CALIFORNIA BILL AB 2109 - URGENT - Page 4

[purslaine]

- and taximom and kathymuggle - you can even go to a naturopath to get it signed! 

I am glad one can use a naturopath (although one usually has to pay for a naturopath out of pocket, so this might be an obstacle for many parents).  Moreover, the naturopath has to be under the supervision of a licensed physician, so some bias may still be floating around.  It could make the situation a bit less bias-riddled, but is still not ideal.  

I am also glad there are a variety of other options (school nurse for example) for getting the form signed - it doesn't mean I agree it is warranted in the first place, though.

Edited by purslaine - 6/9/12 at 9:15am

[ajsmom]

Since the California Health and Safety Code currently provides exemption from immunization, AB 2109 amounts to a fine for opting out of an optional medical procedure. It is the same as making you pay for a doctor’s appointment to get a signed document about a procedure you don’t require.

The stated goal of the bill AB 2109 is to ensure parents are informed properly of the risks and benefits of vaccines before they sign the exemption. If this is so, then the state should also care that the information presented is consistent throughout the state.

To meet the bill's goal, the state could create an immunization fact sheet that includes the benefits and risks of vaccines, as well as a signature section for parents to sign that they are or are not vaccinating their child. Every child in the state will have this form included in the paperwork required for school. This way, the information given to parents does not vary from doctor to doctor and parents won't have to spend precious resources of time and money so they can opt out of a procedure that is not required by the state to attend school. It would also keep schools at full attendance.

Most parents who opt out have done so after exhaustive research. When we sign the exemption, we have more than enough information. We should not have to pay for it.

Please use the above information when contacting your California senators.  EVERY California legislator took money from the pharmaceutical industry in the last election so you must impress upon them their obligation to represent YOU this time.

For more information about campaign contributions visit: http://maplight.org/california

[prosciencemum]

Originally Posted by ajsmom 

Since the California Health and Safety Code currently provides exemption from immunization, AB 2109 amounts to a fine for opting out of an optional medical procedure. It is the same as making you pay for a doctor’s appointment to get a signed document about a procedure you don’t require.

You don't have to pay. This will be available at free vaccination clinics and the school nurse will also be able to do it. It doesn't have to be a Doctor. I have already posted these things in greater length a few posts up. 

Most parents in CA who currently take the exemption have not done the research. Because it's currently less hassle to get an exemption than the shots. This bill won't significantly affect parents who have selection to not, or partially vaccinate after an informed decision, but it will prevent parents just taking an easy option without thinking about it. 

[Bokonon]

Originally Posted by prosciencemum 

 Because it's currently less hassle to get an exemption than the shots. 

No, it's not.

I live in CA, and have had to speak to the school district head nurse each time my children have entered a new school, to even be allowed to sign the exemption card.  This conversation involves a discussion of yes, I understand the risks and herd immunity and etc. etc., for each child.  If we move to a different school or school district?  Same process and hassle all over again.  It honestly feels like bullying, and I'm quite sure that's the intent.

Shots?  Go in for a regularly scheduled well-child visit and my kids are given the shots.  No hard time given by the doctor and/or nurse, no explanation needed. 

You don't live in California, and you don't live in the United States.  You don't know what you are talking about.

[Taximom5]

In every state I have lived in, the school DISTRICT, not just the school, has required a signed form from the doctor allowing the child to participate in gym--and gym is a required "subject"--and this form includes a page for vaccine records. The school DISTRICT maintains a file even if your child goes to private school, and the school district nurse contacts you if your child's vaccine records are not up to date.

My kids have medical exemptions from further vaccination, but, in my current state, I not only have to provide a new, updated and signed copy from the doctor every single year, but every single year, AFTER I provide it, I get a call (for each child) from the school nurse, telling me my child's vaccines are not up to date and I need to get them caught up on vaccines or they will not be permitted to attend school. Every year, she claims she has no record of a medical exemption for them, even after I provide it, and I have to drop everything and run to the school with yet another copy.

When my oldest started high school, he wasn't sent his class schedule before the start of school. When we called to ask why, we were told that he wouldn't receive it until his vaccine form was turned in--even though the doctor had FAXED them a copy of his exemption note and signed form 2 months earlier.

I brought them another copy--and then we were told that my son's schedule would have to be completely redone, because some of the classes were now too full--including his chosen elective.

Darn right I feel bullied.

