Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Nonmedical Exemptions for Vaccinations Shifting
Open Forum Infect Dis; 2017 Nov 15; Omer, et al
While the requirement to receive vaccination in order to enter kindergarten has had a powerful impact in reducing the incidence of vaccine-related diseases, the rate of non-medical exemptions has been growing in recent years, according to an analysis of state regulations. Key points include:
- The rate of nonmedical exemptions was higher from 2013-2014 through 2015-2016, when compared to 2011-2012 through 2012-2013, at 2.25% vs 1.75%.
- The researchers pointed out, however, that nonmedical exemptions stabilized during the 2015-2016 school year.
- The nonmedical exemption rate in states that allowed parents to claim exemptions for philosophical and religious reasons was more than twice the rate seen in states that only permitted religious exemptions (incidence rate ratio=2.41).
Citation:
Omer SB, Porter RM, Allen K, RA. Trends in kindergarten rates of vaccine exemption and state-level policy, 2011–2016. Open Forum Infect Dis. [Published online ahead of print November 15, 2017]. doi:10.1093/ofid/ofx244.
This study looks at trends in nonmedical exemptions for kindergarten vaccine requirements. This is an important issue as high rates of nonmedical exemptions are associated with higher rates of vaccine preventable diseases, as demonstrated by the recent pertussis outbreak in California. Annual data show that while the rate of nonmedical exemptions increased over time, the rates stabilized at the end of the time studied. It will be important to continue to look at the data to monitor the results of the recent legislative changes to remove all nonmedical exemptions in California to see if this strategy improves kindergarten vaccination rates as hoped.
-Sarah Rawstron, MB, BS, FAAP, FIDSA
Pediatric Residency Program Director, The Brooklyn Hospital Center, NY
Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY