RUTHFULLY YOURS

“I think the parent knows best, and the parent is going to live with the outcome,” she said in an interview with The Wall Street Journal. She is awaiting discipline by the board after a judge recommended her license be revoked. “I’m warning my patients to have a Plan B.”

California on Oct. 1 became the first state to require all eligible school students to get a Covid-19 vaccine after one is fully approved for their age group to attend school in person.

The use of medical exemptions by states is a longtime practice to excuse students for medical reasons from taking one or more vaccines, including measles, polio and tetanus. They can be temporary or permanent exemptions and last the duration of a child’s schooling. The Covid-19 vaccine is the latest one required in California.

Medical exemptions in California have recently increased, quadrupling over a four-year span through 2019-20 for kindergarten students, the entry grade tracked by the state and federal government, despite population size decreasing. That rate far outpaces national figures that have been flat in the same period, according to federal data.

At the same time, the state is disciplining more doctors over their exemptions, which in most cases excused children from all vaccines, a review of state medical data found.

California follows federal guidelines in determining acceptable medical exemptions, which include having a severe reaction to a previous dose or a condition that increases the risk for serious reactions. In 2016, the state stopped allowing exemptions for personal beliefs, leaving only the medical exception.

Some parents call the Covid-19 mandate the last straw in a state pushing vaccinations for children and are hunting for sympathetic doctors to write exemptions, looking at home schooling or even relocating.

The Centers for Disease Control and Prevention last week recommended the Covid-19 shot for children 5 to 11, increasing tensions for parents opposed to the mandate. It is under emergency authorized use, seen as a step toward full approval.

Kristal Flores had grown tired of fighting to keep her two children—10 and 16—exempt from school-required vaccines in California, and the new state requirement put her over the edge.

“I told myself it’s time to go,” said Ms. Flores, who moved to Arizona last month and says she is antivaccine. Pushing her over was that her oldest’s medical exemption was being revoked because the doctor who granted it got disciplined, she said.

The doctor was sanctioned by the medical board for improper exemptions, the Journal found.

Ms. Flores said that the doctor based her childrens’ exemptions on previous vaccine reactions and family medical history, and she sought him out after her children’s pediatrician turned them down. She said that she paid about $100 out-of-pocket as the doctor didn’t take insurance.

California medical boards have disciplined 12 doctors since 2020 for issuing unjustified exemptions for school-required vaccines and have cases pending against six others—a huge leap from the single doctor disciplined over the issue between 2016 and 2019, the Journal found. Punishments have ranged from a public letter of reprimand to loss of a medical license.

Data provided by the San Diego Unified School District shows the impact of a few doctors: 13 of the doctors disciplined over medical exemptions, or with cases pending, account for 25% of 885 exemptions in the district from July 2015 to Sept. 2021, according to a Journal analysis.

The Golden State provides a window into the complexities of addressing a health emergency, while balancing government reach and personal rights. Experts say that the Covid-19 vaccine will likely become a required one for schools in other states after it is fully approved for all school-age groups and in wider use by them.

California’s Covid-19 vaccine requirement is being implemented by grade span, expected to first apply to students in grades 7 through 12 in July next year.

California State Sen. Richard Pan, a Sacramento Democrat and pediatrician, has authored bills in recent years to cut down on the use of exemptions—something which he said has led to people threatening and stalking him. As for the Covid-19 vaccine, he said children not vaccinated endanger other children and their families.

This year, as part of an effort to end unjustified exemptions, all new medical exemptions go through a state registry, with those in certain instances getting reviewed, such as doctors writing more than five a year.

State law now also requires that medical exemptions issued before Jan. 1, 2020 by any doctors who have been disciplined be revoked. About 9,000 of the state’s 145,000-plus licensed doctors had disciplinary records in March, state information shows.

Parents can appeal a voided exemption to the state health and human services agency.

Dr. Sutton said about 1,000 of her medical exemptions could be revoked.

Medical exemptions for kindergarten students jumped in California from 993 in the 2015-16 school year to 4,249 in 2019-20, despite a population drop, the latest federal data shows. The increases began after the state ended the personal-belief exemption.

The Los Angeles Unified School District, the state’s largest, reported 3,009 medical exemptions so far this school year through Sept. 15 for all grades. It is on track to grow marginally from last school year’s full tally of 3,001. The district said it didn’t have information available to determine which doctors provided the exemptions.

The San Diego Unified School District, the state’s second largest, received about 80 medical exemptions in the 2015-16 school year, compared with about 250 issued last school year.

San Diego parent Lisa Ames is seeking an exemption for her 9-year-old, who she said is allergic to components of the flu shot and she doesn’t know how she would react to the Covid-19 vaccine. “They are using this vaccine that still needs to be studied,” she said, adding that she isn’t yet comfortable taking the vaccine herself.

Dr. Tara Zandvliet, who wrote the most exemptions in San Diego schools, at 149, said vaccine mandates take away a person’s ability to make their own decisions. “No one else should be able to decide what to do with your body. Only you,” said Dr. Zandvliet, adding that she isn’t against vaccines but doesn’t like mandates.

Dr. Zandvliet is on probation for negligence in a medical exemption case, is currently banned from writing exemptions and faces more allegations.

The CDC says vaccinations are essential to provide immunity before children are exposed to potentially life-threatening diseases. High rates of vaccination coverage also helps maintain low rates of vaccine-preventable diseases, the agency says.

Dr. Zandvliet said that hundreds of exemptions she provided for children in the state have been voided. She said that some who lost their exemptions are home schooling, opted to get vaccinated or left the state. She added that, “If they can get another doctor to write an exemption, great.”

The case against Dr. Sutton, a founding member of a nonprofit group of doctors and professionals who support voluntary vaccination, alleges she unjustly gave permanent exemptions for all required vaccines to eight children, and says she didn’t document vaccine reactions or underlying conditions as required.

Dr. Sutton, who has practiced for 50 years, said that she has provided proper treatment, which includes assessing family medical history. She said that she has given vaccines but is against mandates.

As Dr. Sutton awaits her fate, she has relocated to Rhode Island where she has a license to practice in Massachusetts. She said that she is issuing medical exemptions in the state—cautiously—along with her other medical offerings.

“I have to be careful,” she said. “I don’t want my medical license in Massachusetts to be put at risk.”