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SB 792
Page 1
SENATE THIRD READING
SB 792 (Mendoza)
As Amended September 4, 2015
Majority vote
SENATE VOTE: 34-3
Committee
Votes
Ayes
Noes
Health
17-1
Bonta, Maienschein, Bonilla,
Burke, Chiu, Gomez, Gonzalez,
Roger Hernández, Lackey,
McCarty, Nazarian, Patterson,
Ridley-Thomas, Rodriguez,
Steinorth, Thurmond, Wood
Waldron
Human Services
6-1
Chu, Calderon, Lopez,
Maienschein, Mark Stone,
Thurmond
Mayes
Appropriations
16-1
Gomez, Bigelow, Bloom, Bonta,
Calderon, Chang, Gordon,
Eggman, Gallagher,
Eduardo Garcia, Holden, Quirk,
Rendon, Wagner, Weber, Wood
Jones
SUMMARY: Requires day care workers or volunteers to be vaccinated for specified infectious
diseases as a condition of participation. Specifically, this bill:
1) Prohibits, after September 1, 2016, a day care center or a family day care home from
employing any person, or allowing any person to volunteer, who has not been immunized
against measles, pertussis, and influenza (flu).
2) Specifies circumstances under which a person would be exempt from the immunization
requirement based on medical safety, current immunity, or, for flu vaccine, timing of hire or
employee declination.
3) Permits a person to be employed or volunteer conditionally for 30 days after submitting a
written statement attesting that they have been immunized as required, but need additional
time to obtain and provide their records.
4) Requires any person hired or volunteering as a teacher in a day care center to present
evidence of a current tuberculosis clearance, as specified.
FISCAL EFFECT: According to the Assembly Appropriations Committee, costs to
Department of Social Services, which licenses child care facilities, are expected to be minor and
absorbable.
COMMENTS: According to the author, children in day care settings have close, intimate
contact with each other and with the staff who work there. Many of these children are too young
to be fully immunized against potentially serious communicable diseases. Children who are too
young to be vaccinated rely on those around them to be immunized to prevent the spread of
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disease. The author states that this bill will protect children in day care by requiring those who
care for them to maintain immunity.
Public health experts agree that vaccines represent one of the greatest achievements of science
and medicine in the battle against disease. Vaccines are responsible for the control of many
infectious diseases that were once common around the world, including polio, measles,
diphtheria, pertussis, rubella, mumps, tetanus, and Hib meningitis. Vaccines helped to eradicate
smallpox, one of the most devastating diseases in history. Over the years, vaccines have
prevented countless cases of infectious diseases and saved literally millions of lives.
Some diseases, such as the flu, cause only a relative inconvenience to healthy adults. However,
this same disease can require hospitalization and be potentially fatal for infants or individuals
with suppressed immune systems. Importantly, many vaccines require multiple doses before a
child is protected against the disease, and children in day care settings are often too young to
complete the recommended series of vaccinations.
1) Pertussis is a highly contagious bacterial disease that can be spread by coughing. People
with pertussis have severe coughing attacks that can last for months. Infants too young for
vaccination are at greatest risk for life-threatening cases of pertussis. Pertussis vaccinations
are given starting at two months of age, but multiple doses are required before the child is
considered fully immunized. According to the California Department of Public Health,
during a major pertussis outbreak in 2010, there were 9,000 cases of pertussis resulting in 10
infant deaths. In 2014, there were 11,114 reported cases of whooping cough with three infant
deaths. As of June 1, 2015 there have been 2,552 new cases of pertussis in California this
year. Sixty-two infants younger than four months of age have been hospitalized and one
death was reported in an infant that contracted pertussis at three weeks of age.
2) Measles is a highly contagious viral disease, and is considered the most deadly of all
childhood rash/fever illnesses. It is recommended that children receive their first measles
vaccination at 12 to 15 months; to be most effective, a second dose is recommended at four
to six years. Measles is particularly dangerous for babies and young children. From 200113, 28% of children younger than five years old who had measles had to be treated in the
hospital. For some children, measles can lead to pneumonia, lifelong brain damage,
deafness, or death. According to the Centers for Disease Control and Prevention (CDC), the
United States declared that measles was eliminated from this country in 2000; however,
measles is one of the first diseases to reappear when vaccination coverage rates fall. In 2014,
there were over 600 cases reported to the CDC, the highest in many years. Between 2000
and 2007, the average number of cases was 63 per year, less than half the number of the
December 2014 outbreak in California, which is one of five outbreaks so far this year
reported by the CDC.
3) Influenza, or flu, is a contagious respiratory illness caused by influenza viruses. The CDC
recommends a yearly flu vaccine for everyone six months of age and older as the first and
most important step in protecting against this serious disease. Because there are many
different flu viruses, the flu vaccine is redesigned annually to protect against the flu strains
that research indicates will cause the most illness during the flu season. Last year in
California, 10 children died of influenza. According to the CDC's nationwide surveillance,
142 children passed away during the 2014-15 flu season due to complications with the flu,
bringing the total of pediatric deaths since 2004 to over 1,000.
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Herd immunity occurs when a significant proportion of the population (or the herd) has been
vaccinated, and this provides protection for unprotected individuals. The larger the number of
people who are vaccinated in a population, the lower the likelihood that a susceptible
(unvaccinated) person will physically come into contact with the infection. It is more difficult
for diseases to spread between individuals if large numbers of people are already immune, and
the chain of infection is broken. The reduction of herd immunity places unvaccinated persons at
risk, including those who cannot receive vaccinations for medical reasons. Those who cannot
receive vaccines include those with compromised immune systems, older adults, small children
and babies, all depending on the vaccine.
In recent years a few other states, including Vermont, Colorado, and Illinois have considered
legislation to require vaccinations for teachers or child care workers. In 2014, Texas passed a
law requiring child-care facilities to develop and implement a policy concerning vaccination of
employees.
The Health Officers Association of California, sponsor of this bill, writes that given that child
care workers have close, intimate contact with children who are unable to be fully immunized, it
is important to ensure that these dedicated professionals are not inadvertently exposing children
to potentially fatal, yet vaccine-preventable, childhood diseases. Knowledge Universe, the Santa
Clara County Board of Supervisors and other supporters state that it is important to ensure that
child care professionals are not inadvertently exposing children to potentially fatal, yet vaccinepreventable, childhood diseases.
The California Right to Life Committee and several other groups opposed to vaccination
mandates state that this bill places an unwarranted burden on child care employees, as well as an
unnecessary mandate that day care owners must enforce.
Analysis Prepared by: Dharia McGrew / HEALTH / (916) 319-2097
FN: 0002104