Experts say Dr. Sears offers bad advice on vaccine exemptions

The state medical board is accusing prominent Orange County pediatrician Dr. Bob Sears of "gross negligence" for improperly excusing a 2-year-old child from immunizations in 2014. Meanwhile, experts say Sears has also been publicly peddling false medical reasons that supposedly would exempt children from vaccinations.

In July 2015, following the signing of California’s new vaccination law, Sears - who was a vocal opponent of the measure as it moved through the legislature - advised his nearly 62,000 Facebook followers on how they might get a medical exemption from vaccines. The law bans exemptions based on personal or religious beliefs, while maintaining medical exemptions.

On his Facebook page, Sears listed several conditions that, if found in a family member, "might prompt a doctor to grant a legitimate exemption," including: celiac disease, fibromyalgia, multiple sclerosis, Type 1 diabetes, asthma, eczema, learning and behavioral disorders, genetic abnormalities and severe food allergies.

He included autism in the family, noting, "despite the lack of published mainstream evidence of a connection between vaccines and autism, many families will consider seeking exemptions for a child with autism and the rest of their children."

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While saying that "it is not my intention to claim that the above scenarios all deserve a medical exemption from vaccines," Sears added, "this issue has not yet been sorted out by research."

Several pediatric infectious disease experts said that Sears, author of several well-known books on parenting, autism and vaccines, is wrong.

Sears' advice on medical exemptions "is basically anti-science," said Dr. James Cherry, distinguished research professor specializing in pediatrics and infectious diseases at the David Geffen School of Medicine at UCLA and Mattel Children's Hospital UCLA.

The Centers for Disease Control and Prevention says there are legitimate reasons that some children shouldn't get some or all vaccines, primarily if they have compromised immune systems or have had severe allergic reactions after a previous dose or to a vaccine component.

"But Dr. Bob's list includes so-called contraindications that aren't contraindications," said Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.

Referring to Sears' advice that a family history of autism could warrant a medical exemption, Offit asked, "what do vaccines have to do with autism? Vaccines don't cause autism. That's been clearly shown, so why would that be a contraindication?"

In 2007, Sears published his popular "The Vaccine Book: Making the Right Decision for Your Child," which provides a rationale for parents not to adhere to the CDC's recommended immunization schedule. Offit and other experts argue that the book, which offers its own alternative vaccination schedule, distorts vaccine science and misleads parents.

In his Facebook post, Sears noted that the law requires a parent to submit a doctor's note to the school; the school administrator will then decide whether to grant the medical exemption.

"Since very few school administrators have the medical expertise to understand or contradict a medical doctor's opinion on this, it is likely that most such letters will be accepted," Sears wrote.

"If the letter is not accepted, parents may attempt to enroll the child into another school where the school staff are more understanding," he said. "For example, standard public schools will likely be more strict than charter public schools or small private schools."

Medical Board of California spokeswoman Cassandra Hockenson said she couldn't discuss ongoing investigations, and therefore couldn't comment on whether the agency is investigating Sears' statements on Facebook.

"If we're looking into someone, we're going to look into every aspect of something," she added.

Sears is not the only doctor promoting questionable reasons for medical exemptions. The website of San Diego pediatrician Dr. Tara Zandvliet also lists conditions dismissed by the experts. 

The Medical Board has accused Sears of medically excusing from vaccines a patient, called J.G. in the complaint, without obtaining the necessary information to make his decision.

"We take the medical board's accusation seriously," said Sears' lawyer in the case, Rick Jaffe.

"But this case is very clear: this child had two unusual and severe vaccine reactions, as the accusation itself points out," he said. "His situation therefore warranted a medical exemption, and to continue vaccination would have put him at risk of further harm."

Under the new vaccination law, parents can no longer opt out of immunizing their incoming kindergartners or 7th graders on the basis of personal or religious beliefs. The law also applies to students of any grade who are new to the state and to kids entering daycare.

The only students exempt from the law are those who can not be vaccinated for medical reasons or who are on Individualized Education Programs.

The law says any parent desiring a medical exemption for their child must submit to the school a doctor's note, describing the medical condition or circumstances, possibly including family medical history, that prevent the child from being vaccinated.

Last year, less than one-quarter of 1 percent of California kindergartners had a permanent medical exemption from vaccines, according to the California Department of Public Health. The state is expected to publish this year's school vaccination data later this fall.

This story has been updated to include comments provided by Sears' attorney Rick Jaffe on Sept. 12, 2016.