Dr. Rene Bravo has practiced pediatrics in San Luis Obispo for close to three decades. He’s frank and thoughtful, and in possession of a cool detachment that experience can bring. Lately, he’s been witnessing one of the most polarizing trends in parenting history: the anti-vaccination movement.
“We’ve become fairly complacent,” Bravo said, “because we have benefited from the science of the last century.”
Bravo said he’s seen more whooping cough cases in the past five years than in the previous 25 years combined. He is unequivocal in his support of vaccinations applied deliberately and conscientiously, and he’s also the go-to physician for many local parents who question the vaccination guidelines laid out by the Centers for Disease Control (CDC) and the California Department of Public Health (CDPH).
It’s unclear how many kids in SLO County are unvaccinated, because the state only releases comprehensive information about new students entering kindergarten, rather than a tally. In 2014, SLO County had one of the highest rates of unvaccinated kindergarteners in the state—more than 8 percent of kids entering the school system that year were unvaccinated because of their parents’ personal beliefs.
This trend may be declining (only 5.5 percent of county parents filed personal belief exemptions this year), but state lawmakers aren’t waiting for parents to come around. SB 277 is a controversial vaccination bill that would require nothing short of a doctor’s recommendation to allow unvaccinated children into schools—no more personal belief exemptions, no more alternative vaccination schedules.
Bravo works with many parents to dispel fears about vaccinations, but he can’t shake his own fear that there will be consequences if the state requires all incoming kindergarteners to be vaccinated before entering school.
“I am afraid that it may create entrenchment and calcification among people who are already questioning this choice,” Bravo said. “It’s always better for public health when people choose to do the right thing.”
The bill was overwhelmingly passed in the state Senate on May 14 and introduced to the Assembly the same day. During the last week of May, the bill went before the Assembly Health Committee, the first of three committees that need to give the OK to pass the bill on for a floor vote.
Current state law requires students in public and private schools to be vaccinated against nine communicable diseases: tetanus, diphtheria, pertussis (whooping cough), hepatitis B, measles, mumps, rubella, poliomyelitis (polio), and varicella (chickenpox). Students are expected to be immunized by the time they enter kindergarten, but there are a couple of loopholes. Statewide, thousands of parents file personal belief or religious exemptions each year and a small number of parents file medical exemptions; both of them require consultation with a doctor about vaccines.
Under SB 277, the medical exemptions would still be available based on a doctor’s recommendation, but parents who refuse to vaccinate because of personal beliefs would be faced with a tough choice. Sen. Bill Monning (D-Carmel), who represents SLO in the state Legislature, said parents who don’t want to vaccinate could still educate their children at home.
“I respect the right of personal choice,” Monning said, “but there are limits when personal choice can infringe on the rights of others.”
In SLO County, personal belief exemptions were filed on behalf of 165 kindergarteners for the current school year, and 240 kindergarteners last year. But that only tells half the story. In addition to the 165 kids whose parents opted out of vaccinating them in 2015, there were 210 kindergarteners who had some but not all of the required vaccinations. Those “partially” vaccinated kids are admitted to school on a conditional basis.
Some of these students will eventually receive all of the recommended vaccines, others may permanently opt out of specific vaccines.
“Many of them are not anti-vaccine,” Bravo said. “Some of them believe their kids are too young, or that the vaccines will be a shock to their systems. None of that is really based in science. Immunologically, we are faced with millions of virus and bacteria every day. Our systems can handle it.”
The CDC recommends close to 30 vaccination applications for children by age 6. Common side effects for some vaccines include fever, rashes, lethargy—all of which can be scary for parents of young children, so many opt for alternative schedules. Under SB 277, children would no longer be granted conditional admission to schools without the expressed consent of a doctor. Essentially, it would force parents to get on the recommended schedule.
For many parents this seems like a huge government intrusion. After all, there’s no public health crisis yet. One parent who spoke with New Times was frustrated that a child who actually had a disease, such as hepatitis B, would have a legal right to public education, but her child, who doesn’t have any disease and isn’t vaccinated, could be denied public education.
Monning said the bill was one of the most heavily lobbied pieces of legislation he’s seen. He added that there is a lot of bad information circulating on the Internet. Parents still bring up autism, for example. According to Bravo, some parents express fear that vaccines contain “preservatives,” heavy metals, and even parts of human fetuses.
Local Assemblyman Katcho Achadjian, who could soon get his chance to vote on the bill, also expressed that parents from all over the state were contacting him about the issue. Achadjian said the best way to deal with things like infectious disease would be outreach and education.
“We were educated by our doctor,” Achadjian said, referring to his own family. “That’s the best way to take care of business, not having government in our everyday business.”
Bravo said non-vaccination is a thorn in the side of pediatricians, and many of his colleagues refuse to see patients who don’t vaccinate their kids.
“I have had parents come to me and say [measles] is just a rash,” Bravo said. “Well, does it have to be to be Ebola to come to the level of vaccine-preventable illness?”
Staff Writer Kylie Mendonca can be reached at email@example.com.