Senator Pan presenting Senate Bill 277 in Senate Health Committee.

"Vaccines are so effective that parents, and even many younger physicians, have never seen many vaccine preventable diseases. This lack of personal experience with these diseases has created opportunities for anti-vax charlatans to spread misinformation and create anxiety and doubt about vaccines for their own personal gain." –Sen. Richard Pan, M.D.

As a physician, I have witnessed first-hand how vaccines protect our children and communities from dangerous diseases. I attended medical school at the University of Pittsburgh, where I learned microbiology from Julius Younger, Sc.D., who worked with Jonas Salk, M.D., to develop the first successful polio vaccine. I never expected to see measles, but in 1991, in a Philadelphia clinic, I witnessed an outbreak that infected over 900 people and killed nine children. In the meantime, widespread use of the Hib (Haemophilus influenzae type b) vaccine began while I attended medical school, and during my residency, I only saw one case of invasive Hib, a disease that previously filled pediatric ICUs.

Vaccines are so effective that parents, and even many younger physicians, have never seen many vaccine preventable diseases. This lack of personal experience with these diseases has created opportunities for anti-vax charlatans to spread misinformation and create anxiety and doubt about vaccines for their own personal gain.

Years of vaccine hesitancy, fueled by a fraudulent study linking vaccines with autism, have taken a toll on the community immunity needed to keep diseases at bay. In 2000, only 0.77 percent of California kindergartners had personal belief exemptions on file. By 2013, that percentage more than quadrupled to 3.15 percent statewide. In some places in the state, vaccination rates dipped below 70 or 80 percent.

As community immunity eroded, preventable diseases returned—with dangerous consequences. In 2010, there were 9,120 cases of pertussis reported in California—more than any year since 1947, and 10 babies died in that outbreak. Measles infections nationally rose from 37 infections in 2004 to 644 in 2014. Then, in 2015, a measles outbreak began at Disneyland, infecting 147 people and hospitalizing at least 20 people.

Parents demanded action to keep their children safe, and thanks to the advocacy of Vaccinate California, Senator Ben Allen and I authored and passed SB 277, which eliminated non-medical exemptions to school vaccination requirements. In the first year of implementation, vaccination rates among kindergarteners rose to levels not seen in a decade and a half. Kindergarten students receiving required vaccines rose from 93 percent in the 2015-16 school year to 96 percent in 2016-17. However, many older children who previously received exemptions remain unvaccinated, and an entire generation of young people—referred to as the “Wakefield generation,” after the discredited anti-vax researcher—remain vulnerable and can accelerate the spread of future outbreaks.

While laws like SB 277 have a tremendous impact on vaccination rates, continued success requires physicians to educate our patients about the benefits of vaccines and the dangers of the diseases they prevent. Vaccine misinformation continues to be spread by social media, videos and books. Even the President has given credibility to vaccine myths and welcomed anti-vax quacks. Fake news sites such as Natural News, InfoWars and Mercola.com spread anti-science conspiracy theories and attack science advocates like Paul Offit, M.D. But this misinformation can be overcome by physicians who build trust with their patients and families, listen carefully to their concerns, and speak with confidence about the efficacy and safety of vaccination.

As a pediatrician, I learned the science of vaccines; but while passing vaccine legislation, I also learned the myths of anti-vaxxers. Anti-vax charlatans promote parental anxiety about vaccines so parents are more susceptible to the marketing of alternative products they’re selling. These frauds sow distrust of physicians and science and downplay the dangers of disease. Some misinformed parents even say they’d prefer their children get infected with polio, measles, pertussis and chicken pox than to be vaccinated.

Fortunately, a large majority of parents listen to our advice and support vaccination. However, even if only a few percent of parents don't vaccinate their children, community immunity is compromised for the entire community. Thus, physicians and our public health and education partners must reach out to parents and counsel them about the truth of vaccine-preventable diseases. Physicians should not wait until a baby’s first visit to discuss vaccines, but should begin the discussion while parents are planning a pregnancy or during pregnancy. Too often, parents begin searching the internet for information on vaccines—where anti-vax misinformation is rampant and paid to be at the top of search engines. We need to reach parents early to answer their questions and allay their anxieties.

Thanks to a strong partnership between parents and physicians, SB 277 passed in California and our children are safer for it. Many of our most vulnerable children, including very young infants and children who have cancer, transplants, or immune conditions, cannot be vaccinated, and they depend on community immunity from vaccinated people. As physicians, we need to maintain the political will to sustain California’s vaccination laws through our vigorous efforts to teach all parents about the efficacy and safety of vaccines and the dangers of the diseases they prevent.

Richard Pan, M.D., MPH, FAAP, is a pediatrician and State Senator representing Senate District 6 (D-Sacramento). He has been a member of the California Medical Association and the Sierra Sacramento Valley Medical Society since 1999.