Senate Bill 277 adds California to the majority of states — 31 total — that do not allow parents a vaccine exemption for their school-age children based on personal beliefs.  However, most of these other states do allow parents to opt out by choosing a religious exemption, which is not addressed by the California law. Though doctors can still provide parents with a medical exemption for their children if deemed necessary, the only education alternative for parents who simply don’t want their child vaccinated is home-schooling.

Childhood vaccination has been so successful that it is easy to dismiss the diseases prevented as mild or not serious as memory of their devastation fades.

Many remember chickenpox as a few days of fever and an itchy rash, a childhood rite of passage, before immunization. But before we started using the chickenpox (or varicella) vaccine in the US, about 100 people died every year from chickenpox, and half of these were previously healthy children.  Now death from chickenpox is nearly eliminated.  

Some say whooping cough, or pertussis, results in a few weeks of coughing. They don’t see what I see: children in the intensive care unit, requiring a ventilator to breathe. Or the five infants who died from pertussis last year in California; sadly, there has already been one death this year in California from whooping cough.

Look at the recent measles outbreak. One dose of the measles vaccine results in about 93 to 95 percent protection. Two doses increase its effectiveness to about 97 percent. But when measles hit Disneyland last December, it spread. The outbreak was amplified by those who were not vaccinated, and the 3 percent for whom the vaccine did not work. And for those who say that measles isn’t serious: 1 to 2 out of every 1,000 cases results in death. The disease has claimed a victim in the U.S. this month. More children have died from measles than any other disease.

If vaccines worked 100 percent of the time, there would be no need for requiring immunizations. If vaccines worked 100 percent of the time, those vaccinated would feel secure that they are protected. But vaccines don’t work 100 percent of the time. Depending on the vaccine, they are about 80 to 99 percent effective, and immunity may wane over time. That’s why it is important to have as many in the population immunized — so if an infectious exposure occurs, transmission is limited.

There is no scientific controversy about vaccine safety and vaccine effectiveness among mainstream doctors and scientists. Unfortunately, there is much public misinformation about vaccine safety and effectiveness. Unsubstantiated beliefs regarding vaccine safety and effectiveness lead many parents to opt out of childhood vaccination.

Even this would likely not be a problem if the small proportion of parents opting out of childhood vaccination was evenly geographically distributed. But instead, opt-out tends to cluster. Although the overall opt-out rate is less than 3 percent in California, some schools have opt out rates of 10 or 20 percent, some 50 percent or greater. This leaves pockets of children susceptible to preventable diseases; disease exposure leads to sustained transmission. This results in disease not just among those who choose not to be vaccinated, but also those who are (remember, vaccines don’t work 100 percent of the time). In addition, those too young to be vaccinated may be infected.

Is SB 277 fair to parents fearful of vaccines? Does this place an undue burden on them by requiring them to home-school? These questions harken back to similar public and private health choices that the legislature has addressed: requiring infant car seats and seat belts, and regulating second-hand smoke in particular, which puts not only the individual’s health in jeopardy but those around him or her. There is no scientific reason to opt out of vaccination and opting out not only puts that child at risk, but the community at large.  

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