Easy Vaccine Exemption Laws Boost Outbreaks
The incidence of whooping cough is 50% higher in 19 states where parents are permitted by law to exempt their children from school vaccinations by reason of "personal beliefs" compared with states that allow exemptions only for medical reasons or religious beliefs, according to a report in the Journal of the American Medical Association, Reuters reports. The rate also is about 50% higher in states that have easy exemption laws compared with states that have more stringent restrictions, according to study authors Saad Omer of Johns Hopkins University and Daniel Salmon of University of Florida College of Medicine (Norton, Reuters, 10/10).
In all states, exemptions to the vaccination mandate are permitted for medical reasons, and 48 states allow exemptions for other reasons, including either religious or personal beliefs. In most states, nonmedical exemptions require documentation, notarized paperwork and a visit to a local health department.
In states with lax laws, parents only have to sign an exemption letter (Tanner, AP/Houston Chronicle, 10/10). According to the study, the rate of nonmedical exemptions has grown by 6% per year from 1991 through 2004.
In a previous study, Salmon and colleagues found that 69% of parents who sought exemptions did so because of concerns over vaccine safety.
According to Omer, higher rates of whooping cough point to the "very real consequences" of relaxing vaccination requirements. Salmon has recommended that states adopt "administrative controls" that make nonmedical exemptions more difficult to obtain, suggesting a system through which parents would have to demonstrate a "strongly held belief." In turn, the government either would have to prove an "overwhelming need" for universal vaccination or grant the exemption (Reuters, 10/10).
Omer said, "States must balance parental autonomy with the enormous individual and community benefits of vaccines when considering their exemptions policies" (Washington Post, 10/11).