Despite Protests, States Limit Exemptions from Mandatory Vaccines

Published October 21, 2019

Lawmakers were galvanized by a recent outbreak of measles which peaked in April with 341 new cases that month. Since then, the number of new cases has decreased radically, to 24 in August, according to the Centers for Disease Control and Prevention. As of September, the total number of cases for 2019 was 1,241, with more than 75 percent linked to outbreaks in New York State.

Five states—California, Maine, Mississippi, New York, and West Virginia—do not allow exemptions from mandatory childhood vaccinations for personal, philosophical, or religious reasons. On September 9, California Gov. Gavin Newsom signed legislation clamping down on medical exemptions as well. S.B. 276 allows the government to investigate physicians who write more than five medical exemptions for vaccines within one year for children who attend schools with immunization rates under 95 percent.

Opponents of these policies are not going away quietly. In Maine, they are seeking to overturn the law by putting the issue on the March 2020 ballot.

Interfering with Doctors’ Orders

The medical exemption restriction in California applies to all physicians, including those who treat immune disorders.

“There is no exception,” said Marilyn Singleton, an anesthesiologist and attorney in California and president of the Association of American Physicians and Surgeons (AAPS).

“If the state determines a physician is ‘contributing to a public health risk,’ it will report the physician to California’s Medical Board,” said Singleton. “This process takes the final judgment out of the hands of the patient’s physician.”

The law could have a chilling effect on doctors’ decision-making, says Jane Orient, a physician, executive director of AAPS, and policy advisor to The Heartland Institute, which publishes Health Care News.

“Not only does [S.B. 276] severely restrict acceptable contraindications, it is so onerous that most doctors will decline to write any at all, out of fear of harassment or even loss of licensure,” said Orient.

Tweaking an Unpopular Bill

S.B. 276 gained a large amount of attention. During the legislative debate, thousands of protesters descended on the state capitol. Several were arrested. 

Hours before a scheduled vote, Newsom pushed for amendments to the bill. What emerged was a companion bill, S.B. 714, which would invalidate any medical exemption written by a physician who has faced disciplinary action and grandfather in exemptions written before January 1, 2020. To prevent a mad rush to a doctor’s office before that date, the law requires students to get a new exemption at kindergarten, 7th grade, and any time the child moves to a new school. It also removes a provision requiring doctors to certify under penalty of perjury that an exemption is accurate.

 The provisions are improvements but do not eliminate the law’s overreach, says Singleton.

“The law holds a doctor’s integrity and clinical judgement hostage to the state by intimidation and fear of losing one’s license and livelihood,” said Singleton. 

“The law strips individuals of their right to choose their medical treatment and benefit from their physician’s judgment based on the patient-physician relationship,” said Singleton. “The law interferes with the physician’s right to practice medicine according to the ethics embodied in the Oath of Hippocrates.”

‘More State Control’

Limiting exemptions, not measles, is the reason behind the new laws, says Singleton.

“The powers that be saw that medical exemptions were on the rise since the elimination of the personal-belief exemption,” said Singleton. “The increase in measles cases helped spur the new legislation. This is an opportunity, not for a measured evaluation of public health concerns, but for more state control.”

“There is a push in many states to either remove exemptions or make it very difficult to get them, like onerous ‘education’ burdens on parents,” said Orient. 

Orient says parents have a right to be concerned about side effects of vaccines, and lawmakers should respect the Nuremburg Code, which sets ethical guidelines for medical research and influenced the process for informed consent.

“Nuremberg was supposed to establish the right to informed consent,” said Orient. “It is considered unethical and illegal to violate this basic human right. The vaccine exemption is a dangerous precedent.”

Ashley Bateman ([email protected]writes from Alexandria, Virginia.