I Speak of Dreams

California's AB 2109: Will Vaccine-Refusing Families Have A Hard Time Finding Health Care?

Here's Dr. Bob Sears on the issue:

However, what gravely concerns me is that some doctors will refuse to sign this form. I know how doctors think. Many doctors strongly believe that vaccines should be mandatory, and that parents should not have the right to decline vaccines. Some doctors are willing to provide care to unvaccinated kids, despite this difference in philosophy. But now the power over this decision will be put directly into doctors' hands. He or she can simply refuse to sign the form. Doctors who oppose vaccine freedom of choice have been frustrated for years over this issue. Finally, they will have the power to impose their beliefs on their patients. Patients will be forced to find another doctor to sign the form, submit to vaccines, or get kicked out of public school.

Several things to notice: he's sure that only doctors can sign the form (wrong: Physician Assistants and Nurse Practioners with appropriate qualifications can sign); and notice that he doesn't quantify anything, or use any facts.  It's just "I know how doctors think" and the threat of "being kicked out of public school".  

It's important to know how many vaccine providers there are (pediatricians, family practice MDs, and the county health departments' low-cost or free vaccine clinics) and how many of those would "fire" or discharge vaccine-refusing families.

The survey of physicians reported at the 2011 meeting of Infectious Diseases Society of America showed enormous regional variation in practice responses to vaccine refusal.  The survey didn't cover California or the West at all.

Let's look at some real doctors.  

Heidi Roman MD is a mother and a pediatrician who practices in California.  She recently wrote Why I Won't Fire Vaccine-Hesitant Families, giving three sound reasons

....the particular issue of families who are hesitant about vaccinating their children is something all child health providers have come across. I won’t dismiss patients/families for this reason.

Wendy Sue Swanson MD practices in Washington state, but has written (and made videos) about vaccine issues.  In Pediatricians Who Refuse Families Who Don't Immunize, she wrote

I will always keep my practice open to vaccine-hesitant families. However, the waiting room risk (unimmunized kids & risk to vulnerable populations–ie infants, those too young for vaccines, and immunocompromised children) is a good one and the only compelling reason to close to patients who refuse immunizations in my opinion.

But it’s not a good enough reason for me to send families away who have questions and hesitations about the AAP/CDC schedule. All children deserve a pediatrician versed in immunization benefit/risk & deserve an expert in conversation w their parents to foster insight & understanding. Frankly, if waiting room risk is the concern, there are ways to create separate waiting rooms for kids “up to date” and kids who are not.

Roy Benaroch, MD at The Pediatric Insider develops a typology of vaccine-refusing parents, and  concludes:

...my own philosophy that it’s not the kids fault they’re not vaccinated; and with patience and continuous discussions, I can usually get even the most stubbornly misinformed parents to vaccinate. So finally, with a lot of extra work, the kids get protected. That’s my goal.

Linda Shaw MD practices in a low-income area, and has very, very few vaccine-hesitant or vaccine-refusing families.  Given the constraints of her practice,

Our practice group has decided that caring for vaccine-refusing patients is too much of a liability risk. We will alter vaccine schedules if the parents request it, but they are informed that they may have additional out-of-pocket costs. Patients who adamantly refuse to consider immunization for their children are asked to find another provider to see them. (We will also discharge from the practice patients who chronically "no show" for appointments.)

I think that even if AB 2109 passes, the California Medical Association or the two Public Health Associations (North and South) should sponsor research into the facts on vaccine refusal and hesitancy in California.

Dr. Bob Sears: What Was His Role in the 2009 San Diego Measles Outbreak?

I am keeping a list of reactions (pro and con) to the California Assembly Bill 2109 (AB 2109), which would make Personal Belief Exemptions (PBE) to required school entry vaccinations  slightly -- very slightly-- more difficult to obtain.

But there's a side issue.  One of the opponents to the legislation, Dr. Bob Sears, has been caught in ... a fib?  a misunderstanding? 

I decided not to add those posts to the list, because the Dr. Bob question isn't really about AB 2109, but about the veracity of a physician who has done more to raise false fears of vaccines.  (If you think that's an exaggeration, why don't you read The Problem With Dr. Bob's Alternative Vaccine Schedule (full text at Pediatrics or  Download Offit_Problems_Dr_Bob_Alterna_Schedule (PDF))

What Dr. Bob claimed:

"I was not involved in that [the San Diego measles outbreak] at all."

But he was.

December 29, 2008, in the Orange County Register:

As it turns out, the boy who spread measles is a patient of Dr. Bob Sears, pictured at left, a member of the famous San Clemente pediatrician family and author of “The Vaccine Book.” 

"NOR have I ever spoken with Seth [Mnookin]"

But he has.

A number of people stepped up to confront Dr. Bob, both in commentsat the Huffington Post and later on other blogs.