[Taximom5]

Originally Posted by prosciencemum 

Taximom and Kathymuggle - I've been thinking about your comments about how I would feel about being required to consult with a "non-vaxxing naturopath" about my vaccination choices. 

Wikipedia tells me that: 
(link http://en.wikipedia.org/wiki/Naturopath)

"Naturopathy
, or 
Naturopathic Medicine
, is a form of 
alternative medicine
 based on a belief in 
vitalism
, which posits that a special energy called vital energy or vital force guides bodily processes such as metabolism, reproduction, growth, and adaptation.
^[1]

 Naturopathic philosophy favors a 
holistic
 approach and seeks to find the least invasive measures necessary for symptom improvement or resolution, thus encouraging minimal use of 
surgery
and unnecessary 
drugs
. According to the 
Association of Accredited Naturopathic Medical Colleges
, "Naturopathic medicine is defined by principles rather than by methods or modalities. Above all, it honors the body’s innate wisdom to heal."
^[2]
"


So I guess they would advise me that I shouldn't give my kids any drugs and let their "vital energy" heal them instead?

Well if I was required to do that it would be annoying, but I think I could manage to listen and then say that I believe in Evidence Based Medicine and that there is no evidence supporting their ideas about medicine, and plenty suggesting that modern medicine saves lives. I'd ask them to sign the form and leave, and if they tried to use signing the form to co-erce me into their point of view which I strongly disagree with I'd leave and find another naturopath who could follow the rules set out to them. 

 I think the difference between that and the requirement in the bill comes back to comments I made that a choice to not vaccinate has wider implications outside of your own family. The choice to vaccinate has no such implication. 

 I stand by my comment that it has been demonstrated that an increase in the number of unvaccinated people in a community will increase the incidence of vaccine preventable diseases, or VPDs (and vice versa). Eireann - you claim this is wrong. Could you explain why that is?  

 Because I believe it is true, I have to stand by the comment that a choice to not vaccinate when there is no reason to suspect you or your child is more susceptible than usual to bad reactions has wider implications on the community you live in, and particularly on people susceptible to complications of VPDs and who are unable to be vaccinated (I know there are many valid reasons). This does not mean you should not be able to make that choice, but the bill under discussion here for California does not state that either. It just requires that you make the choice in an informed manner after a consultation with a licensed health practicioner (doesn't have to be a Doctor if you prefer it to not be). 

So you wouldn't mind having to take several unpaid hours from work and paying a $45 copay every year, for each child, to do this?

Multiply by, say, 4 children, and in 10 years , you will have paid $1800, and, assuming you have to take 3 hours from work each time, you will have taken a total of 120 hours or 15 5/8 days, unpaid.

All to discuss with and get a signed form from a doctor whose views of health care you believe to be completely wrong.

And you wouldn't mind?

[Taximom5]

Originally Posted by prosciencemum 

- and taximom and kathymuggle - you can even go to a naturopath to get it signed! 

I hope that reduces some concerns over the bill. 

Why would you think I would want to go to a naturopath? Just because I disagree with "science-based medicine" doesn't mean I believe in "naturopathic medicine."

I have never been to a naturopath before; why should I pay the hefty initial office visit/exam fee (which is not covered by insurance) to start going, just to get a form signed?

Multiply that by several children, add hours missed from work, athe you can see how prohibitively expensive this would be.

[Nosy]

Originally Posted by kathymuggle 

I am glad one can use a naturopath (although one usually has to pay for a naturopath out of pocket, so this might be an obstacle for many parents).  Moreover, the naturopath has to be under the supervision of a licensed physician, so some bias may still be floating around.  It could make the situation a bit less bias-riddled, but is still not ideal.  

I am also glad there are a variety of other options (school nurse for example) for getting the form signed - it doesn't mean I agree it is warranted in the first place, though.

You can only go to a naturopath "under the supervision of a physician", so your average naturopath is not under the supervision of a physician.  It's really only for naturopaths who administer vaccines w/physician supervision.  I'd feel better about this law if all naturopaths were included.  Sadly the naturopaths group folded right up and said they approve of the bill after this provision was added at the hearing.

[Nosy]

Originally Posted by prosciencemum 

You don't have to pay. This will be available at free vaccination clinics and the school nurse will also be able to do it. It doesn't have to be a Doctor. I have already posted these things in greater length a few posts up. 

Most parents in CA who currently take the exemption have not done the research. Because it's currently less hassle to get an exemption than the shots. This bill won't significantly affect parents who have selection to not, or partially vaccinate after an informed decision, but it will prevent parents just taking an easy option without thinking about it. 

