At stake was Senate Bill 277, signed into law by Gov. Jerry Brown on a wave of concern that “herd immunity” among California children was compromised by a growing anti-vaccination trend. Coauthored by state Sens. Richard Pan, D-Sacramento, and Ben Allen, D-Redondo Beach, SB277 “will require all children entering kindergarten to be vaccinated unless a doctor certifies that a child has a medical condition, such as allergies, preventing it,” as the Los Angeles Daily News summarized the law.

Missing the mark

After submitting signatures gathered in the hopes of meeting the legal threshold of adequate public support, organizers behind the would-be measure discovered that their numbers had fallen short: “They turned in some 228,000 signatures on petitions for a referendum to overturn the measure, far short of the number needed to qualify it for next year’s ballot,” as the Los Angeles Times reported. “Referendum supporters needed the signatures of 365,880 registered voters by Monday to place the measure before state voters in November 2016.”

Efforts to meet the requirements were bedeviled by the shoestring character of the operation. “While the campaign deployed paid signature gatherers in the final stretch before the deadline, it was largely a volunteer effort,” according to the Sacramento Bee, “a tough task given that successful initiative campaigns typically cost millions of dollars.”

Citing internal documentation, the Bee noted that some California counties weren’t represented at all in the final tally. “Organizers in six counties did not submit any signatures by the deadline, according to an initial survey of raw data from the California secretary of state’s office. While the organizers’ spreadsheet contains estimates for large population centers like Orange County, Los Angeles County and Riverside County, they did not have an estimate for 16 counties in addition to the six the secretary of state said did not submit signatures,” the paper reported.

Raising allegations

But one of the foremost political figures behind the movement to restore the personal belief exemption to mandatory child vaccinations alleged that the signature-gathering effort had fallen victim to foul play. “The leading proponent of the effort, former Republican Assemblyman Tim Donnelly, said in an email Monday that volunteers were coerced and threatened while collecting signatures,” according to the Associated Press. “Donnelly did not return repeated messages inquiring about the effort’s chances but said in his email that he was proud of the volunteers who worked on the campaign ‘whatever the outcome is.'” Donnelly said the push “was sabotaged from without and within by powerful forces from its very inception, but we never gave up and we never gave in.”

Although Donnelly had gained notoriety of late as an outspoken gubernatorial candidate, his charges have yet to faze supporters of the stringent vaccination mandate. In remarks to KOVR Sacramento, Pan said he supported “the right to pursue a referendum,” according to the Daily News. But Pan also told reporters he was “sure the voters of California are not interested in letting a privileged few take away the rights of all Californians to be safe from preventable disease,” the AP noted.

Plan B

As the deadline for submitting signatures neared, some anti-vaccination activists created what could be a second opportunity to accomplish objectives similar to the hoped-for referendum. In a recent message posted to Facebook, the group announced that they had filed for a so-called Parental Rights Constitutional Amendment Initiative. “The measure was filed now in part because the filing fee for initiatives is going up Jan. 1 from $200 to $2,000,” the post said, according to the Los Angeles Times. “Supporters have six months to collect signatures for an initiative, far longer than 90 days provided for a referendum.”

Senate Bill 277 “requires almost all California schoolchildren to be fully vaccinated in order to attend public or private school, regardless of their parents’ personal or religious beliefs,” as the San Jose Mercury News reported.

“‘We are going to have a referendum to ask the public to put a hold on the law,’ said Palo Alto resident Christina Hildebrand, president and co-founder of A Voice For Choice. ‘We will continue to fight this — we are not going away,’ said the mother of two unvaccinated children.”

The prospect of a legal challenge was quickly downplayed by one of the bill’s coauthors, state Sen. Richard Pan, D-Sacramento. “The courts have been very clear that you don’t have a right to spread a communicable disease, that there’s a public interest in keeping our communities safe from disease,” he said, according to the Sacramento Bee.

So-called “herd immunity” has been hard to maintain in recent years in some parts of the state. As the Associated Press noted, “suburban areas have seen a decline in immunizations in the past decade, with some schools having immunization rates near 50 percent. Herd immunity for measles is between 92 and 94 percent, according to the U.S. Centers for Disease Control and Prevention.”

