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california legislation > AB 2109

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AB 2109 (Pan)
As Amended August 20, 2012
Majority vote

|ASSEMBLY: |47-26|(May 10, 2012) |SENATE: |22-14|(August 22, |
| | | | | |2012)|

Original Committee Reference: HEALTH

SUMMARY : Requires on and after January 1, 2014, a separate form
prescribed by the Department of Public Health (DPH) to accompany
a letter or affidavit to exempt a child from immunization
requirements under existing law on the basis that an
immunization is contrary to beliefs of the child's parent or

The Senate amendments :

1)Provide that the letter or affidavit document which
immunizations have been given, and which immunizations have
not been given on the basis that they are contrary to the
beliefs of the child's parent or guardian.

2)Require a signed attestation from the health care practitioner
that indicates that the health care practitioner provided the
parent or guardian with information regarding the benefits and
risks of immunizations and the risks of communicable diseases,
as specified.

3)Provides that the following shall be accepted in lieu of the
original form: a) photocopy of the signed form; or, b) letter
signed by a health care practitioner that includes all
information and attestations included on the form.

4)Exempts the form prescribed by DPH from the rulemaking
provisions of the Administrative Procedure Act, as specified.

5)Includes a credentialed school nurse, as specified, in the
list of health care practitioners who could sign the letters
or affidavits.

6)Makes other technical, clarifying, and conforming changes.

AB 2109
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AS PASSED BY THE ASSEMBLY , this bill made changes to existing
requirements which allow school-aged children, as specified, to
be exempt from immunization requirements as long as a parent or
a guardian files a letter or affidavit to the governing
authority indicating that immunization is contrary to the parent
or guardian's beliefs.

FISCAL EFFECT : According to the Senate Appropriations

1)DPH will incur one-time costs of about $80,000 (federal funds)
to develop and distribute the required forms and related
materials to schools and health practitioners.

2)Costs to the Department of Education and the Department of
Social Services for staff training are expected to be minor
and absorbable (General Fund).

3)Minor potential reimbursable mandate costs to schools to
collect the new form with currently required documentation of
personal belief exemptions (General Fund). Under current law,
parents who elect not to have their child vaccinated before
enrolling in school must provide information to the school
regarding their personal belief exemption. Under this bill,
parents would also be required to provide the required form
signed by a health professional. Any marginal costs to
collect and store the additional form are likely to be minor.

COMMENTS : According to the author, "California is one of only
20 states that allows for a personal beliefs or philosophical
exemption to school or childcare immunization requirements.
Under existing law, to exempt the child from the immunization
requirements, a parent or guardian must only provide a signed
written statement or sign their name to a two-sentence standard
exemption statement on the back of the School Immunization
Record. While parents do have a choice to exempt their
children, they are not required to document their concerns about
vaccines or affirm that they have reviewed fact-based, accurate
information regarding the risks and benefits of vaccines and the
risks of vaccine-preventable diseases. The continued increase
in personal belief exemptions and resultant decreases in
community immunization rates in California will result in
outbreaks of diseases such as measles, mumps, and pertussis.
Exposure to these preventable diseases not only places the

AB 2109
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individual child at risk, but the entire community, including
infants too young to be fully immunized and individuals with
compromised immune systems, who are vulnerable to complications
of vaccine-preventable diseases, including death. This measure
would rectify this problem by creating a process where parents
would be able make an informed decision for their children."

School-aged children are required to obtain immunizations for
certain types of diseases to be admitted in school. There are
exceptions to this requirement. First, if the physical or
medical condition of a child would make immunization unsafe, as
long as a statement by a licensed physician to this effect is
submitted to the governing authority. Second, if a letter or
affidavit is filed with the governing authority indicating that
the immunization is contrary to the beliefs of a parent or
guardian; this exemption is generally referred to as the
personal belief exemption or philosophic exemption. According
to the Centers for Disease Control and Prevention, aside from
the philosophic exemption, some states allow for religious
exemptions on the grounds that the religious beliefs of some
people are in opposition to vaccination.

Analysis Prepared by
: Rosielyn Pulmano / HEALTH / (916)

FN: 0005408