I sent the below letter today to California Senator Akilah Weber Pierson, after learning about the upcoming special Senate Health Committee hearing in San Diego that was requested by parents unable to get vaccine medical exemptions for their children. It was a big deal to get such a hearing scheduled, and I give huge props to Amy Bohn and other advocates who keep a great dialogue going with California legislators.

THEN I saw the published agenda, and the HEARING is for the Senate Health Committee to HEAR THEMSELVES and public health officials who do not believe in vaccine injury. Not a single official witness to represent the children who will be injured by vaccination. No, the time for those people is during public comment at the end.

I do hope my readers will attend this hearing for the public comment time. It’s very important that this committee hear from you in a respectful way.

While I appreciate that these few California Senators listen to people on our side, it’s clear it’s more of the same in California, where our voices have been shut out repeatedly to change California’s vaccination laws so much that we now have a de facto vaccine mandate for children to attend school. There is no due process in a mandate.

Re: Senate Health Committee Medical Exemption Hearing – November 12, 2026

Dear Senator Weber Pierson:

Free Now Foundation is a nonprofit that defends the educational access and civil rights of California students. We submit this letter because California’s medical-exemption system for school immunizations has collapsed. It no longer functions as a medical exemption process. It functions as a denial system.

We appreciate the Committee’s decision to hold a hearing on this important issue. My understanding is that the hearing was prompted primarily by concerns regarding students who require medical exemptions from vaccination but are currently unable to obtain them. These families—and the physicians who care for them—have a direct stake in the outcome and should have a meaningful opportunity to be heard.

As currently structured, however, the public agenda provides no witnesses and no dedicated time for those with concerns about the existing medical exemption process, except during a general public comment time, which may limit comment time per person or be truncated. This omission is significant. It risks creating the impression that the Committee is not interested in examining the practical barriers families are facing, which could reflect poorly on the Senate Health Committee.

I respectfully urge you and your colleagues to address this gap before Thursday’s hearing so that the discussion includes the perspectives of those most affected.

Regarding the issue being addressed in the hearing: only 0.1% of California students attend school with a medical exemption. Nationally, medical exemptions among kindergarteners have held steady at roughly 0.2%, while total exemptions (including non-medical) now stand at about 4.2%. California eliminated personal-belief exemptions years ago. What remains is a process so narrow, punitive, and centralized that legitimate medical exemptions have been driven to the vanishing point. The state continues to claim medical exemptions exist. The data show they effectively do not.

Low exemption rates have not produced correspondingly low measles numbers. State-level data from 2025 and 2026 show no consistent correlation between low exemption rates and low measles case counts. States with some of the strictest policies still report cases, while outbreaks have occurred across a range of exemption environments. California’s near-elimination of exemptions has not delivered the disease-control outcome used to justify the current system.

The architecture produces this result by design:

• Exemptions may be written only by California-licensed MDs or DOs and must be entered into CAIR-ME. Out-of-state physicians are barred.
• Criteria are drawn from narrow American Academy of Pediatrics guidance and are routinely treated as temporary, forcing annual re-submission and re-review.
• CDPH reviews exemptions when a doctor writes five or more in a year or when a school’s rate falls below 95%. In practice, CDPH overturns the large majority of exemptions we have seen—without examining the child and through an appeals process that families describe as inadequate.

· Physicians who write exemptions are investigated, disciplined, or permanently barred. CDPH has published a list of more than 9,000 California physicians (roughly 7% of licensed physicians) permanently prohibited from writing exemptions, including many whose prior discipline had nothing to do with vaccines. Surveys of physician offices find virtually none willing to write them. Writing a single exemption can end a physician’s ability to do so again.

This mandate is applied selectively. School staff, teachers, and other adults who make up roughly 10% of the school community face only a recommendation, not a mandate, and are not subjected to any exemption process or CAIR-ME review. Students with IEPs (approximately 13% of the student population) are formally exempt under both state law and the federal IDEA, yet some schools still force those families through the CAIR-ME process. The result is a system that imposes the strictest requirements on the population least able to refuse while exempting large numbers of adults and certain students without equivalent scrutiny.

Students with disabilities that contraindicate vaccination encounter the same refusal: schools that accommodate other disabilities reject vaccine-related accommodations and insist on the state process instead. We know of at least 100 written denials in 2026 in which schools or CDPH stated that state immunization rules override federal disability law.

The outcome is straightforward. Students with documented medical contraindications cannot obtain exemptions that survive state review. Schools then exclude them. Families who cannot homeschool or leave the state are forced to choose between vaccination against medical advice and loss of public and private school access. Low-income families have the fewest options and bear the greatest cost.

These are not abstract compliance issues. They produce permanent medical injury to some children, educational exclusion and social isolation for others, and economic and social losses for entire families. The system has made “medical exemption” a term that exists on paper while being unavailable in practice for nearly every California student who needs one.

We are prepared to provide the Committee with specific case examples, correspondence, physician data, and documentation of denials. We request the opportunity to testify as witnesses, not just in public comment, so that the Committee can examine how a process described as a medical exemption has been reduced to a de facto mandate applied unequally and without demonstrated disease-control benefit.

Please contact me at your earliest convenience.

Respectfully submitted,

Alix Mayer

President & Board Chair

Free Now Foundation

freenowfoundation.org