A San Diego-based doctor who single-handedly wrote at least a third of the area’s vaccine exemptions has now been charged with gross and repeated negligence by California’s state medical board. The news was first reported by the nonprofit news organization Voice of San Diego.

In the charging documents , the board accuses Dr. Tara Zandvliet of gross and repeated negligence for granting a permanent vaccine exemption for a 4-year-old girl based on irrelevant family medical information. The board also alleges Zandvliet failed to maintain adequate and accurate medical records and conducted herself in an unethical and inappropriate way that “demonstrates an unfitness to practice medicine.”

As Ars reported earlier this year, an investigation by Voice of San Diego found that Zandvliet had issued 141 of the area’s 486 medical vaccine exemptions since 2015. The second-highest number of medical exemptions by a single doctor in the area was 26. In the charging document, the board noted that Zandvliet admitted to issuing around 1,000 medical exemptions as of June 2019.

Medical vaccine exemptions are the only type of exemption allowed in the state of California. State lawmakers banned exemptions based on personal and religious beliefs in the wake of a massive measles outbreak in 2015. Since then, the state has seen an explosion in medical exemptions, with the numbers more than tripling. Lawmakers and health experts have blamed unscrupulous doctors for catering to anti-vaccine or vaccine-hesitant parents with bogus exemptions, often charging hefty fees.

Dr. Zandvliet charged $180 for evaluations for vaccine exemptions, and her practice did not accept insurance.

Conditions

Last month, California’s lawmakers passed new laws to crack down on such suspect medical vaccine exemptions. The laws grant the state oversight of the exemptions and require doctors to use only federally accepted criteria in determining which children are eligible. Medical conditions that warrant a vaccine exemption include previous history of a serious allergic reaction to a vaccine or having a compromised immune system, such as cancer patients on chemotherapy.

In the charging documents, the board alleges that Zandvliet was not using medically accepted criteria for issuing exemptions. Instead, she claimed without evidence that patients with family histories of common conditions such as asthma, psoriasis, and eczema should be exempt because they might be more likely to have adverse reactions to vaccines.

In the case of the 4-year-old girl mentioned in the charging document, the board outlined how Zandvliet granted a permanent exemption because—according to the girl’s father—four of the girl’s relatives had histories of asthma and psoriasis. Those relatives included her great-grandmother and her father’s half-brother.

Zandvliet issued the exemption without conducting a physical exam on the girl or finding any evidence that she had an autoimmune disorder. Zandvliet also did not document whether the child had been vaccinated previously. The girl had, in fact, received vaccines before—and had no adverse reactions.

The board will determine Zandvliet’s fate. It could strip her of her license, suspend her, or put her on probation.

The board has only sanctioned one doctor over similar charges, so far—that is, the infamous Dr. Robert Sears, who came to prominence as a vaccine skeptic and anti-vaccine sympathizer. He is currently on probation for negligence.