Lessons Learned From California's Effort To Tighten The Childhood Immunization Law

NPR's Ari Shapiro talks with California state Sen. Richard Pan. Pan is also a pediatrician, and he was one of the leaders of the effort to force parents to vaccinate their children.

ARI SHAPIRO, HOST:

With a record-breaking measles outbreak around the country, many states are considering new laws to force parents to vaccinate their children. These laws would get rid of exemptions for personal belief. Now we're going to look at one of the first states to pass such a law, California.

And joining us to walk through the story of what happened is one of the people who helped lead that effort. State Senator Richard Pan is a Democrat and also a pediatrician.

Dr. Pan, welcome to ALL THINGS CONSIDERED.

RICHARD PAN: Thank you so very much.

SHAPIRO: OK, so let's think back to early 2015 when there's word of a measles outbreak at Disneyland. Parents are worried. A mother named Robin Shi spoke to CBS at the time.

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ROBIN SHI: Coming down here and not knowing what they can get, even at the happiest place on Earth, is pretty scary.

SHAPIRO: Dr. Pan, you were both a state senator and a pediatrician at the time. When you heard of this outbreak, what was your immediate response?

PAN: Well, we were concerned that, well, how far is it going to go? And what we saw was is that as the outbreak spread, it wasn't just people who were at Disneyland. It was people who got infected in Disneyland and then spread it to other people in their community when they returned home. And then we knew we needed to do something to address the low rates of vaccination in the communities in California.

SHAPIRO: In that outbreak, about 150 people got sick with measles. Was it immediately clear to you that legislation was an appropriate response?

PAN: When we saw that people were getting infected from people who were at Disneyland, we knew that we needed to take further steps to protect the people of California.

And I heard from parents who said what is going on? We need to be safe in our communities. I have a baby that's too young to get immunized. I have a child who is being treated for cancer or has a transplant. They need to be protected. They're looking at their school's immunization rates and going, well, it's not high enough for that protection. We need to do something about it.

When people saw on the news, if you rode the public transit, you might be exposed to measles, a clinic is closed because of measles, a day care is closed because of measles, people said we need to do something about this.

SHAPIRO: But there was also pushback from other parents who said this bill is limiting their freedom. Here are some of the voices of people who spoke out against the bill at public hearings.

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UNIDENTIFIED PERSON #1: These are my two children that will be pulled out of the public school system if this bill passes.

UNIDENTIFIED PERSON #2: Public school teacher and mother of two. And this is a violation of our rights, and we oppose this bill.

UNIDENTIFIED PERSON #3: I strongly oppose this bill as a violation of informed consent.

UNIDENTIFIED PERSON #4: On behalf of my five healthy grandchildren, I oppose this bill.

UNIDENTIFIED PERSON #5: Representing 4,000 moms, and we strongly oppose this bill.

SHAPIRO: Some of the people opposing the bill were your own constituents. Did that give you pause?

PAN: Well, the science is clear. Vaccines work, and they are safe. We know, for example, that vaccines do not cause autism. That is settled science. That's been studied over and over again.

We know that vaccinations protect communities. So this really was an issue around school safety. It's an issue about keeping our communities safe because there are people among us, including young infants too young to be vaccinated, who depend on the protection on the rest of us.

So we need to base our policy on sound science and what the evidence showed, which is that vaccines are necessary to protect our community.

SHAPIRO: You also encountered opposition from some of your fellow senators. Let's listen to the voices here of State Senators Joel Anderson and Bob Huff, both Republicans.

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JOEL ANDERSON: I think this is just a direct attack on our liberty and a violation of our parental rights. I still can't support it.

BOB HUFF: We are prescribing a very strong government hand in trying to enforce this by mandating that all children in public schools be vaccinated. I think it's an overreach of government, and I still urge a no vote.

SHAPIRO: Senator Pan, did you have to work to overcome that opposition or was this just a matter of Democrats having enough votes in the state Senate?

PAN: Actually, the bill passed on a bipartisan basis, and there was bipartisan opposition. And really when we think about freedom and rights, all children have the right to attend school and to be safe at school. That includes children who cannot be vaccinated.

So for example, I had a mother who had a child who had a heart transplant because she had a congenital heart condition. And her child was actually kept out of school because another child at school had a family member who had chickenpox, and chickenpox would put her in the ICU - her child in the ICU - or potentially kill her.

What about that child's right to an education? What about that child's right to be with her classmates?

SHAPIRO: After you succeeded at getting this bill passed and the governor signed it into law, vaccination rates in California went up. But to this day, there are still public schools in the state where the majority of kindergarteners are not vaccinated. How is that possible?

PAN: Well, unfortunately, there are a very small number of physicians who saw this as an opportunity to monetize their license. And they began advertising for medical exemptions. And so you see schools with rates of medical exemptions sometimes as high as 50%. And that clearly is not possible in terms of...

SHAPIRO: And I understand you're now working on a bill to close that loophole.

PAN: Exactly. We're working on a bill to close that loophole. That's actually sponsored by the Medical Association and the American Academy of Pediatrics. So it's strongly supported by the physician community.

SHAPIRO: Dr. Richard Pan, a state senator from California, thanks for speaking with us today.

PAN: Thank you so very much.

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