In the midst of a fierce legislative battle over student immunization requirements, a Bay Area News Group investigation found a who’s-who of ‘‘vaccine choice’’ doctors signed the bulk of the 180 vaccine exemptions on file at eight local school districts, with five doctors accounting for more than half.
The exemption practices of three doctors in the records have already come under investigation by California authorities, and many are on lists of “vaccine-flexible” pediatricians circulated online by anti-vaccine parents. Three exemptions were signed by a doctor in New Jersey, and a fourth by one in Florida.
The findings come as vaccine proponents are pushing new legislation to stop doctors from writing bogus medical exemptions as California works to increase vaccination rates at schools in the face of a recent measles outbreak.
“It only takes a small number of physicians to do a lot of damage,” said Sen. Richard Pan, D-Sacramento, who is also a medical doctor. “We need to make sure the medical board is looking into whether these doctors are posing a risk to public health.”
But some of the doctors signing exemptions sharply dispute Pan’s allegation, saying such aggressive scrutiny is imperiling doctors’ ability to make the right choices for their patients and terrifying the vast majority of physicians from even considering vaccine exemptions.
The California Assembly Health Committee is holding hearings Thursday on legislation that Pan is sponsoring, Senate Bill 276, which would give the state significant oversight over student medical exemptions.
Every one would be entered into a database, allowing public health officials to flag signs of bad behavior. The bill would also require doctors who haven’t been seeing the child for a year to either be the primary care provider or notify that doctor of the exemption.
“This is why we need SB 276,” Pan said when presented with the findings of the Bay Area News Group’s analysis. “We’ll have the information to not only protect public health, but the individual kids who need medical exemptions.”
In total, this news agency sent records requests to 31 Bay Area school districts with schools that reported three or more medical exemptions last year, asking for dates and doctor names on exemptions filed since 2015, when a bill from Pan banned exemptions based on a family’s personal beliefs. This news organization did not request any identifying student information.
While many school districts denied the requests, arguing privacy concerns, eight – Albany Unified, Antioch Unified, Alameda Unified, Brentwood Union, Ross Valley Charter, Livermore Valley Joint Unified, Los Gatos Union and Morgan Hill Unified – released names of doctors who had signed exemptions.
Dr. Paul Kenneth Stoller of San Francisco was the only one to appear in every district’s records, signing 38 exemptions in total. His exemption-related medical records were recently subpoenaed by San Francisco City Attorney Dennis Herrera who is investigating whether Stoller violated nuisance laws by writing unnecessary exemptions for students who don’t need them. Last month, GoFundMe took down a campaign set up to help with his legal defense because it violated a policy against promoting vaccine misinformation, according to a spokesperson for the site.
Dr. Ron Kennedy of Santa Rosa signed 11 records found in the news organization’s survey, including at least five of them after the Medical Board of California opened an investigation into his exemption practices in January 2018. Last week, the San Francisco Superior Court denied his appeal to block the medical board from accessing relevant student records.
Dr. Robert Sears of Orange County appeared on two exemptions, one signed after he was placed on probation by the medical board for exempting a 2-year-old without taking a medical history.
SB 276 would bar doctors from writing new exemptions while under board investigation.
Originally, the proposed legislation called for a state public health department review of every exemption. A number of public figures, including actress Jessica Biel, criticized the measure for government overreach.
Gov. Gavin Newsom, too, expressed concern about the state getting between doctors and patients. But his office said Tuesday he would support a new version of the bill limiting state review to schools with dangerously low vaccination rates and doctors who sign more than five exemptions in a year. In 180 records reviewed by this newspaper – a fraction of the more than 4,000 California students with medical exemptions – four doctors met that standard.
Dorit Reiss, professor of Law at UC Hastings College of the Law, believes the amendments present a reasonable compromise between public safety and medical freedom. Alongside limits on review, changes also included new protections against inappropriate practices. Doctors, for instance, would have to examine children before signing exemptions, which the current law doesn’t require.
“At the time it was passed, there was no need. They didn’t anticipate the level of abuse,” Reiss said. “The new law adds safeguards that can balance that.”
Medical experts and regulatory bodies all generally agree children with compromised immune systems, allergies to vaccine components or histories of serious reactions should delay or avoid some or all vaccines. But many exemptions reviewed by this news organization gave reasons well outside that consensus, like ear infections or a family history of autism.
“Most people who have asked their primary care providers for exemptions are turned down out of hand. Most docs won’t even have a conversation,” Lonna Larsh, a Santa Cruz doctor who signed eight exemptions in the survey, told this news organization in a text message.
Three school districts had records of exemptions by Larsh: Los Gatos Union, Livermore Valley Joint Unified, and Morgan Hill Unified. Amber Weiss, Larsh’s physician’s assistant and a licensed homeopath, does an initial exemption consultation by phone, which costs $135.
Larsh said she reviews records and meets with patients in person before signing off. A form on her site requires parents looking for exemptions to hold the practice harmless if their kids get sick.
“There are only a few physicians around the state writing exemptions,” Stoller’s attorney, Rick Jaffe, said. “Most people think people are getting these vaccine exemptions simply because they’re philosophically opposed, but especially with Stoller’s patients, I haven’t seen that. The parents who have called me up, every single one of them is a vaccine-injured family.”
Sabina Sonneman of Redwood City signed 14 exemptions, the third-largest number in the news organization’s survey. She has been included on several lists of vaccine-flexible doctors that have circulated online in recent years. Sonneman, Kennedy and Sears did not respond to requests for comment.
Tiffany Baer, a medical adviser for Physicians for Informed Consent, an organization that opposes vaccine mandates, was the second most prolific doctor in the survey, with 24 exemptions. On her website, Baer has a nine-page form for parents looking for medical exemptions. It requests extensive medical information, including any diseases or learning problems that arose soon after a child or family member received a vaccine.
“I protect children,” Baer said in a phone interview Wednesday night. “I spend my life trying to help people, trying to protect my patients. I do everything by the book. This is doctor bashing — bashing the good doctors. The ones who (Senator) Pan wants to call bad apples, they’re the good doctors.”
Baer practices at Raphael Medicine and Therapies near Sacramento. Her partner there, Mary Kelly Sutton, has long been an opponent of student vaccine requirements; her $97 webinar, “From Cornered to Confident: How to Safely Navigate California’s Vaccine Mandate Law,” is advertised on the site.
A form email received after this reporter signed up for Sutton’s mailing list said the webinar taught parents “how to ask for a medical exemption for my child if I want one!” She did not respond to requests for comment.
Larsh, though, said she wasn’t interested in growing her vaccine exemption patient roster.
“I don’t want to be written about primarily because I don’t want a large influx of people asking me for exemptions,” she wrote in a text. “It is not really my area of interest and it is already taking up more time than I’m happy with.”
