SB 277 Bill Analysis


In many developed nations, the incidence of dangerous infectious diseases is minimal because of high vaccination rates. When the vast majority of the population are immunized, there is a low risk of epidemics, and the medical costs go down due to a reduction in infections. However, for the past few decades, more and more people began to refuse vaccinations based on their personal beliefs. A lot of those people are the so-called anti-vaxxers, who believe that vaccinations bring more harm than good, although high-quality research does not support their views (Allen, 2019). Personal or religious exemptions from immunizations are particularly dangerous for children who are in public education because it is an excellent environment for bacteria to spread. In order to respond to the issue, the state of California enacted a law prohibiting all vaccine exemptions except temporary medical. The present paper will review the policy and its effects on various groups of stakeholders.

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The bill SB 277 was signed into action in California on June 30, 2015, and went into effect from July 1, 2016. The bill prohibits children who have non-medical vaccination exemptions from entering daycare, preschool, and K-12 schools (National Vaccine Information Center, 2019). Before the law, children whose parents or caregivers obtained philosophical or religious vaccination exemptions could study in public education facilities, which increased the risk of infectious diseases. Temporary medical exemptions remained allowed under the bill, and parents have to have them renewed on a regular basis to keep their children in public education (NVIC, 2019). The legislation covers all vaccinations recommended for children by the Department of Health and Human Services and other reputable organizations (NVIC, 2019). Children who do not have these vaccinations for nonmedical reasons can only study at home.

Strengths and Weaknesses

The one key strength of the policy is that it provided an effective solution to a significant health problem. The bill was based on scholarly evidence that vaccines protect children from a variety of infectious diseases that may threaten their life (Haelle, 2015). While the law did not ban medical exemptions and thus did not manage to achieve a 100% vaccination rate among children, the level of 95% or over is considered to be sufficient for establishing and maintaining herd immunity (Gorski, 2017). This means that if 95% of children are vaccinated, even those who cannot receive vaccines due to medical reasons will be protected from infectious diseases. Reports on children’s immunization rates prove that the bill was helpful in improving the overall vaccination rate and minimizing the number of areas with low levels of immunization (Girski, 2017). Hence, the law was effective in addressing the issue of children’s immunization.

One weakness of the legislation is that it did not put measures in place to restrict medical exemptions. Since there are doctors who are also anti-vaxxers, they may give medical exemptions in the absence of sound health reasons. This limitation of the law has been acknowledged already, and a new complementary bill has been designed to regulate medical exemptions and check that they are given only to those who have a medical condition that makes vaccinations dangerous (Karlamangla & Guiterrez, 2019). The complementary bill SB 276 would thus address this weakness and make the policy more effective.

Impact on Stakeholders

There are three primary groups of stakeholders affected by the chosen health policy: children, parents, and care providers. Children and parents are consumer stakeholders because the bill affects them directly. For children, the policy was mostly beneficial because it proved to be effective in enhancing vaccination rates, which, in turn, reduces the risks of infection (Gorski, 2017). Hence, children who are in public education are now less likely to get measles, chickenpox, and many other diseases even if they are medically exempt from vaccinations. For parents, the effect of the bill depends on their stance on vaccinations. Parents who support vaccinations benefitted from the law because they no longer had to worry about their children getting infected with a preventable disease. In the case of anti-vaxxer and religious parents, however, the bill restricted their freedom of choice and may have caused stress despite its positive influence on children’s health.

Provider stakeholders of the bill include doctors and nurses who work in pediatric settings. The policy had a mostly positive impact on all provider stakeholders because it reduces the healthcare burden associated with infectious diseases. Nevertheless, the bill might have increased the workload associated with medical exemptions because more parents would request them. Furthermore, because some doctors and nurses are anti-vaxxers, the policy might have raised an ethical dilemma between legal requirements and their beliefs. Based on the information above, it is possible to say that the benefits of the bill far outweigh its costs.


All in all, vaccination exemptions are an issue that impacts children’s immunization rates, thus increasing the risks of epidemics. The bill SB 277, signed into law in 2015, was the attempt of California’s government to address the problem. The bill prevented children with nonmedical exemptions from enrolling in public education institutions. Research shows that the policy had a positive impact on vaccination rates throughout the state and thus benefitted children, parents, and care providers. The key limitation of the bill is the lack of control over medical exemptions, which will most likely be solved by a complementary law.

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Haelle, T. (2015). California vaccination bill SB 277 signed by governor, becomes law. Forbes. Web.

Gorski, D. (2017). California SB 277: New evidence that restricting nonmedical exemptions to school vaccine requirements works. Web.

Karlamangla, S., & Guiterrez, M. (2019). Bill would strengthen vaccination laws, checking up on doctors who write exemptions. LA Times. Web.

National Vaccine Information Center. (2019). California state vaccine requirements. Web.

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