The year is young, but 2019 is on track to become the worst year for measles since 1992.
According to a recent Washington Post analysis, 387 cases of measles have been reported across the country so far this year. By comparison, 2018 had 372 cases for the entire year. California has some of the strictest vaccination requirements in the nation, but there have already been 16 cases of measles across nine counties in the past three months—a statistic state officials find very concerning considering there were only 21 cases throughout all of 2018.
Many experts have pointed to a weakness in California's vaccination laws that some parents have exploited to avoid vaccinating their kids, ultimately putting the greater population at risk for contracting highly contagious diseases like measles. Now, California legislators are taking action to tighten vaccination laws in an attempt to prevent future outbreaks.
Last week California legislators introduced Senate Bill 276, which aims to tighten the protocol for granting childhood vaccine exemptions. The bill comes in response to mounting evidence that some California doctors have been catering to anti-vaxx parents by signing off on medical exemptions in cases where they were unwarranted.
“Unfortunately, a few unethical physicians advertise medical exemptions for cash,” State Senator Richard Pan, who is a pediatrician and co-sponsor of the bill, said during a press conference in Sacramento.
Currently, exemptions are based solely on the discretion of licensed physicians, and there is no clear process in California for reviewing whether a medical exemption is sound or not. Senate Bill 276 would require doctors to submit a standardized form to the State Department of Public Health on behalf of any child eligible for a medical exemption. The state would then review each request to ensure compliance with the Centers for Disease Control and Prevention’s guidelines before approving or denying the exemption.
The proposed bill would build upon a 2015 law, Senate Bill 277, which banned vaccine exemptions for school-age children on the basis of personal beliefs and made medical exemptions the only way to legally avoid vaccination. Since then, the state has seen an overall increase in the share of kindergartners who are vaccinated — from 90.2 percent in the 2013-2014 school year to 95.1 percent in 2017-2018, according to the California Department of Public Health. At the same time rates of medical exemptions began to rise in California and are currently three times higher than the national average.
“It’s a pretty rare circumstance for a child to have a contraindication to vaccination,” said Dr. Paul Delamater, a researcher at the University of North Carolina at Chapel Hill who published a 2017 analysis of the effects of Senate Bill 277 in the Journal of the American Medical Association.
“I do suspect that at least some of the increase (in medical exemptions) was due to parents attempting to avoid vaccinating their children,” Delamater affirmed.
According to Delamater, California regions with the highest increases in medical exemptions after Senate Bill 277 was implemented were roughly the same areas that had high numbers of personal belief exemptions before the law was enacted. “It would be extraordinarily unlikely that the increase in medical exemptions over the past two years was due to an increase in the number of children with valid contraindications.”
If Senate Bill 276 passes, both California’s vaccination rates and its number of measles cases will hopefully start to look more like those of West Virginia and Mississippi: they are currently the only two states that have both banned non-medical exemptions and require state-level review of each exemption form—and their systems have produced far better track records compared to California.
West Virginia has one of the top vaccination rates for school-age children in the country, at approximately 97 percent, and Mississippi has the nation’s highest rate of vaccination at over 99 percent. Neither state has seen a measles outbreak in over two decades.