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Nonmedical exemptions from school immunization requirements: A systematic review

Author

Listed:
  • Wang, E.
  • Clymer, J.
  • Davis-Hayes, C.
  • Buttenheim, A.

Abstract

We summarized studies describing the prevalence of, trends in, and correlates of nonmedical exemptions from school vaccination mandates and the association of these policies with the incidence of vaccine-preventable disease. We searched 4 electronic databases for empirical studies published from 1997 to 2013 to capture exemption dynamics and qualitatively abstracted and synthesized the results. Findings from 42 studies suggest that exemption rates are increasing and occur in clusters; most exemptors questioned vaccine safety, although some exempted out of convenience. Easier state-level exemption procedures increase exemption rates and both individual and community disease risk. State laws influence exemption rates, but policy implementation, exemptors' vaccination status, and underlying mechanisms of geographical clustering need to be examined further to tailor specific interventions. © 2014, American Public Health Association Inc. All rights reserved.

Suggested Citation

  • Wang, E. & Clymer, J. & Davis-Hayes, C. & Buttenheim, A., 2014. "Nonmedical exemptions from school immunization requirements: A systematic review," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 62-84.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2014.302190_6
    DOI: 10.2105/AJPH.2014.302190
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    Citations

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    Cited by:

    1. Delamater, Paul L. & Leslie, Timothy F. & Yang, Y. Tony, 2016. "A spatiotemporal analysis of non-medical exemptions from vaccination: California schools before and after SB277," Social Science & Medicine, Elsevier, vol. 168(C), pages 230-238.
    2. Berezin, Mabel & Eads, Alicia, 2016. "Risk is for the rich? Childhood vaccination resistance and a Culture of Health," Social Science & Medicine, Elsevier, vol. 165(C), pages 233-245.
    3. Sobo, Elisa J., 2016. "What is herd immunity, and how does it relate to pediatric vaccination uptake? US parent perspectives," Social Science & Medicine, Elsevier, vol. 165(C), pages 187-195.
    4. Çelik, Kezban & Turan, Sevgi & Üner, Sarp, 2021. "I'm a mother, therefore I question”: Parents' legitimation sources of and hesitancy towards early childhood vaccination," Social Science & Medicine, Elsevier, vol. 282(C).
    5. Anderson, Kerri-Ann & Creanza, Nicole, 2023. "A cultural evolutionary model of the interaction between parental beliefs and behaviors, with applications to vaccine hesitancy," Theoretical Population Biology, Elsevier, vol. 152(C), pages 23-38.
    6. Carpiano, Richard M. & Fitz, Nicholas S., 2017. "Public attitudes toward child undervaccination: A randomized experiment on evaluations, stigmatizing orientations, and support for policies," Social Science & Medicine, Elsevier, vol. 185(C), pages 127-136.

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