The school nurse will not be able to do this.  Have you read the bill?

[cloveland]

School nurses and RN's cannot sign the form.  

The new form requires a written statement signed by a physician, surgeon, nurse practitioner, physician assistant, osteopathic physician or surgeon or a naturopathic doctor who is authorized to furnish drugs under supervision of a physician. RNs, school nurses, pharmacists, Christian Science Practitioners and alternative practitioners cannot sign the form. 

[AbbyGrant]

Forgive me if I missed it, but does the bill state how often this would need to be done? Is it a one time thing? Annual? Only when a child becomes eligible for another vaccine?

[Nosy]

Originally Posted by AbbyGrant 

Forgive me if I missed it, but does the bill state how often this would need to be done? Is it a one time thing? Annual? Only when a child becomes eligible for another vaccine?

I don't think this has been clarified.  I would guess you definitely would have to have it before K or enrolling in school, then before 7th grade b/c I think there is a mandatory pertussis booster then.  It's a good question, and it makes a huge difference in cost if parents have to do it every year or if they "just" have to do it when the child is initially enrolling and when other shots become mandatory.

[pammysue]

Originally Posted by prosciencemum 

Most parents in CA who currently take the exemption have not done the research. Because it's currently less hassle to get an exemption than the shots. This bill won't significantly affect parents who have selection to not, or partially vaccinate after an informed decision, but it will prevent parents just taking an easy option without thinking about it. 

This is a really offensive and erroneous statement. What proof do you have to back up this assertion?

[thegoodearth]

Originally Posted by pammysue 

This is a really offensive and erroneous statement. What proof do you have to back up this assertion?

***

Edited by thegoodearth - 6/13/12 at 11:32am

[SweetSilver]

Originally Posted by AbbyGrant 

Forgive me if I missed it, but does the bill state how often this would need to be done? Is it a one time thing? Annual? Only when a child becomes eligible for another vaccine?

Originally Posted by Nosy 

I don't think this has been clarified.  I would guess you definitely would have to have it before K or enrolling in school, then before 7th grade b/c I think there is a mandatory pertussis booster then.  It's a good question, and it makes a huge difference in cost if parents have to do it every year or if they "just" have to do it when the child is initially enrolling and when other shots become mandatory.

And for every child as well.....

Should we start mandating well-child visits?  That might get a lot of information out there to parents, possibly preventing a lot of diseases and accidents, diagnose developmental delays....... Do most parents who avoid well-child visits do so because it is easier, that they haven't thought about the pros and cons?

Seriously, I think if the ends justify the means, then I think that this program would have a lot more over-reaching benefits than simply VPDs.  

Perhaps that sounds ridiculous.  And I would agree.

[ajsmom]

In my school district, I am required to complete the exemption form every year.

My earlier post about the current state code and the changes that 2109 bring were posted after reading the code and the bill.  The idea to have everyone read the same information and complete the same form reduces costs for families AND schools and eliminates the concerns about misinformation.  If you don't live in California and know a lot about California families who opt out then perhaps you could research the topic before posting and share your source data for your statement that most parents are not informed. 

We do not have a nurse at the public school and the bill states that an allopathic practitioner, naturopath or osteopath may sign the form. We do not qualify for a free clinic. We have insurance. If we need this signed we will need to make an appointment and pay a co-pay just for this form.  It is the same as a fee because I do not take my child for wellness visits every year.

I have been contacting my elected state senator and assembly person about this the entire time it has been in the process. I highly recommend you do the same if you are in California.  Whooping cough and measles outbreaks cited as the reason for this bill will not be affected if 2109 passes. 

We all may have strong feelings about this but the state law allows us to exempt ourselves. Period.

[AdinaL]

Originally Posted by prosciencemum 

You don't have to pay. This will be available at free vaccination clinics and the school nurse will also be able to do it. It doesn't have to be a Doctor. I have already posted these things in greater length a few posts up. 

Most parents in CA who currently take the exemption have not done the research. Because it's currently less hassle to get an exemption than the shots. This bill won't significantly affect parents who have selection to not, or partially vaccinate after an informed decision, but it will prevent parents just taking an easy option without thinking about it. 

Generalization such as this, with no evidence to back them up do nothing for the conversation other than start an argument.  It is a vast generalization to say that most parents in CA who take the exemption have not done the research.  I suggest you think about rewording this, or backing it up.  As of right now it looks like you are trying to start a fight.

