Vaccination Policies and Rates of Exemption from Immunization, 2005–2011

Omer, Saad B.; Richards, Jeffrey T.; Ward, Michelle; Bednarczyk, Robert A.

doi:10.1056/nejmc1209037

Cited by 190 publications

(145 citation statements)

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“…1,11,19 The past several decades have seen a shift in parental concerns from disease prevention to vaccination risks, largely and paradoxically because of the success of largescale immunization. 27 Despite the increasing visibility of pockets of unvaccinated schoolchildren and associated outbreaks of vaccine-preventable diseases, attempts by state legislatures to allow more parents to opt out of mandatory school vaccinations continue.…”

Section: Resultsmentioning

confidence: 99%

“…The multifactorial nature of vaccine exemption is demonstrated by the overlapping exemption rates between complexity categories. Philosophical exemptions were historically associated with higher exemption rates, 1,11,19 which may help explain why Maine and Utah have exemption rates higher than 3.0 percent despite exemption procedures of medium complexity. Similarly, Connecticut, Maryland, and South Dakota have rates lower than 1.0 percent despite their less complex procedures, perhaps because they do not grant exemptions for philosophical reasons.…”

Section: Discussionmentioning

confidence: 99%

“…1,11,19 Supporters of Oregon's vaccine education bill therefore must have particular confidence in vaccine education as a way of reducing exemption rates. Indeed, the Oregon Pediatric Society cited the passage of Washington State's vaccine education bill in 2011 and subsequent decrease in exemptions as a precedent for the Oregon bill.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have yielded slightly different complexity cohorts than our review, probably because of the evolution of state exemption procedures over time or the inclusion of child-care exemption laws. 1,11 The justifications for our assignments to states of easy, medium, or difficult complexity levels follow. We categorized as easy those states in which parents were required only to complete a standardized form, available on the state health department's website or at the child's school.…”

Section: Study Data and Methodsmentioning

confidence: 99%

“…1 Small geographic pockets of nonvaccinated children push some state exemption rates to more than 5 percent and are probably helping drive the national increase in exemptions. 2 There has been a concurrent rise in rates of vaccine-preventable diseases-notably measles in 2011.…”

mentioning

confidence: 99%

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Exempting Schoolchildren From Immunizations: States With Few Barriers Had Highest Rates Of Nonmedical Exemptions

2013

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Rates of nonmedical exemptions from school immunizations are increasing and have been associated with resurfacing clusters of vaccine-preventable diseases, such as measles. Historically, state-level school immunization policies successfully suppressed such diseases. We examined state immunization exemption regulations across the United States. We assessed procedures for exempting schoolchildren and whether exemption rates were associated with the complexity of the procedures. We also analyzed legal definitions of religious objections and state legislatures' recent modifications to exemption policies. We found that states with simpler immunization exemption procedures had nonmedical exemption rates that were more than twice as high as those in states with more-complex procedures. We also found that the stringency of legal definitions of religious exemptions was not associated with exemption procedure complexity. Finally, we found that although there were more attempts by state legislatures to broaden exemptions than to tighten them in 2011-13, only bills tightening exemptions passed. Policy makers seeking to control exemption rates to achieve public health goals should consider tightening nonmedical exemption procedures and should add vaccine education components to the procedures by either mandating or encouraging yearly educational sessions in schools for parents reluctant to have their children vaccinated.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Data and Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Exempting Schoolchildren From Immunizations: States With Few Barriers Had Highest Rates Of Nonmedical Exemptions

2013

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Legislative Challenges to School Immunization Mandates, 2009-2012

Omer

Peterson

Curran

et al. 2014

JAMA

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Law, Ethics, and Public Health in the Vaccination Debates

Gostin

2015

JAMA

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Childhood vaccination has become one of the most intensely discussed topics not alone in Romania but other European countries as well. Mass media articles, personal e xperiences claiming that vaccines have side eff ects and can even lead to autism have generated various responses among parents and determined various perceptions and assessments of the health risks. Certain groups have emerged in the middle of these confrontational debates: there are those who resist vaccination, advocating that they infl ict suff erance on children. Yet others who refuse vaccines because they fear the unknown, along with those who have not made a decision and still search for medical opinion, and those who insist upon gathering more information before deciding whether to get their children immunized etc. Each of these groups perceives and defi nes the risk in a diff erent way. A discourse analysis of the comments and posts identifi ed on various online platforms from Romania revealed the fact that the individuals who resist vaccination reframe the risk as unknown, while calling for a more informed decision from parents. These individuals do not bring any logical, practical, or scientifi c argument in order to support their position. Some of them even consider that a mandatory vaccination policy is a characteristic of a totalitarian state thus infringing upon the right of the population to free choice. Another result of our analysis is the fact that the majority of the online debaters tend to perceive the risk of non-vaccination as bigger than the one of vaccination.

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Vaccination Policies and Rates of Exemption from Immunization, 2005–2011

Cited by 190 publications

References 2 publications

Exempting Schoolchildren From Immunizations: States With Few Barriers Had Highest Rates Of Nonmedical Exemptions

Exempting Schoolchildren From Immunizations: States With Few Barriers Had Highest Rates Of Nonmedical Exemptions

Legislative Challenges to School Immunization Mandates, 2009-2012

Law, Ethics, and Public Health in the Vaccination Debates

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