The California Department of Public Health (CDPH) recently released a form that parents can use to comply with the new personal belief vaccination exemption rules. The new law, sponsored by the California Medical Association (CMA), requires a parent or guardian seeking a personal belief exemption from school immunization to first obtain a document signed by a licensed health care practitioner.

In the newly released form, the practitioner is asked to attest that the parent or guardian has been informed of the benefits and risks of the immunization, as well as the health risks of the diseases that a child could contract if left unvaccinated.

The legislation – AB 2109, authored by Sacramento pediatrician and Assemblyman Richard Pan, M.D. – was borne out of a rising concern over the continued increase in personal belief exemptions in California and recent outbreaks of diseases such as measles, mumps and pertussis (whooping cough). Exposure to these preventable diseases places the individual child at risk, as well as the entire community, including infants too young to be fully immunized and individuals with compromised immune systems.

In California, parents could previously exempt their child from all immunizations by simply signing a two-sentence standard exemption statement on the back of the California School Immunization Record or provide a separate written statement that proclaims they are exempting their child. No other information or explanation of reason was required. The law still allows the form to be signed, but after a parent has gained full understanding of the risks and benefits of vaccination from a licensed health care professional.

The form and other resources are available on the CDPH’s "Shots for School" website. CMA will be providing additional information for physicians on implementation of the form in the coming months.