• March 26, 2012 Seth Mnookin at the Panic Virus: Bob Sears: Bald-faced Liar, Devious Dissembler, or Both (includes Mnookin's taped interview with Sears)
• March 27, 2012 Orac at Respectful Insolence Dr. Bob Sears vs. Seth Mnookin: Measles Outbreaks, AB 2109, and Lacking the Courage of One's Convictions
• March 27, 2012 Sullivan at Leftbrain/Rightbrain Who Decides Which Facts Are True?  Perhaps Not Dr. Bob

And here is Dr. Bob's rather ranty response to Lilady's repeated questioning. 

(click to embiggen)

Updated 3/28/2012 There is some confusion.  From news reports in 2008:

The measles-in-the-doctor's-waiting-room transmission:

Eight of the measles cases originated from the Cooperative Charter School, while another four stemmed from the Children's Clinic in La Jolla, according to county health officials.

And this news report from February 16 2008 at SignOn San Diego

The measles outbreak is San Diego County's first since 1991. It began when a 7-year-old patient returned from Switzerland on Jan. 15 with what would later be confirmed as measles. He or she infected two siblings and at least four classmates. The 8-year-old patient identified yesterday is a classmate of the 7-year-old.

 

On Jan. 25, the 7-year-old's parents took the youngster to the Children's Clinic of La Jolla. The child may have coughed and sneezed in the office, thus infecting four other children.

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California: Immunizations Required for Daycare and School Entry AB 2109

Currently in California, it is cheaper and easier to get an exemption from vaccine requirements for school entry than it is to actually comply with the requirements. 

Now Assemblymember Richard Pan (D 5th District), a pediatrician, is planning to change that.  He has introduced AB 2109. (As of March 24, the bill is still in the Assembly Health Committee.) The change in the law is pretty mild: parents wishing an exemption have to talk to a licensed health care provider and have a form signed (just as they do if they are vaccine-compliant).

But I've heard read wild talk of what is required, so I thought I'd post a handy guide:

Immunizations Required for Daycare Attendance (as always, click to embiggen)

You can  Download IZ_for_daycare (full page) pdf by clicking the link

Immunizations Required for k-12 Attendance (as always, click to embiggen)

You can  Download IZ_K-12 (full page) PDF by clicking on the link.  

Read why the US vaccinates against Hepatitis B in childhood.  I live in a part of the United States where Asians and Pacific Islanders (API) make up a significant portion of the population.  The Stanford Asian Liver Center writes:

Why should Asian and Pacific Islanders care about Hepatitis B?

Despite the fact that only 0.2-0.5% of the U.S. population has chronic hepatitis B infection, this is still 1.25 million people, over half of whom are Asian and Pacific Islander (API) Americans. Depending on their country of origin, 5-15% of API immigrants have chronic hepatitis B. In some Pacific Rim countries, as many as 10-20% of the population are chronically infected.

Vaccine Exemptions in California: How Many Exemptions, and How Much Will They Cost? re AB 2109

Bob Sears is a vaccine-rejecting physician.  In a post claiming California Bill AB2109 Threatens Vaccine Freedom of Choice, Sears claimed:

At a time when we are trying to decrease health care spending, this bill will add millions of dollars of extra health care visits for families every year.

I haven't seen anyone quantify the numbers of exemptions and the costs yet.  The bill would become effective as of the beginning of the 2013-2014 school year.  As of the 2010-2011 school year (the last year rates were published) over the whole state, an average of 2.28% of incoming kindergarteners' parents had a Personal Belief Exemption

There are at least two times that families have to provide proof of immunization or an approved exemption, at the beginning of kindergarten (required vaccines) and at the beginning of 7th grade (TdaP-- whooping cough booster)

According to California state records: at http://www.cdph.ca.gov/data/statistics/Documents/VSC-2007-0201.pdf

566,137 live births in 2007 (estimate for incoming kindergarteners in fall of 2013) 
529,245 live births in 2002 (estimate for incoming 7th graders in fall 2013) 

566,137* 0.0228 = 12,680 (with rounding)

529,245** 0.0228 =12,067 (with rounding)

Let's say AB 2109 passes, and let's just round up to 25,000 students whose parents are refusing vaccines who require a signed form from an MD, DO, Physician's Assistant or Nurse Practioner (yes, the latter two can provide the education and sign the form.   "Millions of dollars" -- well, that would be at least $2 million.  Therefore:

25,000 * X = 2,000,000 

X= $80.00

I'm trying to find out what the largest HMO in California, Kaiser Permanente, charges for a drop-in vaccine clinic visit, without success so far.

My own provider, Palo Alto Medical Foundation, offers a host of classes on various parenting topics.  The baby-safety basics class is two hours and costs $40.00. 

So I believe that the cost to vaccine-refusing parents of complying with the provisions in AB 2109 would be far less than $80.00.

