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Annual Review of Public Health

Volume 35, 2014

Personal Belief Exemptions From School Vaccination Requirements

Abstract

Despite the impact vaccination has had on the control and prevention of many infectious diseases, some parents choose not to vaccinate their children. Although there is no federal law requiring vaccination of children in the United States, all states require evidence of vaccination against at least some diseases as a condition of school entry. Which vaccines are required; how many doses are required; whether entry requirements apply to child care, kindergarten, or middle school; and whether exemptions from vaccine requirements will be allowed all differ by state. All but two states allow some kind of personal belief exemption from school vaccination requirements. This article reviews the history of school vaccination requirements and exemptions, the legal status of state vaccination laws and exemptions, the impact of school vaccination requirements and personal belief exemptions on vaccination rates and disease incidence, and strategies for maintaining adequate vaccination rates in states that allow personal belief exemptions.

Keyword(s): immunization, medical exemptions, philosophical exemptions, religious exemptions, vaccine mandates
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2014-03-18
2024-04-19
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Literature Cited

  1. Baldwin P. 1.  1999. Contagion and the State in Europe, 1830–1930 Cambridge, UK: Cambridge Univ. Press
  2. Blank NR, Caplan AL, Constable C. 2.  2013. Exempting schoolchildren from immunizations: states with few barriers had highest rates of nonmedical exemptions. Health Aff. 32:71282–90 [Google Scholar]
  3. Briss PA, Rodewald LE, Hinman AR, Shefer AM, Strikas RA. 3.  et al. 2000. Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. Am. J. Prev. Med. 18:97–140 [Google Scholar]
  4. 4.  Brown v. Stone 378 So. 2d 218, 224 (Miss. 1979)
  5. Calandrillo SP. 5.  2004. Vanishing vaccinations: Why are so many Americans opting out of vaccinating their children?. Univ. Mich. J. Law Reform 37:2353–440 [Google Scholar]
  6. 6. CDC (Cent. Dis. Control. Prev.) 1977. Measles and school immunization—Alaska. MMWR 26:1185–86 [Google Scholar]
  7. 7. CDC (Cent. Dis. Control. Prev.) 1977. Measles—United States. MMWR 26:14109–11 [Google Scholar]
  8. 8. CDC (Cent. Dis. Control. Prev.) 2008. Update: measles—United States, January-July, 2008. MMWR 57:33893–96 [Google Scholar]
  9. 9. CDC (Cent. Dis. Control. Prev.) 2009. Invasive Haemophilus influenza type b disease in five young children—Minnesota, 2008. MMWR 58:358–60 [Google Scholar]
  10. 10. CDC (Cent. Dis. Control. Prev.) 2011. Vaccination coverage among children in kindergarten—United States, 2009–10 school year. MMWR 60:700–4 [Google Scholar]
  11. 11. CDC (Cent. Dis. Control. Prev.) 2012. Vaccination coverage among children in kindergarten—United States, 2011–12 school year. MMWR 61:33647–52 [Google Scholar]
  12. Colgrove J. 12.  2005. “Science in a Democracy”: the contested status of vaccination in the progressive era and the 1920s. Isis 96:167–91 [Google Scholar]
  13. Colgrove J. 13.  2006. State of Immunity: The Politics of Vaccination in Twentieth-Century America Berkeley: Univ. Calif. Press
  14. Colgrove J, Abiola S, Mello MM. 14.  2010. HPV vaccination mandates—lawmaking amid political and scientific controversy. N. Engl. J. Med. 363:8785–91 [Google Scholar]
  15. Dayan GH, Ortega-Sánchez IR, LeBaron CW, Quinlisk MP. 15. Iowa Measles Resp. Team 2005. The cost of containing one case of measles: the economic impact on the public health infrastructure—Iowa, 2004. Pediatrics 116:e1–4 [Google Scholar]
  16. Dempsey AF, Schaffer S, Singer D, Butchart A, Davis M, Freed GL. 16.  2011. Alternative vaccination schedule preferences among parents of young children. Pediatrics 128:5848–56 [Google Scholar]
  17. Diekema DS. 17.  2004. Parental refusals of medical treatment: the harm principle as threshold for state intervention. Theor. Med. Bioeth. 25:4243–64 [Google Scholar]
  18. Diekema DS. 18.  2008. Public health, ethics, and state compulsion. J. Pub. Health Manage. Pract. 14:4332–34 [Google Scholar]
  19. Diekema DS. 19.  2012. Improving childhood vaccination rates. N. Engl. J. Med. 366:5391–93 [Google Scholar]
