(Jeff J. Mitchell: Getty Images)
(Jeff J. Mitchell: Getty Images)

California is one of 20 states that allows parents to “opt out” of vaccines for their children simply by signing a form. It’s called a “personal belief exemption.” But AB 2109 would change that. The bill has cleared the Assembly and is starting its path through Senate committees.

If the bill becomes law, parents who wish to refuse vaccines would first need to receive counseling from a licensed health professional about the risks and benefits of skipping immunizations for their children.

Vaccination rates in California have been dropping in recent years, worrying public health officials. Ten infants died in a whooping cough outbreak in 2009.

“Democratic Assemblyman Richard Pan wrote the bill. He’s also a pediatrician and says parents’ decision not to vaccinate their own child puts others at risk too.

Very young children, infants may be too young to be immunized,” he told me in a recent interview. “People with cancer and on chemotherapy, people with HIV or AIDS … they cannot receive immunizations.”

Republican Assemblyman Dan Logue co-chairs the Assembly’s Health Committee. He opposes the bill – but not for medical reasons.

“What we do now in California is we tell you how much salt to put on your food, what kind of light bulb you should screw in your lamp,” he says. “The people of California are fed up with a state government that thinks it can run our lives better than they can, and enough is enough.”

But Pan counters the nanny-state argument. “This is not about taking away the rights of parents to make decisions. Parents are still free to make these decisions. But it’s also the role of government to protect the public, that’s why we have a police force, to protect us from criminals,” he says. “We have diseases out there that can kill people … and vaccinations are one of the most effective and cost-effective means of protecting the public from infectious disease.”

Statewide, just slightly over 90 percent of all children entering kindergarten have received all required vaccinations, but that rate varies dramatically by county. Public health officials worry when the overall vaccination rate drops below 90 percent, but 95 percent is much better to protect everyone against measles — which is highly contagious.

California counties with the lowest rates of vaccinations include Nevada, Mariposa, Tuolumne and Humboldt, all between 73 and 76 percent. Marin County’s rate is just under 83 percent.

The bill is currently in the Senate Rules committee and is expected to be heard in the Senate Health committee in the next few weeks.

Bill Would Make Vaccine “Opt-Out” A Little Tougher 29 May,2012Lisa Aliferis

  • Anonymous

    Many pediatricians are not going to sign this, it adds a significant cost to families who will have to search out people to sign a form, and finally, it IS about removing parent choice. Assemblymember Charles Calderon stated in the hearing that this was a “good first step” in doing away with a parent’s ability to opt out. At least he calls it what it is, the State listening to big pharma and medical lobbyists in order to make more profit for big pharma and medical lobbyists, and most importantly to Dr Pan, more money in the campaign funds from big pharma and medical lobbyists. Check out his payout from big pharma on this at maplight.com. The idea that a parent is going to change their mind and vaccinate when getting this formed signed after spending years getting talked to at well baby visits and reading on their own is ludicrous. This bill is unconstitutional, because it authorizes MDs to harass patients for their personal and religious beliefs.


  • Thinking Mama Bear

    This bill is an affront to parents. Most parents comply with vaccination requirements and the ones who opt out have some very logical reasons. This is an issue of “who decides whether or not a healthy child is to have a pharmeceutical product that carries risk of life or impairment?” The pharmaceutical companies that manufacture them are free of liability.Parents have the right to decide. Vaccines are not a one size fits all solution.

  • Thegryphonhunter

    This is not going to change the minds of parents who opt out based on personal belief. It just requries us to jump through more hoops to satisfy a government that mandates actions that are in contradiction to our beliefs. I, for one, will pull my kids from public schools and opt for home schooling or charter schooling before I will allow the government to mandate that my children be vaccinated.

    • Anonymous

      Sadly homeschooling will not help you opt out of this. Under California law, all homeschoolers must sign up with a charter school or set themselves up as a private school, and private schools are under the same regulations as all other schools. You would have to have a copy of this form in your private school file or be in trouble with the Board of Health.

  • The bill requires a licensed health care professional to sign a form stating s/he has provided “information regarding the benefits and risks of the immunization and the health risks of specified communicable diseases.” Parents/guardians may still choose to opt out of vaccines on behalf of their minor children. They would need the form to demonstrate informed consent.