The decision not to vaccinate has dollar costs also.  The 2008 San Diego measles outbreak (which originated with an intentionally unvaccinated child who was a patient of Bob Sears) was quantified:

The importation resulted in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated. Two-dose vaccination coverage of 95%, absence of vaccine failure, and a vigorous outbreak response halted spread beyond the third generation, at a net public-sector cost of $10376 per case. Although 75% of the cases were of persons who were intentionally unvaccinated, 48 children too young to be vaccinated were quarantined, at an average family cost of $775 per child.

 That's a healthy chunk of change for a family, $775.

Roundup For And Against California's Immunization Exemption Bill, AB 2109

This list will be updated silently

 Currently in California, it is cheaper and easier to get an exemption from vaccine requirements for school entry than it is to actually comply with the immunization requirements. 

Now Assemblymember Richard Pan (D 5th District), also a physician, is planning to change that.  He has introduced AB 2109, which adds the requirement that parents speak with a licensed health professional.  The bill is  in the Assembly Health Committee and will be heard April 17, 2012.

Blog posts and newspaper reports on AB 2109--In favor

• February 29, 2012: Press release from Richard Pan Dr. Pan Introduces Bill to Provide Parents Immunization Information to Prevent Outbreaks
• March 20, 2012 Kenny Goldberg, KPBS Bill Attempts To Reduce Number Of Unimmunized Children In California
• March 20, 2012 ToddW at Harpocrates Speaks California Assembly Working to Protect Public Health
• March 20, 2012 Liz Ditz at I Speak Of Dreams Californians, Protect The Health of All Children: Support AB 2109 (with links to the Assembly Health Committee)
• March 21, 2012 Vincent Iannelli at About Pediatrics Pass the New California Vaccine Bill
• March 22, 2012 Erin Digitale at Scope Stanford School of Medicine Blog Pending vaccine bill would protect vulnerable Californians
• March 22, 2012 Modesto and Sacramento Bee Editorial We all have stake in vaccination rate
• March 22, 2012 ToddW at Harpocrates Speaks The Anti-Vaccine Crowd Shows They Are Anti-Informed Consent
• March 22, 2012 Nurses Who Vaccinate at Nurses Who Vaccinate California's AB 2109
• March 23, 2012 Orac at Respectful Insolence California Bill AB 2109 Real Informed Consent vs. Anti-Vaccine Misinformed Consent
• March 24, 2012  Liz Ditz at I Speak of Dreams California's AB 2109, Strengthening School-Entry Vaccination Requirements, A Mild Change
• March 25, 2012 Liz Ditz at I Speak of Dreams Vaccine Exemptions in California: How Many Exemptions and How Much Will They Cost (re AB 2109) 
• March 26, 2012 David Gorski MD at Science-Based Medicine California Bill AB 2109 The Anti-Vaccine Movement Attacks School Vaccine Mandates Again
• March 29, 2012 Hannah Guzik, California Health Report  Number of vaccinated kids drops steadily in California

Blog posts and newspaper reports on AB 2109--Oppposed

• March 2, 2012 Tim O'Shea DC End of Vaccine Exemptions in California?
• March 5, 2012 Sayer Ji various sources  Corporate Media Blackout On AB 2109 Threatening Vaccine Rights
• March 11, 2012 Alan Phillips JD at Natural News ALERT: California's AB 2109 Would Make Doctors Gatekeepers for Non-Medical Vaccine Exemptions!
• March 11, 2012 at Susanne Posel at Occupy Corporatism  AB 2109 Legislation To Take Away Our Right Not To Vaccinate
• March 14, 2012 Action Alert, Autism Action Coalition  Senator Wolk Receives $58K from Vaccine Manufacturers and Sponsors Restrictive Exemption Bill
• March 15, 2012 Sylvia Pimental of the Canary Party Request Assemblyman Pan Withdraw AB 2109
• March 22, 2012 Bob Sears ("Dr. Bob") at Huffington Post California Bill AB2109 Threatens Vaccine Freedom of Choice
• March 23, 2012 Dawn Richardson of NVIC, e-mail posted at another blog Let's Stop AB2109
• March 25 Emily at Laundry and Lullabies AB 2109 - no "personal belief" vaccine exemptions
• No date: Dawn Richardson  at the National Vaccine (mis)Information CenterCalifornia: Oppose AB 2109 Restricting Vaccine Exemptions

 

Evidence-Based Resources

• Shots for School (California Department of Health Website)
• Informed Consent for Vaccination from VaccineEthics.org
• Vaccination Requirements and Exemptions from VaccineEthics.org
• Vaccination Refusal: Ethics, Individual Rights, and the Common Good by Jason L. Schwartz, MBE, AM and Arthur L. Caplan, PhD

California's AB 2109, Strengthening School-Entry Vaccination Requirements, A Mild Change

Currently in California, it is cheaper and easier to get an exemption from vaccine requirements for school entry than it is to actually comply with the requirements. 

