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Objectives. To understand the experiences of local health jurisdictions with Senate Bill 277 (SB277), the California law that eliminated nonmedical vaccine exemptions for public- and private-school entry. Methods. We conducted semistructured telephone interviews with health officers and local health department (LHD) staff in California between August and September 2017. Results. Two overall themes emerged: (1) vague legislative and regulatory language led to variation in the interpretation and implementation of SB277, and (2) lack of centralized review of medical exemptions allowed medical exemptions that are not consistent with valid contraindications for immunizations to be accepted. Variation in the interpretation and implementation was commonly reported with provisions related to individualized education programs and special education, and independent study programs and homeschooling. Without a centralized review of medical exemption requests, respondents reported variation in the interpretation of which specialties of physicians can write medical exemptions, which conditions constitute a valid contraindication for immunization, and the process for reporting a questionable or suspicious medical exemption. Conclusions. The regulatory language within SB277 led to variation in how the law was interpreted and implemented within and across LHD jurisdictions and school districts. [ABSTRACT FROM AUTHOR]

Recent measles and pertussis outbreaks in the US have focused national attention on state laws governing exemptions from mandatory vaccines for school entry. After several years of increases in nonmedical exemptions in California, the state assembly passed Assembly Bill 2109 in 2012, making nonmedical exemptions more difficult to obtain by requiring parents to obtain a signature from a health care provider. We used data from the California Department of Public Health to describe changes in the overall prevalence of personal belief exemptions and compositional changes in immunization status for the school years 2012–2013 through 2015–2016. Following the implementation of Assembly Bill 2109, the statewide exemption rate declined from 3.1% in 2013 to 2.5% in 2014 and then to 2.3% in 2015, representing a 25% reduction from the 2013 peak . Continued surveillance of exemption rates and vaccine refusal are needed to monitor and protect herd immunity against vaccine-preventable diseases. [ABSTRACT FROM AUTHOR]

The article discusses the impetus for Proposition 65 and provides an overview of its controversial features. It highlights the fundamental flaws of Prop 65 focusing on consumer product warnings and bounty hunter provisions that continue to persist notwithstanding recent legislative and regulatory efforts to address them. It refers to Proposition 65 as one initiatives on the ballot in the November 4, 1986 California general election where voters declared to protect themselves against chemicals.

Objectives. We examined the variability in the percentage of students with personal belief exemptions (PBEs) from mandatory vaccinations in California schools and communities according to income, education, race, and school characteristics. Methods. We used spatial lag models to analyze 2007-2013 PBE data from the California Department of Public Health. The analyses included school- and regional-level models, and separately examined the percentage of students with exemptions in 2013 and the change in percentages over time. Results. The percentage of students with PBEs doubled from 2007 to 2013, from 1.54% to 3.06%. Across all models, higher median household income and higher percentage of White race in the population, but not educational attainment, significantly predicted higher percentages of students with PBEs in 2013. Higher income, White population, and private school type significantly predicted greater increases in exemptions from 2007 to 2013, whereas higher educational attainment was associated with smaller increases. Conclusions. Personal belief exemptions are more common in areas with a higher percentage of White race and higher income. [ABSTRACT FROM AUTHOR]

Requiring immunization for school attendance greatly reduced morbidity and mortality in children over the past seven decades but is now highly controversial. This two-part exercise on the implementation of a 'personal belief' exemption allows students to examine constitutional questions as well as legislation and regulations as they affect public health and school officials. [ABSTRACT FROM AUTHOR]

Highlights: [•] Personal belief exemption rates in CA schools rose by 9.2%/year over 1994–2009, from 0.6% in 1994 to 2.3% in 2009. [•] Exemption rates increased faster among private schools than public schools. [•] Schools in rural areas had higher exemption rates than schools in urban areas. [•] Community-level demographics were associated with exemption rates. [ABSTRACT FROM AUTHOR]

Delamater and colleagues projected the percentage of California schoolchildren with a vaccination exemption under 3 scenarios: California law as it has stood since the 2015 passage of Senate Bill 277, which permits medical but not personal belief exemptions; the law as amended by Senate Bill 276, an attempt to tighten the circumstances for medical exemptions; and a hypothetical world in which neither law was implemented. The editorialist discusses the findings and proposes 5 provisions that laws narrowing vaccination exemptions should include. [ABSTRACT FROM AUTHOR]

Five nineteenth-century policies for alienating the federal public domain only partially fulfilled their objectives when applied in the arid setting of Owens Valley, California. The Homestead Law was most successful in advancing the family farm ideal, to judge by the persistence of small holdings several decades after land entry. Preemption claims, coincident in time and space with homesteading, were more often consolidated into larger farm units. The Desert Land Act, though designed to encourage irrigated farming in the arid West, tended to attract nonresident speculative entries on marginal lands, most of which were eventually consolidated into large grazing units. State Land Grants also contributed to large-scale holdings, whereas the Timber Culture Act, though used for entry in the 1880s, had little relevance to final settlement. Public land policies were generally adequate for settling the well-watered north end of Owens Valley, hut they were unsuccessful in reclaiming most of the irrigable lands of the vast arid stretches of the valley's southern townships. Federal land measures failed to account for the environmental diversity which prevails in the arid West and made no provision for the cooperative reclamation of desert lands. Unsound land alienation policies for the and public domain resulted in the urban use of Owens Valley's water resources. [ABSTRACT FROM AUTHOR]