Physicians with the Coastal Health Alliance met with locals over the past week to provide information on how the nonprofit plans to approach changes brought about by Senate Bill 277, which ended personal belief exemptions of school-required vaccinations for all preschoolers, kindergarteners and seventh graders this year. Since the bill’s passage in July, some parents who would have chosen personal belief exemptions for their kids have indicated that they will now seek medical exemptions. Speaking at the San Geronimo Valley Community Center on Tuesday, Dr. Anna O’Malley said C.H.A. physicians will consider writing medical exemptions but only under “very specific criteria,” such as for patients with immunodeficiency issues. “There’s some grey area here,” she said. “Physicians who believe strongly that certain conditions qualify for a medical exemption can write medical exemptions. That’s a very personal and professional decision.” Another alternative presented at the meeting is “conditional entry,” under which children not fully up-to-date with their vaccines may be allowed to enter school “if they have a written plan from a medical provider outlining when each missing immunization will be given.” But Dr. O’Malley and her colleague, Edwin Munich, stressed that they will still have to abide by the law. It will be critical for parents to work closely with their doctors in devising mutually acceptable solutions to the issue. “We don’t pretend to be not biased as medical providers,” said Dr. Munich, the alliance’s medical director. “We tend to think that vaccines are generally helpful, but we’re not dogmatic about it. Our goal is to really encourage conversation, and a lot of that can take place in the exam room.” Additionally, Dr. O’Malley said students enrolled in special education programs who have individualized education plans will be exempted from vaccines. Likewise, children who receive blood draws—known as titer tests—that show immunity to a particular disease would not be required to receive more than one dose of multi-dose vaccines. Despite the openness to signing off on medical exemptions and conditional entries, Dr. O’Malley and Dr. Munich stressed that the alliance has not reached a consensus yet on what specific conditions might merit an exemption or alternate schedule.