Now Assemblymember Richard Pan (D 5th District), also a physician, is planning to change that.  He has introduced AB 2109. (As of March 24, the bill is still in the Assembly Health Committee.) The change in the law is pretty mild.  Vincent Iannelli MD summarizes the change:

Instead of simply signing a personal belief vaccine exemption form on their own, parents will be required to have a written statement signed by a [licensed] health practitioner that says the parent was given information about the benefits and risks of immunizations and the risks of certain vaccine-preventable diseases.

The provisions of AB 2109 are much milder than the recommendations from the The Pediatric Infectious Diseases Society ( Download Pediatric_infectious_disease_soc_vaccine_exemptions).  I've excerpted part of the Position Statement below, and added emphasis

Position Statement Regarding Personal Belief Exemption from Immunization Mandates from The Pediatric Infectious Diseases Society March 2011

It is recognized that in some states, failure to pass personal belief exemption legislation or regulation could result in public backlash that will erode support for immunization mandates. If legislation or regulation is being considered in this situation, it should contain the following provisions, which are intended to minimize use of exemptions as the “path of least resistance” for children who are behind on immunizations (whereby it would be easier to obtain an exemption than to catch-up the child’s immunizations):

• The personal belief against immunization must be sincere and firmly held.
• Before a child is granted an exemption, the parents or guardians must receive state-approved counseling that delineates the personal and public health importance of immunization, the scientific basis for safety of vaccines, and the consequences of exemption for their child as well as other children in the community who are vulnerable to disease and cannot otherwise be protected.
• Before a child is granted an exemption, the parents or guardians must sign a statement that delineates the basis, strength, and duration of their belief; their understanding of the risks that refusal to immunize has on their child’s health and the health of others (including the potential for serious illness or death); and their acknowledgement that they are making the decision not to vaccinate on behalf of their child.
• Parents and guardians who claim exemptions should be required to revisit the decision annually with a state-approved counselor and should be required to sign a statement each year to renew the exemption.
• Children should be barred from school attendance and other group activities if there is an outbreak of a disease that is preventable by a vaccination from which they have been exempted. Parents and guardians who claim exemptions for their children should acknowledge in writing their understanding that this will occur.
• States that adopt provisions for personal belief exemptions should track exemption rates and periodically reassess the impact that exemptions may have on disease rates.

Despite the relative mildness of AB 2109, both in-state and out-of-state anti-vaccine activists are opposing the bill. 

Update: AB 2109 will be heard TUESDAY, APRIL 17, 2012
Health
MONNING, Chair
1:30 p.m. - State Capitol, Room 4202

 

Action Item: Ask Your Representative to Join The Congressional Dyslexia Caucus

ANNOUNCEMENT FROM DR. SHAYWITZ:

There is a newly-formed US Congressional Dyslexia Caucus. It is very important that parents in every state contact their US Congressional Representative NOW and encourage them to join the caucus by contacting Rep. Peter Stark (D-CA) and/or Rep. Bill Cassidy (R-LA).

Steps:

1. Find your zip +4 code by going to https://tools.usps.com/go/ZipLookupAction!input.action
2. Go to https://writerep.house.gov/writerep/welcome.shtml
3. Put in your state and your zip +4 
4. The utility will automatically take you to your representative's contact form.
5. Compose a message and send.  The message I sent is at the bottom of this post; you might talk about how dyslexia has affected you or a family member.

Please take action now. Dr. Shawitz talked about how important it is to get a discussion about dyslexia going at the national level. 

Dyslexia is real and US Public Schools are moving too slow to address it properly.

Date Approved: 1/18/2012
Chair(s): Rep. Bill Cassidy; Rep. Pete Stark
Staff Contact Information:
David Pulliam (Cassidy) 202.225.3901, david.pulliam@mail.house.g​ov 
Jeff Hild (Stark) 202.225.5065, jeff.hild@mail.house.gov

Here's the message I sent to David Pulliam and Jeff Hild:

Thanks to Reps. Cassidy and Stark for forming the US Congressional Dyslexia Caucus.

I wrote to Rep. Eshoo and asked her to join the caucus, using data from our local elementary district (Redwood City Elementary).

From this website, I found data for my county (San Mateo)

http://data1.cde.ca.gov/dataquest/SpecEd/SpecEd2.asp?cChoice=SpecEd2&cYear=2010-11&TheCounty=41%2CSAN%5EMATEO&cLevel=County&cTopic=SpecEd&myTimeFrame=S&submit1=Submit&ReptCycle=December

I see that the total number of students with Specific Learning Disability (as dyslexia is identified in IDEA) is 3,815.

Looking at the change by age, many students aren't identified until after third or fourth grade. This is too late; we can screen for phonemic awareness issues as soon as the second half of kindergarten.


From this website,

http://www.ed-data.k12.ca.us/App_Resx/EdDataClassic/fsTwoPanel.aspx?#!bottom=/_layouts/EdDataClassic/profile.asp?level=05&reportnumber=16


I see that there are 92,097 total students in San Mateo County

3,815/92,097 = 4.1% of the total number of students in San Mateo County are identified as having Specific Learning Disability.  That percentage is far too small.

