Brady Collins
California Senate Bill 277 (SB277) was enacted in 2015 and eliminated non-medical exemptions from immunization requirements for schoolchildren. Before SB277, California allowed exemptions from mandatory vaccination for medical reasons or because of personal beliefs if the appropriate forms were submitted. The bill was prompted by the 2014 Disneyland measles outbreak and low levels of vaccination in parts of California, with some schools having vaccination rates below 60%. After the bill's passage, vaccination rates among California schoolchildren increased, but unjustified medical exemptions also increased, fueled by anti-vaccination parents.
| Characteristics | Values |
|---|---|
| What was SB277? | California Senate Bill 277 (SB277) is a California law that removed personal belief as a reason for an exemption from the vaccination requirements for entry to private or public elementary or secondary schools in California, as well as day care centers. |
| Who proposed it? | California state Senators Richard Pan and Ben Allen |
| When was it passed? | June 30, 2015 |
| When did it go into effect? | January 2016 |
| What prompted the bill? | 2014 Disneyland measles outbreak and low levels of vaccination in pockets of California, with some schools having vaccination rates below 60%. |
| Who supported the bill? | The California Medical Association, the American Academy of Pediatrics' California affiliate, the California State PTA, the California Immunization Coalition, and the California Children's Hospital Association. |
| Who opposed the bill? | Anti-vaccine activists |
| What was the impact of the bill? | The percentage of incoming kindergarteners up-to-date on vaccinations in California increased after the implementation of SB277. |
| What were the criticisms of the bill? | Public health officials said that they faced an increasing number of unusual reasons cited as justifications for medical exemptions. Groups of anti-vaccine parents challenged the law in court, arguing that it violated the right to an education, the right to religious freedom, and parental rights. |
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What You'll Learn
SB277 removed non-medical exemptions
Before the enactment of SB277, California allowed exemptions from mandatory vaccination for medical reasons or because of personal beliefs, provided that the necessary forms were submitted to the relevant school or institution. This meant that parents could opt their children out of required vaccinations for non-medical reasons, such as religious or philosophical objections.
However, SB277, or the California Senate Bill 277, eliminated these non-medical exemptions. The bill was enacted in 2015 and signed into law by Governor Jerry Brown on June 30 of that year, with the non-medical exemption removal going into effect in January 2016. After SB277, only medical exemptions were permitted, with the decision to grant these exemptions left to the discretion of physicians.
The bill was co-authored by California state senators Richard Pan and Ben Allen and was a response to the 2014 Disneyland measles outbreak and low vaccination rates in some areas of California, with some schools having vaccination rates below 60%. The bill was supported by several medical and health organizations, including the California Medical Association and the American Academy of Pediatrics' California affiliate.
The removal of non-medical exemptions for vaccinations in California was significant as it was the first time in nearly 30 to 35 years that a state had eliminated these exemptions. The law's implementation led to an increase in vaccination rates among schoolchildren in California. Studies analyzing the impact of SB277 found that the percentage of incoming kindergarteners up-to-date on their vaccinations increased after the law's enactment.
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Medical exemptions increased post-SB277
California's Senate Bill 277 (SB277) eliminated non-medical exemptions from immunization requirements for schoolchildren. The bill removed personal beliefs as a reason for exemption from vaccination requirements for entry to private or public elementary or secondary schools in California, as well as daycare centers.
The bill's implementation led to an increase in medical exemptions, with rates rising by 250% from 0.2% in 2015-2016 to 0.7% in 2017-2018. This significant increase has been attributed to several factors. Firstly, SB277 gave full discretion to physicians to grant medical exemptions, and the less-detailed regulatory language of the bill may have emboldened some doctors to grant exemptions for reasons outside of accepted contraindications to vaccination. This resulted in physicians writing questionable or problematic medical exemptions, which concerned health officers and staff in local health jurisdictions. The lack of a centralized review system for medical exemption requests led to variations in interpreting the law, with some physicians taking advantage of the bill's language to provide exemptions for vaccine-hesitant parents.
Secondly, counties with high personal belief exemption rates before SB277 saw the most significant increases in medical exemptions during the first year of implementation. This suggests that anti-vaccination parents sought and received medical exemptions as an alternative means to exempt their children from vaccinations. The bill's passage resulted in a replacement effect, with medical exemptions for independent study/homeschooled students largely offsetting the decrease in personal belief exemption rates.
Thirdly, the burden of reviewing medical exemptions fell on school staff due to a shortage of school nurses. This put school staff in a challenging position, as excluding unvaccinated students could result in losing average daily attendance funding. Additionally, some physicians charged fees for medical exemptions, which was viewed as taking advantage of parents.
Lastly, public health officials were not authorized to oppose unjustified medical exemptions provided by physicians, which further contributed to the increase in medical exemptions.
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Religious and personal belief exemptions
California Senate Bill 277 (SB277) was enacted in 2015 and signed into law by Governor Jerry Brown on June 30, 2015. The bill eliminated non-medical exemptions from immunization requirements for schoolchildren, including personal beliefs and philosophical reasons. Before SB277, California allowed exemptions from vaccination requirements for personal beliefs, in addition to medical reasons.