  20. Diekema DS, Marcuse EK. 20.  2007. Ethical issues in the vaccination of children. Public Health Ethics: Theory, Policy, and Practice R Bayer, LO Gostin, B Jennings, B Steinbock 279–88 New York: Oxford Univ. Press [Google Scholar]
  21. Duffy J. 21.  1978. School vaccination: the precursor to school medical inspection. J. Hist. Med. Allied Sci. 33:3344–55 [Google Scholar]
  22. Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE. 22.  2000. Individual and community risks of measles and pertussis associated with personal exemptions to immunization. JAMA 284:3145–50 [Google Scholar]
  23. Feinberg J. 23.  1986. Harm to Self: The Moral Limits of the Criminal Law New York: Oxford Univ. Press
  24. Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM. 24.  2010. Parental vaccine safety concerns in 2009. Pediatrics 125:4654–59 [Google Scholar]
  25. Glanz JM, McClure DL, Magid DJ, Daley MF, France EK. 25.  et al. 2009. Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. Pediatrics 123:61446–51 [Google Scholar]
  26. Glanz JM, McClure DL, Magid DJ, Daley MF, France EK, Hambidge SJ. 26.  2010. Parental refusal of varicella vaccination and the associated risk of varicella infection in children. Arch. Pediatr. Adolesc. Med. 164:166–70 [Google Scholar]
  27. Hershey JC, Asch DA, Thumasathit T, Meszaros J, Waters VV. 27.  1994. The roles of altruism, free riding, and bandwagoning in vaccination decisions. Organ. Behav. Hum. Decis. Process. 59:177–87 [Google Scholar]
  28. Hodge JG, Gostin LO. 28.  2001–2002. School vaccination requirements: historical, social, and legal perspectives. Ky. Law J. 90:831–90 [Google Scholar]
  29. Horlick G, Shaw FE, Gorji M, Fishbein DB. 29. Work. Group Legis. Vaccin. Adolesc. Health 2008. Delivering new vaccines to adolescents: the role of school-entry laws. Pediatrics 121:Suppl. 1S79–84 [Google Scholar]
  30. Imdad A, Tserenpuntsag B, Blog DS, Halsey NA, Easton DE, Shaw J. 30.  2013. Religious exemptions for immunization and risk of pertussis in New York State, 2000-2011. Pediatrics 132:137–43 [Google Scholar]
  31. 31.  Jacobson v. Mass. 197 US 11 (1905)
  32. Jackson CL. 32.  1969. State laws on compulsory immunization in the United States. Public Health Rep. 84:9787–95 [Google Scholar]
  33. Kennedy AM, Brown CJ, Gust DA. 33.  2005. Vaccine beliefs of parents who oppose compulsory vaccination. Public Health Rep. 120:252–58 [Google Scholar]
  34. Lantos JD, Jackson MA, Opel DJ, Marcuse EK, Myers AL, Connelly BL. 34.  2010. Controversies in vaccine mandates. Curr. Probl. Pediatr. Adolesc. Health Care 40:38–58 [Google Scholar]
  35. Leavitt JW. 35.  2003. Public resistance or cooperation? A tale of smallpox in two cities. Biosecur. Bioterror. 1:3185–92 [Google Scholar]
  36. 36.  McCarthy v. Boozman 212 F Supp. 2d 945 (WD Ark. 2002)
  37. Mill JS. 37.  1956. On Liberty Indianapolis, IN: Bobbs-Merrill
  38. 38. NCSL (Natl. Conf. State Legis.) 2012. States with Religious and Philosophical Exemptions from Immunization Requirements, December 2012 Washington, DC/Denver, CO: NCSL http://www.ncsl.org/issues-research/health/school-immunization-exemption-state-laws.aspx
  39. Novak A. 39.  2005. The religious and philosophical exemptions to state-compelled vaccination: constitutional and other challenges. J. Const. Law 7:41101–29 [Google Scholar]
  40. Omer SB, Pan WK, Halsey NA, Stokley S, Moulton LH. 40.  et al. 2006. Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence. JAMA 296:141757–63 [Google Scholar]
  41. Omer SB, Enger KS, Moulton LH, Halsey NA, Stokley S, Salmon DA. 41.  2008. Geographic clustering of nonmedical exemptions to school immunization requirements and associations with geographic clustering of pertussis. Am. J. Epidemiol. 168:1389–96 [Google Scholar]
  42. Omer SB, Salmon DA, Orenstein WA, deHart P, Halsey N. 42.  2009. Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. N. Engl. J. Med. 360:191981–88 [Google Scholar]
  43. Opel DJ, Diekema DS. 43.  2012. Finding the proper balance between freedom and justice: why we should not eliminate personal belief exemptions to vaccine mandates. J. Health Policy Polit. Law 37:1141–47 [Google Scholar]
  44. Opel DJ, Diekema DS, Marcuse EK. 44.  2008. A critique of criteria for evaluating vaccines for inclusion in mandatory school immunization programs. Pediatrics 122:e504–10 [Google Scholar]
  45. 45. Or. Immun. Progr., Or. Health Auth 2013. Immunization requirements for school and childcare Or. Immun. Progr., Portland, Or. http://public.health.oregon.gov/PreventionWellness/VaccinesImmunization/GettingImmunized/Pages/school.aspx
  46. Orenstein WA. 46.  2006. The role of measles elimination in development of a national immunization program. Pediatr. Infect. Dis. J. 25:1093–101 [Google Scholar]
  47. Orenstein WA, Hinman AR. 47.  1999. The immunization system in the United States—the role of school immunization laws. Vaccine 17:Suppl. 3S19–24 [Google Scholar]
  48. 48. Pediatr. Infect. Dis. Soc., Vaccine Advocacy Comm 2011. A statement regarding personal belief exemption from immunization mandates. Pediatr. Infect. Dis. J. 30:7606–7 [Google Scholar]
  49. 49.  Prince v. Commonw. Mass. 321 US 158 (1944)
  50. Robbins KB, Brandling-Bennett AD, Hinman AR. 50.  1981. Low measles incidence: association with enforcement of school immunization laws. Am. J. Public Health 71:270–74 [Google Scholar]
  51. Ross LF, Aspinwall TJ. 51.  1997. Religious exemptions to the immunization statutes: balancing public health and religious freedom. J. Law Med. Ethics. 25:202–9 [Google Scholar]
  52. Rota JS, Salmon DA, Rodewald LE, Chen RT, Hibbs BF, Gangarosa EJ. 52.  2001. Processes for obtaining nonmedical exemptions to state immunization laws. Am. J. Public Health 91:645–48 [Google Scholar]
  53. Salmon DA, Haber M, Gangarosa EJ, Phillips L, Smith NJ, Chen RT. 53.  1999. Health consequences of religious and philosophical exemptions from immunization laws: individual and societal risk of measles. JAMA 282:147–53 [Google Scholar]
  54. Salmon DA, Moulton LH, Omer SB, deHart MP, Stokley S, Halsey NA. 54.  2005. Factors associated with refusal of childhood vaccines among parents of school-aged children. Arch. Pediatr. Adolesc. Med. 159:470–76 [Google Scholar]
  55. Salmon DA, Sapsin JW, Teret S, Jacobs RF, Thompson JW. 55.  et al. 2005. Public health and the politics of school immunization requirements. Am. J. Public Health 95:5778–83 [Google Scholar]
  56. Salmon DA, Siegel AW. 56.  2001. Religious and philosophical exemptions from vaccination requirements and lessons learned from conscientious objectors from conscription. Public Health Rep. 116:289–95 [Google Scholar]
  57. Stadlin S, Bednarczyk RA, Omer SB. 57.  2012. Medical exemptions to school immunization requirements in the United States—association of state policies with medical exemption rates (2004–2011). J. Infect. Dis. 206:7989–92 [Google Scholar]
  58. Sugerman DE, Barskey AE, Delea MG, Ortega-Sanchez IR, Bi D. 58.  et al. 2010. Measles outbreak in a highly vaccinated population, San Diego, 2008: role of the intentionally undervaccinated. Pediatrics 125:4747–55 [Google Scholar]
  59. Swales JD. 59.  1992. The Leicester anti-vaccination movement. Lancet 340:1019–21 [Google Scholar]
  60. Thompson JW, Tyson S, Card-Higginson P, Jacob RF, Wheeler G. 60.  et al. 2007. Impact of addition of philosophical exemptions on childhood immunization rates. Am. J. Prev. Med. 32:3194–201 [Google Scholar]
  61. 61.  Vaccination is the curse of childhood (Antivaccination circular distributed in Boston during a smallpox epidemic). 1901. Countway Libr. Med., Harvard Univ. http://pds.lib.harvard.edu/pds/view/5817279?n=1&imagesize=1200&jp2Res=.25&amo;printThumbnails=no
  62. Walkinshaw E. 62.  2011. Mandatory vaccinations: the Canadian picture. CMAJ 183:16E1165–66 [Google Scholar]
  63. 63. Wash. State Dep. Health 2013. School immunization status data reports. Wash. State Dep. Health, Olympia. http://www.doh.wa.gov/DataandStatisticalReports/SchoolImmunization/DataReports.aspx
  64. Wenger OK, McManus MD, Bower JR, Langkamp DL. 64.  2011. Underimmunization in Ohio's Amish: Parental fears are a greater obstacle than access to care. Pediatrics 128:179–85 [Google Scholar]
  65. Willrich M. 65.  2011. Pox: An American History New York: Penguin
  66. 66.  Workman v. Mingo County Board of Education 667 F. Supp. 2d 679 2009.
  67. 67.  Wright v. DeWitt School District 238 Ark. 906, 385 S.W. 2d 644 (Ark. 1965)
  68. 68.  Zucht v. King 260 US 174 (1922)
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Personal Belief Exemptions From School Vaccination Requirements
Annual Review of Public Health 35, 275 (2014); https://doi.org/10.1146/annurev-publhealth-032013-182452
/content/journals/10.1146/annurev-publhealth-032013-182452
/content/journals/10.1146/annurev-publhealth-032013-182452
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