Dr. Shaywitz estimates the percentage of students with dyslexia (or specific learning disability: reading) is at least 10%; the International Dyslexia Association has the view that 15-20% of the population has a language-based learning disability, including dyslexia.

I would also like to know about the effects of untreated dyslexia and reading failure on the drop-out rate. Students don't start to fail just before they drop out; the failure has been going on for years.

 

Once Upon A Mattress in Menlo Park (well, Atherton) California

Youth theater and high-school theater can be great and are a bargain for a night out.  Tomorrow through Sunday, Menlo Atherton High School is presenting the musical comedy Once Upon A Mattress (the fairytale Princess and the Pea, retold).

Preview at In Menlo.  Tickets are available online.

7:30 p.m. Thursday, March 22, through Saturday, March 24, at the Menlo-Atherton Performing Arts Center, 555 Middlefield Road, in Atherton.

 

 

Californians, Protect The Health of All Children: Support AB 2109 Before March 25

Update: AB 2109 will be heard TUESDAY, APRIL 17, 2012
Health
MONNING, Chair
1:30 p.m. - State Capitol, Room 4202

California has one of the most lax vaccine-exemption laws in the United States, according to Mark Netherda, MD of the Sonoma County Medical Society. 

A parent or guardian need only sign the Personal Beliefs Affidavit on the back of the California School Immunization Record for a child to be granted admission to school without immunizations

In other words, it is cheaper and easier to get a vaccine exemption, which puts other children at risk, than it is to comply with school entry laws.

Now Assemblymember Richard Pan (D 5th District), also a physician, is planning to change that.  He has introduced AB 2109:

“Parents are on the front line when it comes to the protecting the health of their children and their communities,” Dr. Pan said. “This bill empowers them with up-to-date, accurate information about immunizations. As a pediatrician, I have spent my career making sure families, physicians and public officials are working in unison to build healthier communities.  AB 2109 strengthens this relationship through education to help save our children from infectious outbreaks that can only be prevented by working together.”

With overwhelming bipartisan support, California has passed legislation calling for children to be immunized for certain diseases that pose an immediate threat to public health.  California is also one of 20 states that allow parents to sign a form that excludes their children from having to receive the immunizations. AB 2109 would simply ensure that parents receive accurate information about immunizations from a licensed health care practitioner before they decide if they will sign the form.

I have posted the current text of the bill at the bottom of this post.  You can keep up with the bill at this link: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120AB2109&search_keywords=

Alaska's Section on Epidemiology (SOE) has published a list of recommendations to reduce outbreaks of vaccine-preventable disease; "educating parents" is first on this list.  

Vermont recently eliminated moved closer to eliminating all "philosophical exemptions"; at Vermont Steps Toward Improved Public Health, Public Health activist ToddW lists some of the vaccine-refusers' pet talking points about "informed consent" and "the right to refuse vaccines" and refutes them in detail.

Anti-vaccination groups based outside of California are targeting the members of the committee hearing the bill, the Assembly Committee on Health (here and here)

Several people found the following confusing: If you would like to let the Health Committee know your views on making vaccine exemptions to be slightly easier and certainly less expensive than actually complying with the law and getting their children vaccinated, you can contact members of the Assembly Committee on Health, and ask them to support AB 2109.  The contact link takes you to each individual Assemblyperson's contact form. 

If you would like to let the Health Committee know that you support the simple provisions of AB 2109, and that you would like the Committee to approve the bill for hearing in the Assembly, the names and contact information of the Committee are listed below.

There's a sample phone script below the list; feel free to suggest other talking points in the comments

William Monning (D) - Chair
Tel: (916) 319-2027
Fax: (916) 319-2127
Contact Assembly Member William W. Monning

Dan Logue (R) - Vice Chair
(P) 916-319-2003
(F) 916-319-2103
Contact Assemblyman Dan Logue

Tom Ammiano (D)
Tel: (916) 319-2013
Fax: (916) 319-2113
Contact Assembly Member Tom Ammiano

Toni Atkins (D)
Tel: (916) 319-2076
Fax: (916) 319-2176
Contact Assembly Member Toni Atkins

Susan Bonilla (D)
Tel: (916) 319-2011
Fax: (916) 319-2111
Contact Assemblywoman Susan Bonilla

Mike Eng (D)
Tel: (916) 319-2049
Fax: (916) 319-2149
Contact Assembly Member Mike Eng

Martin Garrick (R)
(P) 916-319-2074
(F) 916-319-2174
Contact Assemblyman Martin Garrick

Richard .S Gordon (D)
Tel: (916) 319-2021
Fax: (916) 319-2121
Contact Assemblyman Richard S. Gordon

Mary Hayashi (D)
Tel: (916) 319-2018
Fax: (916) 319-2118
Contact Assembly Member Mary Hayashi

