![]() 7 Also, the rate of exemptions in Colorado counties with outbreaks of pertussis was higher than counties that did not have outbreaks of pertussis (4.3% vs 1.5%, respectively P = .001). 6 Children in Colorado with nonmedical exemptions between 19 were 22 times more likely to contract measles and 5.9 times more likely to contract pertussis than vaccinated children. Children in the United States with nonmedical exemptions between 19 were 35 times more likely to contract measles than vaccinated children. 5Ĭhildren who have exemptions to these laws are at greater risk for contracting VPDs and transmitting disease to children too young to be vaccinated, persons with medical contraindications to immunization, and persons who do not develop protective responses to vaccines (vaccine failure). In addition to medical exemptions, 48 states offer religious exemptions and 19 states offer personal or philosophical exemptions. 3, 4 All states require children entering school to receive certain vaccines, and all states permit medical exemptions to these immunization requirements. 1, 2 Smallpox has been eradicated, polio will likely soon follow, and the incidence of most vaccine-preventable diseases (VPDs) has been reduced by 98% to 99% in the United States. Laws requiring immunization for school attendance have contributed to the enormous success of the US immunization program. ![]() Parents of exempt children were significantly less likely to report confidence in medical, public health, and government sources for vaccine information and were more likely to report confidence in alternative medicine professionals than parents of vaccinated children.Ĭonclusion Continued efforts must be made to educate parents about the utility and safety of vaccines, especially parents requesting nonmedical exemptions to school immunization requirements. Parents of exempt children were significantly more likely than parents of vaccinated children to report low perceived vaccine safety and efficacy, a low level of trust in the government, and low perceived susceptibility to and severity of vaccine-preventable diseases. The most common reason stated for requesting exemptions (190 of 277) was concern that the vaccines might cause harm. The most common vaccine not received was varicella (147 of 277 exempt children). Results Most children (209 of 277) with nonmedical exemptions received at least some vaccines. Surveys were completed by 2435 parents (56.1%). ![]() Participants Surveys were mailed to the parents of 815 exempt children (cases) and 1630 fully vaccinated children (controls randomly selected from the same grade and school) recruited from 112 private and public elementary schools. Setting Colorado, Massachusetts, Missouri, and Washington. Objectives To determine why parents claim nonmedical exemptions and to explore differences in perceptions of vaccines and vaccine information sources between parents of exempt and fully vaccinated children. Shared Decision Making and Communicationīackground The rate of nonmedical exemptions to school immunization requirements has been increasing, and children with exemptions have contributed to outbreaks of vaccine-preventable diseases.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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