About a third of medical vaccine exemptions in San Diego came from one doctor

Enlarge / A nurse prepares to administer the measles, mumps, and rubella (MMR) vaccine as well as a vaccine used to help prevent the diseases of diphtheria, pertussis, tetanus, and polio at Children's Primary Care Clinic in Minneapolis, MN. (credit: Getty | The Washington Post)

A single San Diego doctor wrote nearly a third of the area’s medical vaccination exemptions since 2015, according to an investigation by the local nonprofit news organization Voice of San Diego.

The revelation follows growing concern that anti-vaccine parents are flocking to doctors willing to write dubious medical exemptions to circumvent the state’s vaccination requirements. Since California banned exemptions based on personal beliefs in 2015, medical exemptions have tripled in the state. The rise has led some areas to have vaccination rates below the levels necessary to curb the spread of vaccine-preventable illnesses. Moreover, it signals a worrying trend for other states working to crack down on exemptions and thwart outbreaks of vaccine-preventable diseases. There are currently six outbreaks of measles across the country.

Medical vaccination exemptions are intended for the relatively few people who have medical conditions that prevent them from receiving vaccines safely. That includes people who are on long-term immunosuppressive therapy or those who are immunocompromised, such as those with HIV or those who have had severe, life-threatening allergic reactions (e.g. anaphylaxis) to previous immunizations. Such patients typically receive medical exemptions incidentally during their medical care. But some doctors are providing evaluations specifically to determine if a patient qualifies for an exemption and granting exemptions using criteria not based on medical evidence. Some doctors are even charging fees for these questionable exemption evaluations—including the doctor in San Diego, Tara Zandvliet.