Vaccine Exemption Rates Higher in White, Affluent Calif. Communities
California communities that had more white and high-income residents had higher rates of personal belief exemptions for childhood vaccination or for childhood vaccination requirements, according to a study published in the American Journal of Public Health, HealthDay/U.S. News & World Report reports (HealthDay/U.S. News & World Report, 11/12).
Background
In July, Gov. Jerry Brown (D) signed a bill (SB 277) to end all personal belief exemptions to California's childhood vaccination requirements (California Healthline, 7/1).
SB 277, by state Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Redondo Beach), only allows children who have received vaccinations for certain diseases, such as measles and whooping cough, to be admitted to schools in the state. The legislation allows exemptions for medical reasons.
In addition, the measure was amended to:
- Allow unvaccinated children to enroll in private home-schooling programs that serve multiple families, rather than programs that serve just one family;
- Permit such children to participate in independent study projects that are overseen by school districts but do not include classroom time;
- Remove a provision that would have required schools to inform parents of immunization rates; and
- Allow physicians to consider family histories when determining medical exemptions.
The law also includes a provision that would give unvaccinated children with existing exemptions more time to comply with the rule (California Healthline, 10/1).
Study Findings
About 3% of school-aged children filed personal belief exemptions to avoid obtaining required vaccinations in the 2013-2014 school year -- twice as many as six years earlier, according to the study.
Tony Yang, lead author of the study and an associate professor at George Mason University, said, "Many commentators have said that white, higher-income, more-educated parents are the primary drivers" of the trend of parents increasingly seeking personal belief exemptions.
The researchers found that theory to be partly true. The study found that communities in California with larger white populations and higher median incomes had higher rates of parents filing the exemptions. However, they found that education levels did not typically show an influence on exemption rates.
In 2013, personal belief exemptions were filed at private schools in the state at nearly twice the rate of those filed for public school children, at 5.5% and 3%, respectively.
Yang said the pattern of higher personal exemption rates being higher in more affluent, largely white populations also could be true for other states. "People with more resources are better able to jump the hurdles than low-income people are," he added.
Comments
Yang said efforts to educate the public on the safety of vaccines should be geared toward white, higher-income communities.
However, Paul Offit, a vaccine expert who was not involved in the study, said more-advantaged parents might opt out of vaccinations because they look up information online and "think they ... know more about vaccines than the doctor does."
Offit said he doubts education efforts in such communities would be successful. "I think the people who exempt their children from receiving any vaccines ... know that vaccines stand on a mountain of scientific evidence, and they've chosen to discount that."
He said he believes other states should implement laws similar to SB 277 that would bar personal belief exemptions (HealthDay/U.S. News & World Report, 11/12).
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