A tipping point

The new law made California’s inoculation rules among the nation’s strictest. Only Mississippi and West Virginia also bar religious and personal exemptions while maintaining a narrow allowance for medical excuses. (“Unvaccinated children without a medical exemption would have to be home-schooled or study in small, private homeschooling groups,” Reuters noted.)

But as is often the case with California, the state’s about-face on vaccines was set upon by critics and supporters as a potential bellwether and momentum-shifter for similar regulations across the country.

Capturing an emerging consensus in the realm of health policy, Wired characterized the situation as a “historical inflection point.”

“If public health researchers and politicians can look carefully at the state of the state’s vaccination rates and disease numbers before and after SB277 is enacted, they’ll get a powerful tool to either support more bans of these exemptions — several of which are on the table in other states right now — or drive the United States toward different, perhaps more effective strategies to reduce vaccine-preventable disease.”

Pan himself lent his support to the idea that other states should follow where he has led California. “Asked if he thought California’s action would spark similar changes in other states, Pan said Brown’s swift action on the bill will send a ‘strong signal’ across the country,” reported the Mercury News. “Neither California nor any other state ‘wants to continue to see [outbreaks] happen in their neighborhoods,’ Pan said.”

A reversal for Brown

Supporters of California’s now-obsolete exemptions had put faith in Gov. Brown, who ensured not long ago that Golden State parents could claim a religious objection to vaccinating their children. “Brown’s decision to sign the bill marks an about-face for the former seminarian who three years ago opposed eliminating the religious exemption for school vaccines,” Reuters observed.

In 2012, signing prior legislation “requiring parents to consult a health professional before declining vaccinations for their schoolchildren,” Brown set up a special carve-out for those claiming an exemption on account of religious beliefs.

“In his signing statement Tuesday, the Democratic governor noted that the bill exempts children whose family medical histories lead a physician to recommend against immunization,” according to the Sacramento Bee. “But unlike in 2012, the former Jesuit seminarian said nothing about religion.”

Sweeping changes

As CalWatchdog.com previously reported, state Sens. Richard Pan, D-Sacramento, and Ben Allen, D-Santa Monica, had to rewrite key passages of the bill’s language in order to head off potential constitutional challenges to its treatment of kids without the specified vaccinations.

The bulk of the original bill remained intact, however, sweeping away California’s longstanding and generous rules permitting parents to keep their children vaccine-free. “Several Republican senators tried to stall the bill by introducing a series of amendments that would have reinserted the religious exemption and required labeling of vaccine ingredients,” according to the Sacramento Bee. But Democrats moved swiftly to shut them down.

For some critics, barring unvaccinated children from public school remained a bone of contention. “It’s clear that a large portion of concerned parents will likely withhold their children from public schools because of their concerns or lack of comfort from the vaccination process,” said GOP state Sen. John Moorlach, according to the Christian Science Monitor.

But some carveouts were set to remain. “The legislation only addresses families that will soon enroll their children in school,” as Newsweek observed. “Under the proposed law, children who aren’t currently immunized are not required to get vaccinated until seventh grade. The law still allows families to opt out due to medical reasons, such as a history of allergies to vaccines and inherited or acquired immune disorders or deficiencies.”

The so-called grandfather clause represented a major concession to parents’ groups, which had succeeded in stalling Pan and Allen’s legislation once before. Now, as the San Jose Mercury News reported, “more than 13,000 children who have had no vaccinations by first grade won’t have to get their shots until they enter seventh grade. And nearly 10,000 seventh-graders who today aren’t fully vaccinated may be able to avoid future shots because the state does not always require them after that grade.”

Regulatory momentum

Despite the lenience built into the advancing legislation, the pro-vaccine logic that propelled it has already increased momentum for an even more assertive approach to enforcing inoculation.

As KQED News has noted, “two other vaccine-related bills are making their way through the Legislature a bit more quietly. One would require preschool and child care workers to have certain vaccinations; another seeks to improve vaccination rates for 2-year-olds.”

“If SB792 becomes law, California will be the first state in the country to require that all preschool and child care workers be immunized against measles, pertussis and the flu.”

Supporters of the ratcheted-up regulation sought to head off more controversy by downplaying the invasiveness and inconvenience of their approach. “We certainly aren’t out to arrest people who aren’t vaccinated,” said Kat DeBurgh, executive director of the Health Officers Association of California, a group that sponsored SB792. “We wanted to make this just like any other violation of code that an inspector would look for. If you don’t remediate, then there is a fine to the day care center.”

