The Marin County Board of Supervisors voted 4-1 on Tuesday to send a letter of support for California Senate Bill 277, which, if passed in the fall, would eliminate personal belief exemptions for school-mandated vaccinations. The lone voice of opposition came from Supervisor Steve Kinsey, who worried—along with many other speakers at Tuesday’s board meeting—that the bill could strip Marin residents of their right to free choice.
“I support the value of vaccinations,” said Mr. Kinsey, who represents West Marin. “But I also believe that respect for individual choice is what makes our community strongest.”
Many Marin residents, some tearful, spoke against the bill on Tuesday, echoing Mr. Kinsey’s opinion. And while for Mr. Kinsey the issue was not about science, but about trust, education and personal choice, public comments drew from personal stories and medical studies to argue that vaccines may cause crippling physical disorders such as autism in children.
But an hour of impassioned pleas was not enough to dissuade the board from endorsing the bill. Supervisor Katie Rice, who brought a draft of the letter before the board, agreed with Marin Health and Human Services officials that ending personal belief exemptions is necessary to protect public health.
“We’ve heard that many choose to vaccinate, and many choose not to vaccinate, for many different reasons,” Ms. Rice said. “Studies have been done that show the vaccines are safe. We not only have a responsibility to our children’s health, but the broader community as well.”
Introduced by state Senators Ben Allen and Richard Pan—a former pediatrician at the University of California, Davis Children’s Hospital—and Assemblymember Lorena Gonzalez, the bill proposes to allow only children with medical exemptions to opt out of vaccines for nine diseases, including measles, whooping cough and polio. The bill would also require schools to notify parents of vaccination rates at the beginning of each school year, a change that officials claim will protect parents’ right to know immunization data before deciding where to send their kids.
Currently, parents may choose for personal reasons—be they religious, social or otherwise—to opt out of several vaccines that schools require prior to admission. The issue of personal exemptions came into sharp focus in January, after an outbreak of measles originating at Disneyland caught national attention.
Two measles cases involving school-aged children in Marin were reported on January 28, though health officials have stated that these cases were quarantined and treated. To date, 146 measles cases have occurred across seven states; 130 of those cases were in California, and health officials claim the majority of them cases involved unvaccinated children.
In West Marin, San Geronimo Elementary School has one of the highest measles vaccine opt-out rates among kindergarteners in the county, according to a January report. A mid-February free clinic put on by the county at the San Geronimo Valley Community Center saw just four patients show up for vaccines. None were kindergarteners and two were district staff. On Tuesday, Marin County Public Health Officer Matt Willis urged the board to endorse the bill. Alongside David Witt, an infectious disease specialist at Kaiser Permanente in San Rafael, Mr. Willis gave a presentation on the bill and the larger context of personal belief exemptions.
Mr. Willis offered a laundry list of reasons why parents choose to opt out of vaccines, ranging from the view that children receive too many vaccines all at once to distrust of pharmaceutical companies and health providers to the alleged connection between vaccines and autism. He responded to each view, but moreover cautioned that infectious diseases, like measles, spread quickly in school settings, and that it only takes one case to infect an entire community.
“S.B. 277 will help keep our community safe,” Mr. Willis said. “When parents vaccinate, their children become a key part of their community’s defense against disease.”
Mr. Witt took the public-health stance a step further, intent on the position that vaccines are all that stand in the way of a resurgence in infectious diseases. He noted that many people have forgotten or are too young to remember the national fear and panic caused by widespread cases of polio during the first half of the 20th century.
“The reality is that people have the ability to [opt out] because the vast majority of people have been vaccinated,” he said. “If one person doesn’t get vaccinated, then you put the safety of the entire community at risk.”
Many parents, however, strongly disagreed. Some argued on Tuesday that vaccines pose a health and safety risk to their own children. San Geronimo resident Sarah David told how one of her sons, now 9 years old, was hospitalized for rotavirus and “regressed into autism” after doctors administered the DTaP vaccine (which treats diphtheria, tetanus and whooping cough).
“There have been 86 families of children with autism disorders who have been compensated by federal vaccine injury courts, [which exist] to indemnify pharmaceutical companies for children like mine who are injured by the vaccines,” she said. “I think common sense would tell you that if 86 children got autism from vaccinations, there are more, like me, who haven’t had the resources to take our cases to court and have them be known.”
(Mr. Willis noted that a controversial 1998 article published in the Lancet that linked vaccines with autism was
retracted.)
Another Marin resident, Sarah Igual, broke down in tears as she described how her son was diagnosed with autism after receiving vaccinations. She pointed out that the American Medical Association is opposed to mandatory vaccines. (The A.M.A.’s Code of Medical Ethics advocates “informed consent,” meaning that “The patient should make his or her own determination about treatment.”)
“I’m not anti-vaccine,” she said. “I’m for safer vaccines.”
Others said the bill would “criminalize” parents who claim exemptions for their kids. The bill, they said, would take away their right to free choice. Additionally, the bill appeared to leave a gray area for homeschooled students, who would have to be vaccinated despite not participating in dense school environments.
“The only stated consequence of noncompliance is that children will not be allowed to attend school,” said Julie Schiffman of the Homeschool Association of California. “What that means to us, as homeschool, is unknown.”
Before approving the letter, the board agreed to add language requesting that the bill’s application to homeschoolers be clarified. The bill has not been amended since it was introduced in February.
The bill must pass in the Senate by June 5 and in the Assembly by Sept. 4. Should no amendments delay the bill, Governor Jerry Brown could sign it into law by the end of September.
Despite murmurs from the audience, Ms. Rice praised the crowd for engaging in dialogue with the board and health
officials. “We’ve demonstrated that we can have a respectful discussion here,” she said. “I expect that to continue as this bill moves forward.”