Roger Hernandez (D)
Tel: (916) 319-2057
Fax: (916) 319-2157
Contact Assembly Assistant Majority Whip Roger Hernández

Bonnie Lowenthal (D)
Tel: (916) 319-2054
Fax: (916) 319-2154
Contact Assembly Member Bonnie Lowenthal

Allan R. Mansoor (R)
(P) (916) 319-2068
(F) (916) 319-2168
Contact Assemblyman Allan R. Mansoor

Holly J. Mitchell (D)
Tel: (916) 319-2047
Fax: (916) 319-2147
Contact Assembly Member Holly J. Mitchell

Brian Nestande (R)
(P) 916-319-2064
(F) 916-319-2164
Contact Assembly Member Brian Nestande

Richard Pan (D) – sponsor
Tel: (916) 452-0505
Fax: (916) 452-5525
Contact Assembly Member Richard Pan

V. Manuel Perez (D)
Tel: (916) 319-2080
Fax: (916) 319-2180
Contact Assembly Member V. Manuel Peréz

Jim Silva (R)
(P) 916-319-2067
(F) 916-319-2167
Contact Assembly Member Jim Silva

Cameron Smyth (R)
(P) 916-319-2038
(F) 916-319-2138
Contact Assembly Member Cameron Smyth

Das Williams
Tel: (916) 319-2035
Fax: (916) 319-2135
Contact Assembly Member Das Williams

If you decide to phone, here is a sample Phone Script:

• Call the office number and introduce yourself and ask to talk to someone about AB 2109. If this is your assembly member’s office, let them know you are a constituent and what town/city you are from.
• Let the appropriate person know you are in favor of AB 2109 because its passage would increase vaccine uptake of the most serious infectious diseases. (If your family has been affected by someone else's vaccine refusal, be sure to mention it here.)
• Let the legislative office know that you are aware of concerted, organized out-of-state anti-vaccine activists who are targeting the Health Committee
• Let the person you are speaking to know about the distortions, outright lies and misinformation provided by anti-vaccine sites such as the National Vaccine Information Center, Sheri Tenpenny, Mercola.com, and Natural News

 

If you don't live in California, Public Health activist ToddW has a suggestion for you, 

I encourage my readers to get in touch with their state legislators to inquire about current vaccine requirement and exemptions laws and to advocate for similar legislation as that described above. We all have a role to play in preventing outbreaks of diseases. Doing what we can to increase vaccination rates in our states is just one step we can take to help ourselves and our communities.

sources:

• http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_2101-2150/ab_2109_bill_20120223_introduced.html
• http://asmdc.org/members/a05/newsroom/press-releases/item/2766-dr-pan-introduces-bill-to-provide-parents-immunization-information-to-prevent-outbreaks
• http://www.kpbs.org/news/2012/mar/20/bill-attempts-reduce-number-unimmunized-children-c/
• http://silencedbyageofautism.blogspot.com/2012/03/follow-bouncing-ball.html
• http://silencedbyageofautism.blogspot.com/2012/03/vermont-steps-toward-improved-public.html
• http://science.kqed.org/quest/2010/10/13/health-officials-to-consider-tightening-vaccine-exemptions/
• If you live in the San Francisco Bay Area, you can check vaccination exemption rates by county, town or school district at http://www.baycitizen.org/data/immunizations/

 

Text of the bill as it stands on March 20, 2011 reproduced below, from http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_2101-2150/ab_2109_bill_20120223_introduced.html. You can keep up with the bill by going to this link: http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201120120AB2109&search_keywords=

BILL NUMBER: AB 2109 INTRODUCED BILL TEXT

 

INTRODUCED BY Assembly Member Pan
(Principal coauthor: Senator Wolk)
(Coauthor: Assembly Member Fuentes)

FEBRUARY 23, 2012

An act to amend Section 120365 of the Health and Safety Code, relating to communicable disease.

 

LEGISLATIVE COUNSEL'S DIGEST

AB 2109, as introduced, Pan. Communicable disease: immunization exemption.

Existing law prohibits the governing authority of a school or other institution from unconditionally admitting any person as a pupil of any private or public elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center, unless prior to his or her first admission to that institution he or she has been fully immunized against various diseases, as specified. Existing law prohibits admission or advancement of a pupil to the 7th grade level without a full immunization against hepatitis B.

Existing law exempts a person from the above-described immunization requirement if the parent or guardian or other specified persons file with the governing authority a letter or affidavit stating that the immunization is contrary to his or her beliefs. However, whenever there is good cause to believe that the person has been exposed to one of the diseases, a person may be temporarily excluded from the school or institution, as specified.

This bill would require, on and after July 1, 2013, the above-described letter or affidavit to be accompanied by a form prescribed by the State Department of Public Health that includes a written statement signed by a health care practitioner, as defined, that indicates that the health care practitioner provided the parent or guardian of the person, or the person, if an emancipated minor, who is subject to the immunization requirements with information regarding the benefits and risks of the immunization and the health risks of specified communicable diseases. The bill would also require the form to include a written statement by the parent, guardian, or person, if an emancipated minor, that indicates that he or she received the information from the health care practitioner.

