State law or no state law, Grass Valley mother Kay Pisarek is adamant that she won’t vaccinate her 8-year-old son – because she believes vaccines are unsafe.

Senate Bill 277, which goes into effect July 1, eliminates personal belief exemptions and requires children to be vaccinated in order to attend public or private school or day care. Parents will have to show vaccination records to enroll their child in a new school, kindergarten or seventh grade. The only way out is to get a release from doctors for medical reasons (such as having an allergic reaction to shots) or to home school.

Pisarek’s current personal belief exemption will stand until her son reaches seventh grade. But when that time comes, she isn’t sure what she will do.

“I think lawsuits should start happening,” she said. “I think school districts should be sued. A lot of people are going to do independent study. We may come together and do something on our own.”

The new law was sponsored last year by Sen. Richard Pan, D-Sacramento, a pediatrician, in response to a 2014 measles outbreak that began at Disneyland and infected mostly unvaccinated children and adults. Pan pointed out that vaccinations have prevented countless people from hospitalization or death from diseases like measles, polio and whooping cough. He faced tremendous opposition from parents who believe vaccines can cause harm and who resent what they see as an infringement on parental rights.

Gov. Jerry Brown signed the bill into law June 30, giving California one of the toughest vaccination laws in the nation. Only two other states – Mississippi and West Virginia – have also eliminated personal belief exemptions.

Some schools that have low vaccination rates are now facing the potential loss of large numbers of students if parents against vaccinations pull their children out. The new law is a hot topic at the school Pisarek’s son attends – Yuba River Charter School in Nevada City. In 2014-15, 70 percent of its 60 kindergartners and 46.1 percent of its 26 seventh-graders had personal beliefs exemptions on file.

Ron Charles, the school director, has had several meetings with parents to educate them about the law. “There’s a strong belief that there will be some pushback when (the law) goes into effect,” he said.

Holly Hermansen, Nevada County Superintendent of Schools, said there are still some gray areas of the law that need to be clarified.

Though the law states that home-study students are exempt from the law, it’s not clear if they may attend some classes with other students. The other big issue is students with disabilities. The new law states that it is not meant to prevent students who need special education from accessing those services. But school districts are interpreting that in different ways. The Los Angeles Unified School District, which serves more than 640,000 K-12 students, has announced that it will not require students in special education to get the required immunizations. Orange County, in contrast, is requiring special education students to get the immunizations unless they obtain medical exemptions.

“We have seen an increase in the number of students getting vaccinated,” Hermansen said. “I do not foresee a lot of dropping out.”

Data recently released by state public health officials indicate that the new law might be pushing some parents into getting their children vaccinated. California’s vaccination rate for its 500,000 kindergartners at public and private schools was 92.9 percent in 2015-16, up from 90.4 percent in 2014-15 and 90.2 percent in 2013-14.

Studies by the Center for Disease Control and Prevention say that a 90 percent vaccination rate is necessary to keep diseases like whooping cough and measles from spreading. Most California counties fit that standard – as examples, in Riverside County, 95.2 percent of kindergartners are fully vaccinated, in San Francisco, it’s 92.5 percent and in Los Angeles, it’s 90 percent. The lowest vaccination rates are in rural areas- Trinity County (77 percent), Tuolumne County (77.7 percent) and Nevada County (77.1 percent).

“There are a lot of alternative philosophies of health in our area and people are influenced by their peer group,” said Ken Cutler, M.D., public health officer in Nevada County.

However, Cutler said nurses at Nevada County public health clinics have noticed a moderate increase in the number of children getting vaccinated since the law was approved. He said that families who have never vaccinated their children don’t have to worry about getting all the required shots at once to attend school. Students who begin the process can be conditionally admitted to school.

Lara Weiss, deputy director of public health in Humboldt County, where the kindergarten vaccination rate is 82 percent, said a public education campaign to promote immunizations is already underway in her area. A committee, which includes education officials, public health staffers, early childhood education workers and more, has distributed posters around town in English and Spanish with the slogan “Be Wise, Immunize.”

Weiss said the issue is personal to her. “I have a daughter with some medical complications and she went to a school with a very low vaccination rate,” she said. “She could get vaccinated but it’s better for her to be in community of people that has protection.”

Gita Matlock, who lives near Nevada City, decided to delay vaccines for her two small children after reading books recommending that, and because of her own concerns about risks from the vaccines. She is not sure what she will do when her kids are old enough to attend kindergarten.

“We’re banking on this stuff going away by that time,” she said. “It all sort of feels like a bad dream. It seems like it shouldn’t be legal to mandate a bunch of vaccines. It’s between a doctor and patient.”