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Parents and children take part in a press conference opposing the vaccination requirement bill SB277 on Monday, June 22, 2015, in Berkeley, Calif. (Aric Crabb/Bay Area News Group)
Parents and children take part in a press conference opposing the vaccination requirement bill SB277 on Monday, June 22, 2015, in Berkeley, Calif. (Aric Crabb/Bay Area News Group)
Cat Ferguson,reporter covering the intersection of health and tech for the Bay Area News Group. (Laura A. Oda/Bay Area News Group)
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Ramping up the pressure in a statewide battle over medical exemptions for student vaccinations, San Francisco City Attorney’s Office has issued a subpoena to Dr. Kenneth Stoller, a vocal opponent of mandatory vaccines. The city is requesting medical and billing records related to every medical exemption he’s written since 2016.

The unusual move comes as tensions rise over vaccination requirements during the worst measles outbreak in the United States in nearly two decades.

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In 2015, California passed Senate Bill 277, which outlawed so-called personal belief exemptions for student vaccination requirements. Any licensed physician is still allowed to write exemptions for legitimate medical concerns.

Such medical exemptions have increased significantly since SB 277. State Sen. Richard Pan, D-Sacramento, who wrote the 2015 law, and public health experts believe some doctors are selling exemptions, whether kids need them or not.

San Francisco City Attorney Dennis Herrera’s office is looking for evidence Stoller violated nuisance laws by writing unnecessary exemptions for students who don’t need them, according to the subpoena.

“You have to have a legitimate medical condition to exempt a child from getting vaccinated,” Herrera said. “Whenever we believe someone might be violating the law and putting the broader community at risk, we take action.”

Stoller’s attorney, Rick Jaffe, declined to say exactly how many exemptions his client has written but insisted he isn’t abusing the law.

“I don’t know the exact number – dozens or hundreds. It’s quite a few,” he said. While many of Stoller’s patients come to him after other doctors reject their requests for exemptions, “he does screen people out. You can’t get an exemption just because you have a personal belief,” Jaffe said.

The CDC has issued guidance about who should not get different vaccines. Most of the suggestions focus on severe allergies to vaccine ingredients, weakened immune systems, or a family history of immunodeficiency. Stoller has said in past interviews that he believes exemptions should apply for much broader reasons.

While some medical experts express alarm over the rise in vaccine exemptions, doctors have wide latitude under SB 277 on what they determine is a valid medical reason.

“Physicians do have to specify the condition, but it’s up to their discretion,” said Dorit Reiss, professor of law at UC Hastings, who studies vaccine policy. “The schools cannot reject a medical exemption.”

Pan has said medical exemptions for vaccines have more than tripled since the law went into effect. While he finds that alarming, medical exemptions still account for less than 1 percent of California’s school pupils.

Pan has written a followup bill, SB 276, which would give final say over individual exemptions to the California Department of Public Health.

In April, Stoller signed a joint letter opposing the proposed law. The letter claims that “research robustly explores the connection between” vaccines and autoimmune, psychiatric and developmental disorders. The FDA, CDC, World Health Organization, American Medical Association and other major medical bodies around the world have all determined there is overwhelming evidence of the safety and efficacy of vaccines.

Shortly after the personal-belief exemption ban, a Facebook group called Stop Mandatory Vaccination posted that Stoller would evaluate children for medical exemptions. “He fought against SB277. He is in the San Francisco Bay area and he can take initial Skype appointments,” the post said.

Several Google reviews for Stoller mention vaccines, including one a year ago thanking him for writing an exemption for “valid health reasons” after the family was unable to get a philosophical exemption.

“I think Dr. Stoller is a true believer” that vaccines can be dangerous, said Reiss, who has studied anti-vaccine efforts on the internet, including Stoller’s web presence. “That doesn’t mean he’s not profiting off this.”