    • Anonymous

      Lisa, if you have children, you know that every well baby visit involves a discussion about vaccines. I can’t believe that there is a parent who hasn’t had a discussion about the benefits of vaccines with their health care provider. The problem with this bill is that it is a “first step” in eliminating this choice at all (see Assemblymember Calderon’s statement in the 3rd vote in the Assembly). Put any other word in this bill besides vaccine and ask yourself whether you’d support it. How about we have informed consent about opting out of antibiotics so we don’t spread germs when we have an infection? Hummers are bad for the environment, so why don’t we require all Hummer salesmen to give a presentation on the benefits of hybrids before someone is allowed to buy a Hummer? Shouldn’t we have to pass a literacy test to vote? Shouldn’t we have to attend a presentation by Republicans before switching to the Democratic party? After all, they are more informed than us.

      It’s wrong to make people who have a vested financial interest in vaccines (many pediatricians get a bonus from pharmaceutical companies for high vaccination rates) in charge of whether people should opt out. If this were a video produced by the State Health Department that people had to watch or a book they had to read, I think it would be different than paying $100 for an office visit to get a lecture by someone who stands to profit from bullying people for their personal and religious beliefs. What about people who can’t find anyone to sign this form? In a town of 100 pediatricians, I only know 1 who might sign in my town. Most pediatricians use the excuse that their insurance companies won’t allow them to accept unvaccinated patients in their office.

      I know that NPR has pro-vaccine views, but this bill is not about vaccine safety, it’s about whether we are going to allow big pharma to manage our legislature and our freedoms. The money that our legislators are taking from big pharma is truly amazing. In California, we have a medical exemption and the personal belief exemption. The CDC only recommends a medical exemption if you have had an anaphylactic reaction to one vaccine. Thus you are supposed to sign your child up for more vaccines with almost identical ingredients (also see the CDC website) and hope they don’t have another anaphylactic reaction. This philosophical belief exemption allows children who have already had a severe reaction to a vaccine to opt out of another one when they can’t get a medical exemption. Someone with a severely peanut allergic child would be considered a child abuser for repeatedly giving their child peanuts, but someone with an allergy to a component of a vaccine is supposed to sign their child up for more illness with the next vaccine.

      This bill affects people who opt out or delay a single vaccine, not just people who don’t give their children any vaccines. It affects homeschoolers, private schools and public schools, so all children.

      You might consider covering SB1318, which would require mandatory flu vaccinations for health care workers. This bill will supposedly not pass because the unions won’t let it. The children have no unions to stand up for them.

      • SB 1318 has passed (almost unanimously) out of all committees and is currently on the Senate floor.

        • Anonymous

          Then I guess that means the pharmaceuticals are more powerful than the unions, good to know. Do you know that vaccines are the ultimate product because no one can sue a vaccine manufacturer when their child dies or becomes disabled? Each vaccine has a tax on it so that people who are injured or die can get compensated from the federal vaccine compensation fund. When car manufacturers make a defective product, the cars are recalled and people can sue the car manufacturer. When a drug is introduced that causes bad side effects, the drug is pulled and people can sue the drug manufacturer. Vaccine manufacturers or the doctors who administer them cannot be sued. Read through VAERS reports, it will break your heart. They have no incentive to make products that don’t hurt people. They hide behind the benevolent do-gooder mask but they are corporations, just like any other corporation, out to make money for the least cost and the most profit.

          What I don’t understand is how no self-respecting Democrat would vote yes on a bill for “informed consent” for abortion, because they would understand that the bill is only meant to restrict a mother’s choice and reduce the chance of abortion, but they are all for “informed choice” on vaccines when they know that will only serve to reduce a person’s freedom with vaccines. This from the perspective of someone who has always voted for Democrats.

  • Cathee Flores

    Washington State implemented this policy last year and they have already seen their exemption rates go down by 2.5 percent (from 6%) in first 9 months of implementation. It works fine there. Parents still can exempt their children and if parents had a hard time finding a signature to document that they received information, their local health department helped connect them with a provider.

    Statements about ‘forced vaccination’ are absolute nonsense. Parents/guardians are only required to docuement that they received information on the benefits and risks of vaccines and the risks of the diseases. They can still decline immunizations.

    Thirty states do not even have a personal or philosophical belief exemption (only religious or medical) and their communities are doing just fine.


Lisa Aliferis

Lisa Aliferis is the founding editor of KQED’s State of Health blog. Since 2011, she’s been writing and editing stories for the site. Before taking up blogging, she toiled for many years (more than we can count) producing health stories for television, including Dateline NBC and San Francisco’s CBS affiliate, KPIX-TV. She also wrote up a handy guide to the Affordable Care Act, especially for Californians. Her work has been honored for many awards. Most recently she was a finalist for “Best Topical Reporting” from the Online News Association. You can follow her on Twitter: @laliferis

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