By imposing new duties upon local officials, this bill would create a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

SECTION 1. Section 120365 of the Health and Safety Code is amended to read:

120365. (a) Immunization of a person shall not be required for admission to a school or other institution listed in Section 120335 if the parent or guardian or adult who has assumed responsibility for his or her care and custody in the case of a minor, or the person seeking admission if an emancipated minor, files with the governing authority a letter or affidavit stating that the immunization is contrary to his or her beliefs. However, whenever there

(b) On and after July 1, 2013, a separate form prescribed by the State Department of Public Health shall accompany the letter or affidavit filed pursuant to subdivision (a). The form shall include both of the following:

(1) A written statement signed by a health care practitioner that indicates that the health care practitioner provided the parent or guardian of the person, or the person if an emancipated minor, who is subject to the immunization requirements of this chapter with information regarding the benefits and risks of the immunization and the health risks of the communicable diseases listed in Section 120335 to the person and to the community. This statement shall be signed not more than six months from the date when the person subject to the immunization requirements is first admitted to the school. If the person was admitted to the school prior to entering the 7th grade and is about to enter the 7th grade, then an additional letter or affidavit shall be filed with the written statement signed by the health care practitioner not more than six months from the first day of school for a person about to enter the 7th grade.

(2) A written statement signed by the parent or guardian of the person, or the person if an emancipated minor, who is subject to the immunization requirements of this chapter that indicates that the signor has received the information provided by the health care practitioner described in paragraph (1). This statement shall be signed not more than six months from the date when the person subject to the immunization requirements is first admitted to the school. If the person was admitted to the school prior to entering the 7th grade and is about to enter the 7th grade, then an additional letter or affidavit shall be filed with the written statement signed by the parent not more than six months from the first day of school for a person about to enter the 7th grade.

(b)

(c ) When there is good cause to believe that the person has been exposed to one of the communicable diseases listed in subdivision (a) of Section 120325, that person may be temporarily excluded from the school or institution until the local health officer is satisfied that the person is no longer at risk of developing the disease.

(d) A copy of the signed written statement shall be accepted in lieu of the original form. A signed letter from the health care practitioner that references the person's name shall be accepted in lieu of a statement on the original form.

(e) For purposes of this section, "health care practitioner" means a physician and surgeon, licensed pursuant to Section 2050 of the Business and Professions Code, a nurse practitioner who is authorized to furnish drugs pursuant to Section 2836.1 of the Business and Professions Code, or a physician assistant who is authorized to administer or provide medication pursuant to Section 3502.1 of the Business and Professions Code.

SEC. 2. If the Commission on State Mandates determines that this act contains costs mandated by the state, reimbursement to local agencies and school districts for those costs shall be made pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code.

 

 

 

 

 

 

 

Vigil for George Hodgins and other disabled people murdered by their families

Updated 3/19/2012 with Kassiane Sibley's remarks and links to photo and video coverage of the vigil. Scroll donw

Image description: a candle burning against a black background. Image source: By 4028mdk09 (Own work) [CC-BY-SA-3.0 (www.creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

On a rainy Friday night, March 16, 2012, about 25 people gathered to remember George Hodgins and all disabled people killed by family members.  Zoe Gross's remarks are  reproduced below.  She had also prepared a list of disabled people murdered by family members, which we read aloud, one by one.  It was like the long tolling of a bell.  Then Zoe invited others to speak; these are the ones I remember and my frail memory of what they said:  Kathryn Hedges read a statement by Kassiane Sibley; distance prevented Kassiane from attending. (Update 3/19/2012: Kassiane's remarks are reproduced below). Mark Romoser spoke about the value of all human life. Landon Bryce's neurotypical friend spoke of how his perspective has been broadened, how much he has learned, by getting to know Landon.  Steve Silberman talked about the "feebleminded" and "epileptics" murdered by the Nazis in the T-4 program, many of which must have been autistic, who we then remembered. I spoke: I wondered if it was hard for George to have a mother who did not treasure his life.

One of George's teachers from The Morgan Center remembered George, his ready smile, his engagement, his love of swimming and hiking, and that he is missed now and will continue to be missed.

Around the country, those who couldn't attend the vigil light candles to honor George's full humanity and his life.

Remarks by Zoe Gross, who organized the vigil

Last Tuesday, George Hodgins was shot and killed by his mother, who then killed herself. George lived here in Sunnyvale and he was 22 years old. I didn't know George, but I can't stop thinking about him. Maybe it's because we have a lot in common - we lived near each other, we were the same age, we're both autistic, although we led very different lives. I would like to have met George, but I can only mourn him. And I can try to make sure that his story isn't forgotten.

