Patient Portal LoginThere is a lot of emotion surround SB277 (California’s vaccine bill) and I will attempt to simply provide the facts about what the bills means. Here are the top 10 factoids about SB277.
1. Governor Jerry Brown signed SB277 into law on June 30th, 2015 and it will go into effect on July 1, 2016. It is possible that its implementation may be delayed by a proposed referendum.
2. Personal belief and religious exemption waivers may still be obtained until December 31st, 2015. Your pediatrician, family physician, physician’s assistant, nurse practitioner, or naturopathic doctor may sign a personal belief exemptions after counseling on the risks and benefits of immunizations and waiving immunizations up until December 31st, 2015.
3. Children with a signed exemption in kindergarten – sixth grade on January 1, 2016 are not required to get any vaccines until they enter 7th grade OR enter a new school district. They must have all required vaccines except Hepatitis B to enter 7th grade.
4. Children with a signed exemption in seventh-twelfth grade on Jan 1, 2016 are not required to get any vaccines…unless they enter a new school district.
5. Children who are home-schooled or are enrolled in online public school are not subject to this law.
6. Children who have an IEP (individualized education programs) are not subject to this law.
7. The required vaccines are TDaP, MMR, Polio, Hib, Hepatitis B and Chicken pox.
8. Vaccines that are not required by this law include Pneumovax, Rotavirus, Flu vaccines, Hep A and HPV.
9. There is no specific requirement as to when the vaccines must be given (e.g. it is not mandated that Hepatitis B be given at birth). Delayed schedules are possible, although the timing may be difficult if the child is attending preschool.
10. No new personal belief or religious exemption waivers will be accepted after January 1, 2016. Only medical exemptions are allowed. The author of the bill rejected a proposed amendment to allow NDs to sign of on medical exemptions. The guidelines are strict but rely on the doctor’s judgment. In the past, medical exemptions were allowed if the patient had already had the disease in question or had an immune compromising condition. The doctor is allowed to take family history into consideration. The CDC has a list of what they consider to be reasons for medical exemptions. Exemptions can be permanent or temporary.
There are a few mis-statements in your post.
1. Unlike other bills, SB277 will not take effect until July 1, 2016. I believe this amendment was at the request of the California School Nurses association, to more closely align with the start of the school year, when immunization records are collected and reported on.
2. The health care providers qualified to sign a PBE (until Jan 1, 2016): Medical Doctor (MD), Doctor of Osteopathic Medicine (DO), Nurse practitioner (NP) authorized to furnish drugs, Physician assistant (PA) authorized to administer or provide medication, Naturopathic doctor authorized to furnish or order drugs under a physician and surgeon’s supervision or a Credentialed school nurse (a Preliminary or Clear credential from the California Commission on Teacher Credentialing).
3. The 4 times that a student’s vaccination records are required are: 1. Entering daycare or preschool; 2. Entering kindergarten; 3. Entering kindergarten and 4. Any time a k-12 student changes school districts. That is, just changing schools within a district does not require the student’s parent/guardian to provide immunization records.
4. I am not sure the statement “Children who have an IEP (individualized education programs) are not subject to this law” is exactly correct. The law reads: “(h) This section does not prohibit a pupil who qualifies for an individualized education program, pursuant to federal law and Section 56026 of the Education Code, from accessing any special education and related services required by his or her individualized education program.” The California Department of Public Health will be providing additional information on SB277 in the coming months, which will be available at http://www.shotsforschool.org/
5. While immunization against Haemophilus influenzae type b (Hib) is required for entry into daycares and preschools, it is not required for kindergarten entry. So a child who did not attend any school before kindergarten does not need to be vaccinated against Hib for kinder entry.
6. Practically speaking, there are no guidelines in the bill to guide physicians in writing Permanent Medical Exemptions. The bill reads:
“120370. (a) If the parent or guardian files with the governing authority a written statement by a licensed physician to the effect that the physical condition of the child is such, or medical circumstances relating to the child are such, that immunization is not considered safe, indicating the specific nature and probable duration of the medical condition or circumstances, including, but not limited to, family medical history, for which the physician does not recommend immunization, that child shall be exempt from the requirements of Chapter 1 (commencing with Section 120325, but excluding Section 120380) and Sections 120400, 120405, 120410, and 120415 to the extent indicated by the physician’s statement.”
Thanks for your comment and your clarifications — we are mostly in agreement but I made a few clarifying edits to include NPs/PAs for PBEs and denoting school district changes. I also updated the effective date. Thank you!