At the same time, pro-vaccination analysts have speculated that the Golden State will save money the more it ensures vaccination. Referring to a recent study showing that Iowa’s health care spending would double if it added a personal belief exemption, Tara Haelle suggested that California’s “health care cost savings would be far more substantial” once its exemption was eliminated, although, she conceded, “no thorough analyses are currently available.”

“In requiring vaccinations as a prerequisite for enrolling children in school, detractors said, the bill would legalize institutional discrimination,” the Sacramento Bee reported.

According to the Associated Press, some lawmakers warned “it could unconstitutionally create a second-class by depriving unvaccinated children of an adequate education.”

Fierce opposition

Bipartisan support for Senate Bill 277, which would scrap the Golden State’s personal belief exemption and require immunization for school admittance, has remained strong. But although the Senate Health Committee recently cleared the bill in a 6-2 vote, the addition of the discrimination objection gave new force to opposition leveled by anti-vaccination parents and groups.

As a result, SB277 has stalled, only to return once legislators are convinced that the new questions have been conclusively answered.

State Senator Richard Pan

The bill’s sponsors, state Sens. Richard Pan, D-Sacramento, and Ben Allen, D-Santa Monica, have weathered criticism before. As CalWatchdog.com noted previously, party affiliations have been a poor guide to how Californians have responded to the vaccination controversy: Some Republicans have strongly supported tightening exemptions, while others haven’t, and Democrats have ranged from supporting the status quo to advocating an end to all exemptions.

But in recent weeks, the two Senate Democrats have faced a barrage of criticism from parents and activists able to fight the bill’s progress in public. This week, Pan and Allen took to the editorial page of the Fresno Bee to defend SB277.

“We respect the very personal decisions that parents have to make for their children,” they wrote. “But all children deserve to be safe at school, and the personal belief exemption is now endangering the

State Senator Ben Allen

public. Senate Bill 277 will not remove a parent’s choice to vaccinate his or her child. However, choice brings with it responsibility, and under the measure, parents who decide not to vaccinate will have to home-school their children.”

Parental threats

As the San Jose Mercury News observed, SB277 began to take fire from objectors who threatened to deprive schools of enrollment money:

“Parents like San Jose resident Elaine Shtein are being encouraged to bring a son or daughter to stand with them before the eight-member Senate Education Committee on Wednesday with a warning: If the bill passes, they pledge to yank their children out of public and private schools, and home-school them, something they believe will deprive both the state and private school systems of money for every student enrolled.”

According to the Mercury News, education analysts suspected that the impact on school budgets would be relatively marginal. But regardless of how little money schools lose, the prospect of a constitutional challenge to SB277 was enough to spook lawmakers into sending Pan and Allen back to the drawing board.

A “smarter approach”

Although Pan and Allen proceeded with some care in crafting a simple but focused bill, they nevertheless failed to anticipate the level of difficulty they faced in legislating tighter vaccination rules. Pro-vaccination critics warned that Sacramento’s strategy has ineptly fostered a legislative environment, turning each committee hearing on the elimination of the personal belief exemption into a media opportunity for absolutist anti-vaccine groups.

“A smarter approach would be to retain a narrow personal belief exemption in states that already have one and avoid the kind of polarizing fight that California is now having,” wrote Brendan Nyhan at the New York Times. “These states could tighten exemption rules as experts recommend to more appropriately strike the balance between parental choice and the health needs of the community. Given the potential risks that unvaccinated children pose to the community, the process of obtaining an exemption can be rigorous and demanding.”

But a new investigation suggests which parents are actually more likely to seek vaccination waivers for their kids.

The scientists, technologists, and engineers who populate Silicon Valley and the California Bay Area deserve their reputation as innovators, building entire new economies on the strength of brains and imagination. But some of these people don’t seem to be vaccinating their children.

A Wired investigation shows that some children attending day care facilities affiliated with prominent Silicon Valley companies have not been completely vaccinated against preventable infectious diseases. At least, that’s according to a giant database from the California Department of Public Health, which tracks the vaccination rates at day care facilities and preschools in the state. We selected more than 20 large technology and health companies in the Bay Area and researched their day care offerings. Of 12 day care facilities affiliated with tech companies, six — that’s half — have below-average vaccination rates, according to the state’s data.

