Study: Vaccine exemptions drop after parental counseling required
MelissaJenco, News Content Editor
Rates of vaccine exemptions among students in Washington fell significantly after
the state required parental counseling, according to a new study.
“This highlights the importance of more stringent policies for obtaining immunization
exemptions,” authors wrote.
All states allow parents to exempt their children from mandatory kindergarten vaccines
for medical reasons. Twenty-nine also allow religious exemptions, and 18 allow both
religious and personal belief exemptions, according to the study “Exemptions from
Mandatory Immunization after Legally Mandated Parental Counseling” (Omer SB, et al.
Pediatrics. Dec. 18, 2017, https://doi.org/10.1542/peds.2017-2364).
In 2011, Washington passed a law requiring families to discuss vaccine risks and benefits
with a health care provider to obtain a nonmedical exemption. Researchers set out
to determine the impact of the law by studying Washington State Department of Health
data from the 1997-’98 through 2013-’14 school years.
They found a relative decrease in exemption rates of 40.2% and an absolute reduction
of 2.9 percentage points. There also were declines in the probability that kindergartners
would encounter a classmate with an exemption.
Authors said the decrease in exemptions may be due to parents’ trust in physicians
or the extra effort needed to obtain an exemption.
After the law went into effect, about 10% of students were granted conditional school
entrance and did not meet the vaccine requirements. Researchers recommended focusing
on enforcement and suggested that other states follow suit in enacting stricter policies.
“Our findings highlight the importance of evidence-informed legislation to reduce
the risk of vaccine preventable diseases,” they wrote. “States in the U.S. and jurisdictions
in other countries should consider adding parental counseling as a requirement for
obtaining exemptions to vaccination requirements.”
The Academy recommends eliminating nonmedical exemptions. California recently did so in a 2015 effort led by state Sen. Richard J. Pan, M.D., M.P.H., FAAP. In its first year, 96% of California
kindergartners were vaccinated, according to a commentary Dr. Pan wrote in response to the Washington study.
While initial results are positive, Dr. Pan noted “there are also reports of some
physicians monetizing their license selling medical exemptions.” He called for clearly
defined standards and sanctions for physicians who are profiting. He also urged pediatricians
to stand up to anti-vaccine groups and advocate for more effective vaccine policies.
“Educating the public that vaccines are safe and effective is not enough,” Dr. Pan
wrote. “To protect our children and communities, child health advocates must organize
pro-science parents who care about public safety in their community to campaign for
laws to restore community immunity. Vaccines work. Every child needs community immunity.
For our children’s safety, we must fight back.”