California state lawmakers this week introduced a bill that would grant the state's health department the power to approve all medical exemptions for childhood vaccinations, revoke fraudulent exemptions, and maintain a database of exemptions and the physicians who issue them.

The bill, SB 276, is designed to thwart the state's recent problem of "unethical" doctors exempting children from mandatory vaccinations based on dubious or outright bogus medical grounds—often for fees.

Medical exemptions are intended to only be given to children who have legitimate medical conditions that prevent them from receiving vaccines. That includes children who are taking immune-suppressing drugs, such as cancer and transplant patients, and those with life-threatening allergies to vaccines. Yet sham medical exemptions have been on the rise since 2015 when lawmakers banned exemptions based on personal beliefs (SB 277). Since then, the number of kindergarteners with medical exemptions in the state has tripled, bringing the kindergartener exemption rate to 0.7 percent.

During the 2017-2018 academic year, kindergarteners in 105 schools had medical exemption rates at or above 10 percent. Those high rates dragged the schools' overall vaccination coverage below what's necessary to keep vaccine-preventable infectious diseases from spreading, the Los Angeles Times noted.

Recent investigations have revealed that a small number of "rogue" doctors is behind those sham exemptions, and parents opposed to vaccinations are seeking them out. For instance, the state medical board placed Dr. Robert Sears on a 35-month probation last year for exempting a two-year-old from all vaccinations without reviewing the child's medical records—as well as failing to follow up with standard testing after the child was hit on the head with a hammer. Dr. Sears is infamous for promoting alternative vaccination schedules that enable anti-vaccine and vaccine-hesitant parents to refuse or delay life-saving immunizations for their children.

Earlier this month, a media investigation revealed that a single doctor in the San Diego area was responsible for issuing a third of all medical exemptions there. The doctor, Tara Zandvliet, issued exemptions for dubious reasons, including if a child had a family history of hives, diabetes, or asthma. Zandvliet charged a $180 out-of-pocket fee to provide evaluations for such medical exemptions.

The new bill aims to close these loopholes. It would require doctors to use only federally accepted criteria for making a medical exemption request, which state health officials would then review and either approve or deny. State officials would also keep a running tab of exemptions, listing the doctors who issue them. Such a database would make it easy for officials to spot doctors who write an unusually high number of exemptions, such as Zandvliet. Last, the bill would require that schools send in all current exemptions by July 1, 2020 for review, which could then be revoked if the exemptions are determined to be fraudulent.

The bill was introduced by state Sen. Richard Pan (D-Sacramento), the pediatrician behind the original 2015 vaccine law, and Assemblywoman Lorena Gonzalez (D-San Diego). The bill is also being sponsored by Vaccinate California, the California Medical Association, and the American Academy of Pediatrics, California.

In a statement Gonzalez said: