Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes

Introduction: In the United States, high childhood vaccination coverage has reduced the morbidity and mortality due to vaccine-preventable diseases. The success of vaccination programs in achieving this high coverage is due, in part, to vaccination mandates for school entry. All states have such man...

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Main Authors: Robert A. Bednarczyk, Adrian R. King, Ariana Lahijani, Saad B. Omer
Format: Article
Language:English
Published: Taylor & Francis Group 2019-02-01
Series:Expert Review of Vaccines
Subjects:
Online Access:http://dx.doi.org/10.1080/14760584.2019.1562344
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author Robert A. Bednarczyk
Adrian R. King
Ariana Lahijani
Saad B. Omer
author_facet Robert A. Bednarczyk
Adrian R. King
Ariana Lahijani
Saad B. Omer
author_sort Robert A. Bednarczyk
collection DOAJ
description Introduction: In the United States, high childhood vaccination coverage has reduced the morbidity and mortality due to vaccine-preventable diseases. The success of vaccination programs in achieving this high coverage is due, in part, to vaccination mandates for school entry. All states have such mandates, but there is heterogeneity across the states in the allowance of non-medical exemptions (e.g. religious or personal belief exemptions) to these mandates. Areas covered: We examine historical trends in non-medical exemption prevalence in the US, discuss recent state-level policy changes that may impact non-medical exemption prevalence, and review recent studies on the association between non-medical exemptions and infectious disease outbreaks. Expert commentary: State-level implementation of mandates, and related allowances for medical and non-medical exemptions, varies greatly across the United States. Non-medical exemption rates have increased over the last two decades, with an increased risk of disease outbreaks in clusters of children with non-medical exemptions due to differences in state laws. Recent efforts to address non-medical exemption rates range from incorporating additional administrative requirements for exemptions and disallowance of any non-medical exemptions. Continued monitoring is needed to evaluate the impact of these changes on exemption rates, to develop optimal childhood vaccination policy across the United States.
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spelling doaj.art-04ab4b2bc2824243a5d57e1fd47456f92023-09-20T10:18:04ZengTaylor & Francis GroupExpert Review of Vaccines1476-05841744-83952019-02-0118217519010.1080/14760584.2019.15623441562344Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changesRobert A. Bednarczyk0Adrian R. King1Ariana Lahijani2Saad B. Omer3Emory UniversityEmory UniversityEmory UniversityEmory UniversityIntroduction: In the United States, high childhood vaccination coverage has reduced the morbidity and mortality due to vaccine-preventable diseases. The success of vaccination programs in achieving this high coverage is due, in part, to vaccination mandates for school entry. All states have such mandates, but there is heterogeneity across the states in the allowance of non-medical exemptions (e.g. religious or personal belief exemptions) to these mandates. Areas covered: We examine historical trends in non-medical exemption prevalence in the US, discuss recent state-level policy changes that may impact non-medical exemption prevalence, and review recent studies on the association between non-medical exemptions and infectious disease outbreaks. Expert commentary: State-level implementation of mandates, and related allowances for medical and non-medical exemptions, varies greatly across the United States. Non-medical exemption rates have increased over the last two decades, with an increased risk of disease outbreaks in clusters of children with non-medical exemptions due to differences in state laws. Recent efforts to address non-medical exemption rates range from incorporating additional administrative requirements for exemptions and disallowance of any non-medical exemptions. Continued monitoring is needed to evaluate the impact of these changes on exemption rates, to develop optimal childhood vaccination policy across the United States.http://dx.doi.org/10.1080/14760584.2019.1562344vaccination mandatesschool entryexemptionsnon-medical exemptionsstate law
spellingShingle Robert A. Bednarczyk
Adrian R. King
Ariana Lahijani
Saad B. Omer
Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
Expert Review of Vaccines
vaccination mandates
school entry
exemptions
non-medical exemptions
state law
title Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
title_full Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
title_fullStr Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
title_full_unstemmed Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
title_short Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes
title_sort current landscape of nonmedical vaccination exemptions in the united states impact of policy changes
topic vaccination mandates
school entry
exemptions
non-medical exemptions
state law
url http://dx.doi.org/10.1080/14760584.2019.1562344
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