[prosciencemum]

Originally Posted by AdinaL 

Generalization such as this, with no evidence to back them up do nothing for the conversation other than start an argument.  It is a vast generalization to say that most parents in CA who take the exemption have not done the research.  I suggest you think about rewording this, or backing it up.  As of right now it looks like you are trying to start a fight.

I will put some  more information in my next post. 

Edited to remove an annoyed comment - what can I say, we're all human! I have instead flagged a couple of other posts in this thread which I think might violate the "no personal attacks" rule. Trying to stick to the facts, not respond to what feels like people being mean to me. :) 

Edited by prosciencemum - 6/12/12 at 1:28pm

[prosciencemum]

This has been a fast moving thread, and it seems I posted some information which was not well liked. I was asked to back up a few things, so here are some links, and where I got the information from. I'm sorry if I missed something you wanted me to clarify/provide evidence for. 

I hope we can stick to debating the merits/cons of this bill. Given Mothering's informed consent stance on vaccinations, and that the aim of the bill (as stated by it's author) is to improve informed consent for vaccination in CA I'm surprised it isn't better supported here.

I said something about how it could be signed by a school nurse which is apparently untrue. I think this might have been down to my misunderstanding/oversimplification of the statement from Catherine Flores, the Director of the Californian Immunization Coalition. 

"The bill language states that a form or letter documenting that information was provided to a parent or guardian, will need to be signed by a licensed physician (MD, DO), Physician Assistant, Nurse Practitioner, or Naturopath under the supervision of a licensed physician. If a county health department has a clinic with one of those designees on staff, yes they can get a signature there. School health centers which are staffed by Nurse Practitioners and Federally Qualified Health Centers would be another resource for underinsured or uninsured families."

So I didn't mean a school nurse, but a nurse practitioner in a school health centre. I guess that's subtly different? 

Where did the statement of the list of people who cannot sign it come from? 

My statement that most parents getting an exemption in CA have not done the research comes from an article in the Mercury News. I have not chased their primary source. That was a bit lazy. 

http://www.mercurynews.com/opinion/ci_20716917/mercury-news-editorial-california-childhood-immunization-bill-deserves

Thinking about it it'd be quite hard to get statistics on that kind of thing, and also how would you define "having done the research".  I think it comes down to how easy it is to currently get an PBD (Personal Belief Exemption) in CA (below) which I suspect could be a temptation for some parents not bothering to take their children to vaccination clinics. Obviously many parents who want the PBE don't fall into that category - and if you're here you obviously don't either. I'm sorry if this caused offense - it was not meant to.

I read the legislative analysis of the bill which describe the details and offer some analysis. I have also read several opinion pieces, but I admit not the bill. Can you read those things online? How long is it? I'm spending too much time on here right now anyway! 

The legislative analysis is here: http://www.leginfo.ca.gov/pub/11-12/bill/asm/ab_2101-2150/ab_2109_cfa_20120501_150815_asm_comm.html

My statement that it is easier to get an exemption in CA than get immunized (currently) comes straight from the text of that legislative analysis: 

"Under current law, exemption only requires a parent's signature and is simpler than submitting proof of vaccination."

And also this blog post about what's currently required for exemptions in CA: http://californianssupportingab2109.blogspot.co.uk/2012/04/california-immunizations-required-for.html

Even if I lived in CA currently I would have no first hand experience with this as I would not seek this exemption, so I'm can't see how my current geographic location has anything to do with it. 

That text also states (PBE stands for a Personal Belief Exemption and is different from a medical exemption): 

"Currently, about 2.5% of California children are exempt through a PBE, but this number has been growing rapidly since 2001.  Exempted children are not evenly geographically distributed throughout the state.  Persons requesting PBE tend to cluster in certain areas, and are more likely to be white, speak English primarily, and have higher socioeconomic status."

It's not obviously stated how often these forms would be needed, but current exemption forms are required at K entry, and 7th grade, so it looks like two. When I lived in the US co-pays for my daughter's well-child checks were $10, and we had to have those every year anyway as her daycare required evidence she was healthy (something to do with liability for physical play activities I assume).

[AdinaL]

Originally Posted by prosciencemum 

I will put some  more information in my next post. 

Edited to remove an annoyed comment - what can I say, we're all human! I have instead flagged a couple of other posts in this thread which I think might violate the "no personal attacks" rule. Trying to stick to the facts, not respond to what feels like people being mean to me. :) 

Oooh, fast on the edit.

If you wish to discuss it with me more, you are welcome to PM me. :)