Monday, July 1, 2019




          Only rarely does a legislative compromise that waters down an originally tough proposed law end up creating something better. That appears to be what Gov. Gavin Newsom and state Sen. Richard Pan have now accomplished.

          This compromise came about because of an off-the-cuff remark Newsom made in early June while talking to reporters in a hallway at the state Democratic Party’s annual convention.

          Newsom, whose own four children have met all public school vaccination requirements, shocked the medical world in the midst of the worst national measles outbreak in decades when he said he might not sign a bill by Pan, a Sacramento Democrat and the Legislature’s only pediatrician.

          Pan sought to crack down on some parents and the doctors they depend on for medical exemptions from requirements for vaccinations against diseases like polio, whooping cough, rubella and measles. Children need to have had these shots to register for schools at various grade levels, but increasing numbers have gotten the waivers.

          Parents who are skeptical of vaccinations because of firmly debunked pseudo-information contending there’s a connection between inoculations and autism lost their ability to claim a religious exemption when ex-Gov. Jerry Brown signed a previous Pan bill in 2015, after vetoing it the previous year. A brief measles outbreak changed Brown’s mind.

          Anti-vaxx parents immediately began seeking medical exemptions instead. No pro-vaccination bill can ban medical waivers altogether because some individuals, notably those with organ transplants, organ failure or certain allergies, cannot safely be vaccinated.

          Soon, a cadre of physicians willing to sign off on exemptions for fees of about $300 per child developed, and anti-vaxx parents began seeking them out. The Voice of San Diego news website reported last year that one doctor was responsible for about one-third of all medical exemptions in the 130,000-student San Diego Unified school district.

          Pan’s effort this year was to foreclose that avenue for unjustified waivers by subjecting each of them to a review by state health officials. Newsom, in his unscripted comments, called this draconian because, he said, it would put government bureaucrats between doctors and patients.

          Subsequently, the pair met and hashed out a compromise that actually improved on the original Pan plan. Instead of subjecting all medical waivers to state review, the new version covers only exemption forms from doctors who sign off on more than five waivers a year. Schools where vaccination rates fall below the 95 percent saturation level many experts say is needed for the protection of “herd immunity” will also be looked at.

          This should pretty much put medical offices that had become de facto waiver mills out of that business, while also relieving state medical officers of most burdens imposed under the original plan. If the Legislature passes this plan over the vocal objections of anti-vaxx protestors, doctors who write significant numbers of exemptions will now have to demonstrate via medical records that all of them were justified.

          Whenever state health officials believe a doctor’s waiver decisions create a wide risk to public health, they would now have to refer those physicians to the state medical board for potential discipline. This also improves the original plan, which could have allowed non-medical board members to punish offending doctors.

          It still leaves exemptions open for children who really need them, while placing major obstacles in the path of waiver mills.

          This satisfies just about everyone except hard-line anti-vaxxers, who want to enable all parents to choose whether to inoculate their children.

          State officials can now “focus on the two biggest (vaccination) problems – doctors who sell exemptions and schools that lack community immunity,” said an official of the Health Officers Association of California. (About 100 schools now have vaccination levels under 90 percent.)

          The bottom line: This bill is less intrusive than it originally was, while still accomplishing all its major aims. It’s a clear-cut case of compromise causing improvement.

     Email Thomas Elias at His book, "The Burzynski Breakthrough: The Most Promising Cancer Treatment and the Government’s Campaign to Squelch It," is now available in a soft cover fourth edition. For more Elias columns, visit

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