Some cash and a form: how some local parents got around the vaccination requirement

An Escalon clinic drew recent attention by offering medical exemptions to the state law that requires vaccinations for schoolchildren.

Dr. William Clark, medical director of Escalon Physical Medicine, regularly posts anti-vaccination material on his Facebook page. A staff member at the Escalon clinic said this week it no longer offers the service to parents seeking the medical exemptions. The waiver forms and process for arranging an office visit with Clark, costing $200, was recently taken down from the clinic’s website.

The service spurred debate on the clinic's Facebook page by people who favor immunizations and members of the so-called anti-vaxxer movement, who claim that common vaccinations harm children and may cause disabilities such as autism.

“It is bringing a lot of positive and negative attention that we don't want to deal with,” said John Bystrom, a chiropractor at Escalon Physical Medicine on Highway 120 at Fourth Street. “We decided to discontinue the service.”

New anti-vaccination posts on Clark's own Facebook page, which identifies him as medical director of the Escalon clinic, continued Tuesday. The headline for one post said all vaccines are contaminated and toxic.

A share text over a second item claimed an ingredient in the herbicide Roundup is found in vaccines. And a third post suggested that Russian President Vladimir Putin had exposed vaccines as an international conspiracy. Those opinions coming from a licensed physician diverge from the general opinion of the American Medical Association and numerous studies that conclude vaccines are safe.

A clinic employee said Wednesday that Clark was not interested in an interview. According to his Facebook page, Clark previously worked as an emergency medicine physician for hospitals in the area and worked for an addiction treatment facility.

Senate Bill 277, enacted after a multi-state measles outbreak in 2014, removed a legal exemption that allowed parents to opt out of mandated vaccinations for schoolchildren based on personal or religious beliefs. The bill was opposed by anti-vaxxer parents who said the state was denying education for children over their parents’ concerns about vaccines or a desire to spread out the shots for their kids.

The current law permits medical exemptions for parents of children who shouldn’t be vaccinated for legitimate health reasons.

Since SB 277 was enacted, the number of personal exemptions has dropped in California and medical exemptions have sharply increased. According to an annual state report, the number of kindergartners with a permanent medical exemption jumped from 931 in the 2015-16 school year to 2,850 in 2016-17.

Those with medical exemptions represented 1/2 percent of kindergartners in California. The numbers were reported by the Journal of the American Medical Association in a study released this week.

In the kindergarten assessment, the number of students statewide with a personal beliefs exemption fell from 13,086 or 2.4 percent in 2015-16 to 3,133 or a half percent in 2016-17. Some students have personal belief waivers that are grandfathered under the law.

Aurora Licudine, head of school nurses for Modesto City Schools, said that 15 of the 1,570 kindergartners in the local district, or less than 1 percent, had medical exemptions from vaccination requirements as of this week. Nineteen seventh graders or about 1 percent have medical exemptions.

The criteria for the exemption is a physical or medical condition that makes it unsafe to vaccinate the child, Licudine said. As an example, vaccination is not recommended for a child with leukemia who is undergoing chemotherapy. A child may be exempt if he or she had a previous reaction to a vaccine.

Licudine said a school nurse may call the doctor for clarification of an exemption, but exemptions that meet the criteria of the law must be accepted..

Licudine said she was aware of Dr. Clark but could not say if the district accepted any exemptions written by the physician. She recommended that families talk with their physician if they think they have a legitimate need for a waiver. “I advise them to go to their family care provider who knows the family best and the child the best,” she said.

A form previously posted by the Escalon clinic said parents seeking a vaccination waiver needed a primary care physician agreement with Clark.

Bystrom said some requests for exemptions at the Escalon clinic were declined and some were approved.

In Stanislaus County, the number of students entering kindergarten with all the required vaccinations was 96.5 percent in 2016-17, a 1.6 percent increase over 2015-16. The county rate was better than the 95.6 percent statewide.

There was one thing wrong with the county assessment, however. Only 82 percent of schools in Stanislaus County complied last year with a state requirement to report immunization rates to the state. That was the third lowest reporting percentage among counties in California.

San Joaquin County was among the 28 counties with 100 percent of schools reporting their vaccination numbers. Mariposa County was the worst at 14 percent, with one of seven schools reporting.

Fourteen of the 119 public schools in Stanislaus County did not report vaccination numbers to the state. Only six of 16 private schools filed the report. All of the schools in Modesto City Schools complied with the reporting requirement, Licudine said.

Dr. Julie Vaishampayan, who took over as public health officer for the county in May, said county staff members talked with the non-reporting schools and were most often told that staff turnover was to blame, though the county received push-back from a few schools. Some schools said the requirement to file the annual vaccination reports was forgotten as new employees were hired to fill vacancies.

The annual state report in April should tell if the county’s reporting rate has improved.

“We have pretty good vaccination rates in this county and parents who are interested in vaccinations to protect their children,” Vaishampayan said.

“It is well recognized that there are people who can’t be vaccinated,” she said. “But we have thorough studies showing these vaccinations are safe. They have been looked at over and over and over again. The vaccines are way safer than getting the disease.”

This story was originally published September 6, 2017 at 4:50 PM with the headline "Some cash and a form: how some local parents got around the vaccination requirement."