In the wake of this tragedy, I read a lot of articles that asked the readers to imagine how George's mother must have felt. But I didn't see a single article that asked the reader to empathize for George, to imagine how it feels to see your mother point a gun at you. I've seen a lot of people talking about how hard it must be to live with an autistic relative, but I didn't see anyone talking about how terrible it be to die knowing that your parent, who you love and depend on, has decided to hurt and kill you.

Because he was autistic, George is being erased from the story of his own murder.

The story of George Hodgins's death is being discussed and presented as a story of a mother who snapped, and the story of other parents who have felt the same way. It's being told as a story about a lack of services for families with special-needs children, as though a lack of services is a justification for murder.

When disabled people are murdered by their families, this is the story people want to hear. It's the same story that we saw in newspapers after Katie McCarron was murdered, and after Jeremy Fraser was murdered, and after Glenn Freaney was murdered, and after Zain and Faryaal Akhter were murdered. The story goes like this: it is understandable that someone would kill their disabled relative if they don't get help to care for them.

I don't think this is a true story.

Why is the story being told this way? Because we live in a world that doesn't acknowledge the value of our lives as disabled people. Because so many people in our society can't imagine a disabled person living a fulfilling life, so they don't see the tragedy and the wasted potential when one of our lives is cut short.

As disabled people, we have to take a stand against this kind of thinking. We have to get the word out that our lives matter, tha tour lives are our own stories and not just the stories of our non-disabled parents and relatives and caretakers. We have to let people know that they are missing part of the story.

Because the story of George Hodgins's murder is also the story of the disabled community losing one of our own. It's the story of the other disabled people who were murdered by their family members, and it's the story of the society that thinks so little of people with disabilities that these murders are all too often justified as "understandable." Most of all, it's George's story - the story of a young man who enjoyed hiking, who was always looking to learn new skills, who had his whole life in front of him.

Now George is gone, and only his memory remains, and already that memory is being distorted by people who want to tell his story and leave him out. That's not going to happen tonight. We're here to remember the real story.

Kassiane Sibley has kindly given me permission to reproduce her remarks, which are also posted at her blog, Radical Neurodivergence at The Words Said for George

I hate writing for murdered people. It does no good. They're still dead, and people always try to make what I say all about themselves & then they get all mad and hateful at me. But it isn't about them. And it isn't about me, either. It's about the person who is dead but shouldn't be.

This time, it's about George, a pleasant 22 year old man who will never see 23. Before George, it was Katie. It was Christopher. It was Ulysses. It was 100s of autistics before them, know and unknown to me.

These murders are not mercy killings. They are murders, and I am 100% confident in saying that no parent who truly loves their child can kill them. Love does not work that way.

Those of you who are not autistic may be inclined to sympathize with George's murderer. Maybe what you know about autism is tragedy-and-terror style awareness, all about devastation and loss. Maybe you know her, maybe you liked her. Maybe she was your neighbour. Maybe you can't wrap your head around the reality that you had coffee with a murderer. Maybe trying to find mitigating factors makes it easier to integrate that you know someone who killed her son.

Those of you who are autistic are probably feeling more like what I feel-saddened that yet another of our number was killed. Maybe, like me, you are disgusted at the race to exonerate the murderer in the media. And, if you are like me, you are terrified that everyone is blaming lack of services, stress, everything but “HIS MOTHER SHOT HIM” for George's death.

I hate writing for murdered people. Again and again and again I have to defend the very right of the victim to be treated as a human being in all reports, for his very personhood and the personhood of myself and those I hold dear. This stuff shouldn't need saying. My outrage should be the norm, not the exception.

The tragedy here is not autism. The tragedy here is that George, like countless autistics before him, was murdered. The tragedy is that people feel more for his killer than they do for him.

Steve Silberman kindly photographed the vigil; the photographs can be seen at https://www.facebook.com/media/set/?set=a.10151401301460313.815702.830415312&type=3

CBS Channel 5 in San Francisco covered the vigil: http://sanfrancisco.cbslocal.com/video/6851186-memorial-held-for-autistic-sunnyvale-man-killed/

Zoe Gross and the Autistic Self-Advocacy Network are organizing further vigils scheduled for March 30, 2012.

On behalf of the Autistic Self Advocacy Network, I am asking you join us in taking action. On March 30th, help us organize a nation-wide day of mourning for disabled people killed by family members and caregivers. Our goal is to hold vigils in cities across America to memorialize murder victims. Through your help, we hope to amplify our message: that disabled people deserve to live fulfilling lives free of violence

We're calling for volunteers to organize vigils in their local communities on or around March 30th. You may never have organized this kind of event before, but please know that you'll have support - our first vigil was a success, and we can help you as you work to organize yours. If you want to help us take a stand against the violence facing our community, please write to me at zgross@autisticadvocacy.org.

Send a message to society that the disability community has no place for the kind of "mercy" offered by Robert Latimer and others who view us as having lives not worth living. The time has come for us to fight back. On March 30th, help us make it happen.