Positive Early Results for Pro-Vaccination Law in California

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Early reports from California’s Department of Health indicate that new legislation for the compulsory vaccination of kindergartners has already made a positive impact on immunization without the law even going into effect.

Bill SB 277 was signed on June 30, 2015, making it a legal requirement for parents to get their school-going children vaccinated. This has already led to an increased rate of vaccination—92.9% now from 90.2% in 2013—in the half million kindergartners in the state of California.

This law was triggered by an outbreak of measles at Disneyland in December 2014. Measles had officially been eradicated from the United States, but a visitor from a country where measles was endemic had imported this highly contagious disease. The infection then spread to 14 other states, prompting fears for the health of people with weak immune systems such as the very young or old, or those on chemotherapy.

One fear was that levels of vaccination in the wider community had fallen off to the level where there was no longer sufficient ‘herd immunity’ to protect vulnerable individuals. Herd immunity occurs when enough people are vaccinated to provide background immunity to non-vaccinated individuals. When the uptake of vaccination falls below a certain threshold, there is a risk that epidemics could spread across the states as seen at the end of 2014.

This prompted health authorities to reappraise their stance on the parental right to exempt their child from vaccination on the grounds of personal belief. These personal exemptions may be on religious grounds or, more commonly, of fears over vaccine safety. The latter was triggered by a now-debunked study published in The Lancet in 1998 which erroneously linked the measles vaccine to autism in children. Though the paper was retracted, the damage had already been done—many parents began to skip vaccinations.

The loss of confidence in vaccine safety resulted in a rise in the number of personal belief exemptions, which contributed to the eventual reemergence of measles in the United States. Events came to a head in 2014 with the Disneyland epidemic and in 2015 with the first measles-related fatality in 12 years. State legislators felt it appropriate to change the law and bar parents from declining child vaccination on anything other than compelling medical grounds.

While the rise in participation in vaccination scheme points to this stance being a success, not everyone is happy about it. Opponents argue that the new law is an infringement of the democratic right to free choice. They argue for the right to make choices concerning their children’s health and resist state interference in personal decisions. The anti-vaccination lobby has been vocal and their protests include billboards campaigns outside schools. No vaccine is without side effects, but most are minor if they occur at all. Anti-vaccination proponents believe that only a parent can decide what’s acceptable for their child, but their methods of spreading information about the safety of vaccines have been criticized as irresponsible.

The debate seems set to develop countrywide significance. A case of measles in Texas has already revived the heated argument over the right to make personal exemptions. Last year, the equivalent law to California’s SB 277 was rejected in Texas, but with this latest case of measles the legislation back on the books for 2016, and already proving even more controversial than in California.

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