SB277 removed personal belief as a reason for exemption from vaccination requirements for entry to private or public elementary or secondary schools in California, as well as day care centers. The bill was prompted by the 2014 Disneyland measles outbreak and low vaccination rates in some areas of California, with some schools having vaccination rates below 60%.
Prior to SB277, parents could claim a personal belief exemption and submit specified forms to a school or institution to enroll their child without meeting immunization requirements. This exemption was eliminated by SB277, which now only allows exemptions for medical reasons deemed appropriate by the State Department of Public Health.
The bill faced opposition from anti-vaccine activists, who argued that it violated the right to education, religious freedom, and parental rights. However, these claims were rejected by California state courts. After the passage of SB277, vaccination rates among California schoolchildren increased, but there was also an increase in unjustified medical exemptions, fueled by anti-vaccination parents seeking such exemptions.
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Vaccination rates increased in schools
California Senate Bill 277 (SB277) was enacted in 2015 and signed into law by Governor Jerry Brown on June 30, 2015. The bill removed personal beliefs as a valid reason for vaccine exemption for schoolchildren. This was in response to the 2014 Disneyland measles outbreak and pockets of low vaccination rates in California, with some schools having vaccination rates below 60%.
The bill's implementation was associated with an increase in vaccination coverage and a reduction in non-medical exemptions. The percentage of incoming kindergarteners up-to-date with their vaccinations increased after SB277, but there was also a rise in medical exemptions, particularly for independent study/homeschooled students. This suggests a replacement effect, as the decrease in personal belief exemptions was largely offset by an increase in medical exemptions.
In the first year after SB277 was implemented, the percentage of kindergartners entering school not up-to-date with their vaccinations decreased from 7.15% to 4.42%. The conditional entrance rate also fell from 4.43% to 1.91%. However, in the second year, the percentage of kindergartners not up-to-date increased slightly by 0.45%. Despite this, the overall trend indicated an improvement in vaccination rates in schools.
The passage of SB277 faced opposition from anti-vaccine activists, who attempted to have one of the bill's co-authors, Senator Richard Pan, removed through a recall election. These efforts were unsuccessful, and SB277 marked a significant step towards improving vaccination rates in California schools.
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Opposition to SB277
California Senate Bill 277 (SB277) faced opposition from anti-vaccine activists, parents, and religious groups, who argued that it violated the right to education, religious freedom, and parental rights. Here are some of the specific points of opposition to SB277:
Elimination of Non-Medical Exemptions: One of the primary concerns was the elimination of non-medical exemptions for vaccinations. SB277 removed personal beliefs as a valid reason for exemption, which was previously allowed under California law. This change meant that parents could no longer cite personal or philosophical reasons for refusing to vaccinate their children. This was seen as a government overreach and an infringement on individual freedom and choice.
Impact on Education and Parental Rights: Opponents of SB277 argued that the bill violated the right to education by making vaccination a requirement for school entry. They believed that parents should have the ultimate decision-making power over their children's medical treatments and that the state should not impose mandatory vaccinations as a condition for attending school. This led to legal challenges by groups of anti-vaccine parents claiming that SB277 infringed on parental rights and educational choices.
Religious Freedom Concerns: The bill also faced opposition from religious groups who believed that mandatory vaccination requirements infringed upon their religious freedom. While SB277 allowed for medical exemptions, it did not explicitly address religious exemptions, which some religious groups saw as a restriction on their ability to practice their faith.
Concerns About Medical Exemption Process: There were also concerns about the medical exemption process following the implementation of SB277. Public health officials noted an increase in unusual reasons cited for medical exemptions and unethical practices by some physicians who charged high fees for obtaining unjustified medical exemptions. This led to calls for changes in the law to address abuses of the medical exemption process and decrease the possibility of infectious disease outbreaks.
Dissent and Political Opposition: The opposition to SB277 was characterized as a "strident outpouring of political dissent." Anti-vaccine activists launched campaigns to recall Senator Richard Pan, one of the bill's co-authors, and efforts by groups like the Freedom Angels Foundation to repeal the bill through a referendum also took place. These efforts, however, failed to gain sufficient traction.
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Frequently asked questions
Yes, California allowed non-medical exemptions for vaccines before SB277.
California Senate Bill 277 (SB277) was a law that removed non-medical exemptions for vaccinations required for entry to private or public elementary or secondary schools in California, as well as day care centers.
The bill was passed by the California State Assembly in June 2015 and was signed into law by Governor Jerry Brown on June 30, 2015.
After the implementation of SB277, vaccination rates among California schoolchildren increased. However, there was also an increase in medical exemptions, with a replacement effect observed.
SB277 was introduced in response to the 2014-2015 Disneyland measles outbreak and low levels of vaccination in certain areas of California, with some schools having vaccination rates below 60%.
