San Francisco City Attorney investigates pediatrician for medical vaccine exemptions

In an unprecedented move, San Francisco’s city attorney has subpoenaed a doctor’s records to see if he has been illegally been providing medical exemptions allowing parents to avoid vaccinating their children.

This week, Dennis Herrera announced that he wanted all the “anonymized’ medical records from Dr. Kenneth Stoller, a pediatrician who practices in The City.

Herrera’s office is seeking the volume, pattern and rationale behind Stoller's medical exemptions. Specifically, Herrera said he is investigating whether Stoller created a “public nuisance,” meaning something injurious to someone’s health, by providing medical exemptions to parents whose children don’t really need them. 

Under a state law that took effect in 2016, students attending public and private schools in California must be vaccinated unless they qualify for a valid medical exemption approved by a physician, such as having an allergy to vaccine components or because they’re undergoing chemotherapy. The law, known as SB 277, prevents parents from citing religious or personal beliefs, as they had been able to before, as a basis for not immunizing their children. 

However, Herrera noted that since this change in the law, the number of medical exemptions issued has increased dramatically, despite legitimate qualifying conditions being rare, according to Kaiser Health News. The law was approved in 2015 after a measles outbreak that originated at Disneyland sickened more than 120 people.

Stoller’s attorney, Richard Jaffe, a health care litigator who lists that he has offices in Sacarmento, New York and Houston, blogged on Thursday that he is reviewing the subpoena and applicable law.

Jaffe wrote there “does not appear to be any evidence that Dr. Stoller or any of the other exemption writing doctors have engaged in fraudulent exemption writing.”

Jaffe wondering how the city attorney’s office would have gotten any evidence of these exemptions in the first place, and he asked: “what is the specific factual basis of the investigation?”

Stoller has 15 days to respond and he may challenge the subpoena.

Herrera’s spokesman, John Cote, would not say why the city attorney is specifically looking into Stoller, other than to say the office is “in the midst of ongoing investigation and information comes in from a variety of sources." 

 Cote said that Stoller is “the only doctor we’ve announced that we’ve issued subpoenas to.”

Dorit Rubinstein Reiss, a professor of vacinne law and policy at UC Hastings, said that as far as she knows, this is the first time the public nuisance law has been used in a vaccine case.

But she said that it's been used in other public health contexts, such as extracting information in the tobacco, lead and climate change fields. 

For the most part, she said, the strategy has been successful. The tobacco and lead industries have paid out large settlements to consumers to end public nuisance cases out of court.

Stoller earned his degree from the American University of the Caribbean School of Medicine, according to state medical board records. The board's website shows he has had no disciplinary actions, convictions or malpractice judgements against him.

He has been a vocal opponent of vaccines, despite overwhelming scientific evidence of their safety and effectiveness.

In an interview for the Age of Autism, Stoller said he bases his medical exemption decisions off two 30-minute visits and a 23andMe genetic test.

"He's been very vocal online against vaccines," Reiss said. "He sees them as dangerous and his views suggest a permissive approach to these exemptions."