalence of medical exemptions has remained constant, between 0.2% to 0.3%, with state-level ranges showing little heterogeneity over time, never exceeding the range of 0.1% to 1.6% over this period.”
Bednarczyk et al on Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes