Brady Collins
California has strict mandatory vaccination laws for students enrolled in kindergarten through the twelfth grade in both private and public schools. The state offers two exemptions to the immunization requirement: a medical exemption and a special education/IEP exemption. The concept of medical exemptions from immunization was first introduced in February 2015 with Senate Bill 277, which eliminated non-medical exemptions. Since then, multiple bills have been introduced that affect vaccine exemptions, including Senate Bill 276 and Senate Bill 714, which allow for medical exemptions to be reviewed and revoked if they do not meet the standard of medical care. As of 2021, immunization exemptions must be administered through the California Immunization Registry (CAIR-ME), and any medical exemption will remain valid until the next-grade span, the expiration date of a temporary exemption, or revocation due to physician disciplinary action.
| Characteristics | Values |
|---|---|
| Law | SB277 |
| Year | 2015 |
| Implementation | 2016 |
| Applicability | Transitional Kindergarten/Kindergarten through the twelfth grade |
| Vaccinations | Tetanus, Diphtheria, Pertussis (TDAP), Varicella (Chickenpox), etc. |
| Exemptions | Medical, Special Education/IEP |
| Exemption Criteria | Family medical history, for which a physician does not recommend immunization |
| Exemption Application | CAIR-ME |
| Exemption Review | CDPH |
| Exemption Appeal | California Secretary of Health and Human Services |
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What You'll Learn
- Medical exemptions are now administered through the California Immunization Registry (CAIR-ME)
- Medical exemptions must be filed for each vaccination
- Medical exemptions are reviewed when a school's immunization rate falls below 95%
- Medical exemptions are also reviewed if a doctor writes more than five exemptions per year
- Medical exemptions can be appealed if revoked
Medical exemptions are now administered through the California Immunization Registry (CAIR-ME)
California has strict mandatory immunization laws, and all students enrolled in kindergarten through 12th grade in both private and public schools are required to obtain vaccinations. There are, however, two exemptions to this rule: a medical exemption and a special education/IEP exemption.
The concept of medical exemptions from immunization was introduced in February 2015 with the introduction of Senate Bill 277, which focused on public health and mandatory vaccination of children. This bill also removed the phrase "that contraindicate immunization" from the regulatory language for granting a medical exemption, replacing it with "including, but not limited to, family medical history, for which the physician does not recommend immunization." This change gave physicians more discretion in granting medical exemptions.
As of January 1, 2021, all immunization exemptions, including medical exemptions, must be administered through the California Immunization Registry (CAIR-ME) medical exemption site. CAIR-ME is a state-wide, secure, and confidential web-based database that collects and files medical exemptions for vaccinations. This means that a written statement from a doctor is no longer a valid exemption to vaccination requirements. Parents can create an account in CAIR-ME and apply for an exemption, receiving an exemption application number for their child's physician. Any medical exemption filed will remain valid until the child enrolls in the next grade span, the expiration date outlined in a temporary medical exemption, or upon revocation due to disciplinary action against the issuing physician.
It is important to note that exemptions are not limited to CAIR-ME. Children with special needs but without an IEP (Individualized Education Program) will need to seek a medical exemption directly from a licensed physician. Additionally, homeschooled students or those attending home-based private schools or independent study programs without classroom-based instruction are not required to be immunized and thus do not need exemptions.
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Medical exemptions must be filed for each vaccination
In California, students enrolled in kindergarten through the twelfth grade in both private and public schools are required to obtain certain vaccinations. There are currently two exemptions to the immunization requirement: a medical exemption and a special education/IEP exemption.
The concept of medical exemptions from immunization was first introduced in February 2015 with Senate Bill 277. This bill also eliminated the nonmedical exemption option. However, the law contains several provisions allowing students who are not up-to-date on their vaccinations to enter school. For example, kindergartners attending schools without classroom-based instruction and some students with individualized education programs are exempt from vaccination requirements.
As of January 1, 2021, immunization exemptions must be administered through the California Immunization Registry (CAIR-ME) medical exemption site. This is a statewide database for collecting and filing medical exemptions for vaccinations. Parents can create an account in CAIR-ME and apply for an exemption. They will receive an exemption application number for their child's physician.
To apply for a medical exemption, parents must provide the following:
- A separate description of the medical basis for the exemption for each vaccination
- A statement as to whether the exemption is permanent or temporary
- An authorization to release information for the Department to contact the issuing physician
- Certification from the physician that the statement and information are accurate, correct, and complete
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Medical exemptions are reviewed when a school's immunization rate falls below 95%
In California, all children enrolled in kindergarten through the twelfth grade in both private and public schools are required to obtain certain vaccinations. There are currently two exemptions to this requirement: a medical exemption and a special education/IEP exemption.
The California Immunization Registry (CAIR) helps protect children's health and maintain their vaccination records. As of January 1, 2021, immunization exemptions must be administered through the CAIR-ME medical exemption site, a state-wide database for collecting and filing medical exemptions for vaccinations.
The California Department of Public Health (CDPH) is required by law to review exemptions in CAIR-ME when a school or childcare facility's immunization rates drop below 95%. This is because a lower vaccination rate at a school leaves students, staff, and the surrounding community more vulnerable to vaccine-preventable diseases such as measles. The review process involves clinical staff at CDPH (a physician or a nurse) with expertise in vaccine science, including vaccine injury. Only the State Public Health Officer, who is a physician, or a designated physician from the CDPH's immunization program, can revoke a medical exemption.
If a medical exemption is revoked, parents or guardians can appeal to an independent expert panel appointed by the California Secretary of Health and Human Services. Children can continue to attend school while the exemption is under review and during any appeal process.
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Medical exemptions are also reviewed if a doctor writes more than five exemptions per year
California has strict mandatory vaccination laws, and all children must be vaccinated to enrol in kindergarten through the twelfth grade in both private and public schools. There are, however, exemptions to these laws. Medical exemptions are allowed, and these are at the discretion of the physician.
The California Immunization Registry (CAIR) is a database for collecting and filing medical exemptions for vaccinations. Since January 1, 2021, all immunization exemptions must be administered through CAIR-ME. Parents can create an account and apply for an exemption, receiving an exemption application number for their child's physician. A medical exemption can be permanent or temporary, and it must be supported by a detailed description of the medical basis for the exemption for each vaccination.
The California Department of Public Health (CDPH) does not review every medical exemption. However, under SB 276 and SB 714, exemptions will be reviewed when a school's immunization rate falls below 95%, when a doctor writes more than five medical exemptions per year, or when a school fails to provide vaccination rate reports. If a medical exemption is reviewed and revoked, parents can appeal to an independent expert panel.
The introduction of SB277 in 2015 eliminated the non-medical exemption option. However, the law contains provisions allowing students who are not up-to-date on their vaccinations to enter school. For example, kindergarteners attending schools without classroom-based instruction and some students with individualized education programs are exempt from vaccination requirements.
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Medical exemptions can be appealed if revoked
In California, students enrolled in kindergarten through the twelfth grade in both private and public schools are required to obtain certain vaccinations. There are currently two exemptions to this requirement: a medical exemption and a special education/IEP exemption.
The concept of medical exemptions from immunization was introduced in February 2015 with Senate Bill 277. This bill also eliminated non-medical exemptions. However, the law contains several provisions allowing students who are not up-to-date on their vaccinations to enter school. For example, kindergartners attending schools without classroom-based instruction and some students with individualized education programs are exempt from vaccination requirements.
The medical exemption process was amended by Senate Bill 276, which came into effect on January 1, 2021. This bill requires all medical exemptions to be administered through the California Immunization Registry (CAIR-ME), a state-wide database for collecting and filing medical exemptions for vaccinations. Under this bill, a written statement from a doctor is no longer valid as an exemption to vaccination requirements. Instead, parents or guardians must apply for an exemption through CAIR-ME and receive an exemption application number for their child's physician.
If a medical exemption is reviewed and found to be based on clinical information that does not conform to the standard of medical care, it may be revoked. However, medical exemptions can be appealed if revoked. The parent or guardian can appeal to an independent expert panel appointed by the California Secretary of Health and Human Services. The child can continue attending school while the revocation of their medical exemption is being appealed. The expert panel will consist of independent physicians with expertise in primary care or vaccine science, and their decision is final. Information about the appeals process is provided by CDPH and posted on the California Health and Human Services Agency's website.
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Frequently asked questions
SB277 is a bill that was signed into law in California in June 2015, which eliminated non-medical exemptions for vaccinations.
SB277 allows for permanent medical exemptions to vaccination requirements, which are granted at the discretion of physicians.
You will need to seek a medical exemption directly from a licensed physician. As of 2021, exemptions must be administered through the California Immunization Registry (CAIR-ME) medical exemption site. Parents can create an account and apply for an exemption, receiving an exemption application number for their child's physician.
Yes, children are able to attend school while the exemption is being reviewed and during any appeal of a revocation.
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