And those six have a level of measles vaccination that does not provide the “herd immunity” critical to the spread of the disease. Now, this data has limitations — most critically, it might not be current. But it also suggests an incursion of anti-science, anti-vaccine thinking in one of the smartest regions on Earth.

But before you reach any broad conclusions, watch out. People who understand math will see a flaw that makes the Wired report open to questions about overkill and exaggeration. Consider this sentence:

Of 12 day care facilities affiliated with tech companies, six — that’s half — have below-average vaccination rates, according to the state’s data.

So if you have 12 day-care facilities, how many would one logically expect to have below-average rates? That would be six — six below average, six above average.

Are vaccination rates awful at some tech firms’ day-care center? Wired makes that case about the facility run by iconic Pixar. But based on the numbers the magazine cites, its broader indictment of Silicon Valley doesn’t appear to hold up.

A 2012 law, designed to keep children vaccinated, forced parents seeking exceptions to receive counseling and a signature from doctors or other health care professionals. But a carve-out applied by Gov. Jerry Brown allowed those with an objection rooted in personal beliefs to skirt the regulation.

The so-called “anti-vax” movement, which has attracted the attention of politicians since the past decade, has developed largely in response to concerns that the ingredients of many popular vaccines could contribute to autism.

Over the years, officeholders from New Jersey Gov. Chris Christie to President Barack Obama have weighed in, sometimes tentatively, on the debate. Now events in California have sharpened battle lines and made opposing sides more strident.

Dangerous trends

Although California’s initially small population of unvaccinated or more slowly vaccinated children escaped the notice of regulators and activists, a recent increase to more sizable numbers has raised eyebrows and alarms. “State records show more than 13,000 kindergartners in California are unvaccinated because of either personal or religious beliefs,” the San Jose Mercury News reported, with under half without vaccination at some private schools. Thousands more children in other grades, the paper concluded, had also skipped vaccines.

These trends were visible as early as the onset of the previous school year. In September, the Los Angeles Times reported that “parents are deciding against vaccinating their kindergarten-age children at twice the rate they did seven years ago, a fact public health experts said is contributing to the reemergence of measles across the state and may lead to outbreaks of other serious diseases.”

According to state data cited by the Times, the percentage of kindergartens with at least 8 in 100 unvaccinated children had more than doubled over the same time period. The Times observed the 8 percent threshold “is significant because communities must be immunized at a high rate to avoid widespread disease outbreaks. It is a concept known as herd immunity, and for measles and whooping cough at least 92 percent of kids need to be immune, experts say.”

But in a recent follow-up report, the Times noted that vaccination rates had actually climbed in 2014, “Statewide, the rate of vaccine waivers for kindergartners entering school in the fall declined to 2.5 percent in 2014 from 3.1 percent in 2013. Bigger declines were seen in districts with some of the larger vaccine exemption rates.”

Culture war politics

For activists and analysts weighing in on the trends, however, last year’s dip in waivers isn’t enough to bring calm to the cultural storm. The “anti-vax” movement has attracted strong critics on the political right and left, each of which recognizes familiar stereotypes of their cultural opponents among the country’s vaccine rejectors. For conservatives, self-entitled upper-middle-class hipster parents are to blame; for liberals, scorn is directed at what they consider superstitious anti-science Christians.

As for medical professionals themselves, worry has centered around the elevated risk of outbreak for serious, painful diseases. Steven Salzberg, a biomedical engineer at Johns Hopkins, issued a typical warning several years ago concerning the spread of whooping cough. His frustration this year reflects a broad consensus among doctors that at least some vaccines are essential:

“Most of the anti-vax crowd have no scientific training or expertise, which might explain (but doesn’t excuse) their complete ignorance of the science. Over the past 15 years, dozens of studies involving hundreds of thousands of people have shown convincingly that neither vaccines nor any of the ingredients in them are linked to autism. Vaccines are not only safe, but they are perhaps the greatest public health success in the history of civilization.”

If pressure for increased regulation builds, “vaxxers” and “anti-vaxxers” may well be obliged to negotiate, with some vaccines becoming mandatory and others being regulated according to more or less restrictive timetables.

But on both sides, the appetite for compromise is weak. In one quote making the rounds in the media, a mother unwilling to let her child get a measles inoculation told the New York Times she’d rather her daughter “miss an entire semester” than receive one shot.