“Please provide an updated copy of your child’s immunization records” is a standard request when you enroll your child in school. A child who is not fully will prevent enrollment, UNLESS there is a qualified exception. The specific exceptions are: (1) if you have a medical exemption OR (2) if your child has an Individualized Education Plan (IEP).
The concept of medical exemptions from immunization first came into place in February 2015 when Senate Bill 277 regarding public health and mandatory vaccination of children was introduced.
The law set out various childhood diseases for which children would need to obtain immunizations from, including but not limited to Hepatitis B, Chickenpox, Measles, Mumps, Whooping Cough, Poliomyelitis, and a catch-all provision for “any other disease deemed appropriate by the department.” See Health & Safety Code § 120325(a). However, there also were various exceptions to the generic requirement for vaccination, including religious and personal beliefs (before 2016) and medical exemptions. These have been recently been updated to remove the personal and religious beliefs exception. These statutes were later further modified pursuant to Senate Bills 276 and 714 which went into effect January 1, 2020.
Medical Exemptions Option Available until December 31, 2020:
Beginning on January 1, 2016, you could obtain an exception from immunizing your child based on “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.” Health & Safety Code § 120370.
The committee on the Senate Bill 277 addressed the medical exemptions requirement and stated the criteria that would be required for such a medical exemption. “[D]etermination is entirely up to the professional clinical judgment of the physician. There are no required medical criteria for diagnosing circumstances that contraindicate vaccination. A physician must base that decision on their professional judgment and the standard of practice for their field.”
This lax standard for medical exemptions that was the reality of Senate Bill 277 has been modified in the recent amendments to the law. However, for the next few months, you can still obtain qualification under this provision, there is now a deadline of January 1, 2021 for submitting an exemption under this Code. This is extremely time-sensitive, so mark your calendars and schedule your doctor’s visit so you can meet this deadline if this is applicable to your child and his/her medical care.
If you are a parent who already has a medical exemption on file with your school or can get the less stringent exemption filed by December 31, 2020, you still need to be aware of the new law and the implications it may have on your child’s education. One of the new changes to the law as of January 1, 2020 places limitations on those previously obtained medical exemptions.
As of January 1, 2020, and continuing until July 1, 2021, your child’s prior medical exemption statement will be valid to maintain them in school until they make the transition to the next “grade span” (i.e. from preschool to Kindergarten or sixth grade to seventh grade). After July 1, 2021 or when your child makes the transition to the next grade span, whichever occurs first, will be your deadline. You will need to make sure that the medical exemption you have on file meets the new, more rigorous guidelines for medical exemptions.
NEW More Rigorous Standards for a Medical Exemption:
The new guidelines require your child’s medical exemption be completed on a form that the department will make available statewide to be sent directly to the department’s California Immunization Registry (CAIR) and the form shall also be printed, signed, certified and submitted to your child’s school. You should check with your child’s school for the district’s specific policies and procedures for submission of medical exemptions. The new requirements issued by Senate Bill 276 and 714 are much more stringent. They will also require continued reevaluation as even if you obtain a new permanent exemption in line with Health & Safety Code § 120372(a)(2) requirements, you will be still be required to have a new exemption issued prior to your child changing grade spans.
The new form will require the following:
- Your child’s name;
- Identification and contact information of the following people:
- The medical physician issuing the exemption;
- Your child’s primary care physician (PCP) if different from the physician providing the medical exemption;
- Child’s parents’ or guardians’
- The child’s school or other institution
- A statement acknowledging a physical examination and evaluation in line with the requirements of the Code was completed prior to the exemption;
- If the medical physician issuing the exemption is not your child’s PCP than an explanation as to why the PCP is not completing the exemption;
- The length of time the medical physician issuing the exemption has been treating your child;
- A separate description of medical basis for exemption for each individual immunization;
- Determination if the exemption is permanent or temporary. If temporary it must include a date of expiration and cannot exceed one year. However, even permanent exemptions will not extend to the next grade span.
- Authorization for the department to request further information from the physician including release of records regarding the medical exemption;
- Certification by the issuing physician that the statements and information within the form are true, correct, and complete.
Health & Safety Code § 120372(a)(2).
Exception Based on Your Child’s Individual Education Plan (IEP):
Another exemption may be available for children who have an Individualized Education Plan (IEP). Pursuant to Health & Safety Code § 120335(h), the requirement for immunizations “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.” This provision was an addition from Senate Bill 277 and was intentionally not amened during the recent amendments to the law.
In fact, when evaluating the proposed Senate Bill 277 at the Assembly Committee on Health hearing on June 9, 2015, the committee approved the bill with specific amendments, including the inclusion of a provision regarding students with an IEP. The suggested amendments stated:
c) Special education students must have access to services. As previously discussed, under federal and state law disabled children are guaranteed the right to a free, appropriate public education, including necessary services for a child to benefit from his or her education. An amendment should be taken to clarify that students with an IEP will still have access to special education-related services as directed by their IEP.
Section 120335 (h) Nothing in this section shall prohibit a pupil that 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 their individualized education program.
It was the committee’s specific intent to ensure protection for students with IEP’s and this protection remains valid.
If you have a child in school who is not fully immunized you will want to review the law on this issue to ensure you meet any and all deadlines and requirements to ensure your child can continue to attend school without issue. If you would like to discuss the mandatory immunization exceptions and how they apply specifically to your child, please call Moore Law for Children to discuss this issue with an experienced education attorney.