Study explores medical exemptions from school vaccination requirements across states

In states where medical exemptions from vaccination requirements for kindergarten students are easier to get, exemption rates are higher, potentially compromising herd immunity and posing a threat to children and others who truly should not be immunized because of underlying conditions, according to a study published in The Journal of Infectious Diseases and now available online. Nationwide in scope, the study found inconsistency among states in standards allowing medical exemptions from school immunization requirements. The investigators concluded that medical exemptions should be monitored and continuously evaluated to ensure they are used appropriately.

In their study, Stephanie Stadlin, MPH, Robert A. Bednarczyk, PhD, and Saad B. Omer, MBBS, MPH, PhD, from the Hubert Department of at Emory University Rollins of Public Health in Atlanta, evaluated state medical exemptions from kindergarten entry requirements over seven school years (from 2004-'05 to 2010-'11), which totaled 87,631 medical exemptions nationwide over the period studied. The researchers found that, compared to states with more stringent criteria for getting medical exemptions, states with easier requirements saw a significant increase in these exemptions. Their findings suggest that requiring more accountability of both parents and physicians for granting medical exemptions can be helpful in ensuring that these exemptions are valid and not used as an alternative to non-medical exemptions because they are easier to obtain.

"The appropriate use of medical exemptions is important to maintaining sufficient herd immunity to protect those who should not be vaccinated due to medical contra-indications," said Dr. Omer, the senior investigator of the study. "Medical providers, parents, , and state health officials are responsible for ensuring that medical exemptions are actually medically indicated."

In an accompanying editorial, Daniel A Salmon, PhD, MPH, and Neal Halsey, MD, of the Johns Hopkins Bloomberg School of Public Health in Baltimore, noted that "children with valid medical exemptions need to be protected from exposure to vaccine preventable diseases by insuring high coverage rates among the rest of the population. Granting medical exemptions for invalid medical contraindications may promote unfounded vaccine safety concerns." The researchers' findings, they added, should be useful to those responsible for implementing and enforcing school immunization requirements at the state and local levels.

add to favorites email to friend print save as pdf

Related Stories

More kids skip school shots in 8 states

Nov 28, 2011

More parents are opting out of school shots for their kids. In eight states now, more than 1 in 20 public school kindergartners aren't getting all the vaccines required for attendance, an Associated Press ...

Recommended for you

ER visits on the rise, study reports

2 hours ago

(HealthDay)—The number of emergency department visits in the United States rose from about 130 million in 2010 to a record 136 million in 2011, according to the U.S. Centers for Disease Control and Prevention.

Better assessment of decision-making capacity

6 hours ago

Physicians often find it hard to tell if a patient suffering from dementia or depression is capable of making sound judgements. This is shown by a study conducted within the scope of the National Research Programme "End of ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.