Tag Archives: vaccine exemptions

The Best Way to Handle Vaccine Skeptics

Posted on by

According to a recent NY Times editorial, the best way to improve vaccination rates is not to mandate universal vaccination or to label ‘anti-vaxxer’ parents as ignorant.  The best way is to make it more difficult to receive personal exemptions –this is something the government can be quite good at.

Here’s the link: How to Handle Vaccine Skeptics -NY Times

Here’s an excerpt:

They [States} can require parents to write a letter elaborating on the reason their child should be exempt. They can require that the letter be notarized. They can insist that parents read and sign a form that discusses the risks of nonvaccination. Better yet, they should mandate in-person counseling so that the decision not to vaccinate is truly informed.

States can also require that parents obtain an exemption form by specifically requesting one from the state or local health department, rather than downloading it online. They can insist that these parents acknowledge that they will be responsible for keeping the children away from school during outbreaks. Moreover, they should have procedures to review each request for exemption rather than automatically approving them, as many states do now. And they should require parents with exemptions to apply annually for renewal…

 In a 2012 study, which my colleagues and I [Saad Omer] published in The New England Journal of Medicine, nonmedical exemption rates were 2.3 times higher in states with easy administrative policies for granting exemptions (like Connecticut, Missouri and Wisconsin) than in states with difficult policies (like Florida, Minnesota and Texas). Moreover, the annual rate of increase in nonmedical exemptions was about 60 percent higher in states with easy exemption policies compared with states with difficult policies.

1400 Different Immunization Schedules -What Could Go Wrong?

Posted on by

A recent study (J Pediatr 2015; 166: 151-6) has examined the frequency of “alternative” (non-standard) vaccination schedules among 222,628 children in New York (2009-2011), using a statewide mandatory immunization information system.

Key findings:

  • 25% of children followed an non-standard immunization schedule.
  • At 9 months of age, children on an non-standard schedule were less likely to be up-to-date (15% compared with 90%, P<0.05).

The authors note that in a separate study that there were “1400 individualized vaccination patterns.”  These patterns break down into three: delays of vaccine, selective refusal of specific vaccines, and reduction in the number of vaccines.

In a brief summary, Sarah Long notes that for parents/doctors –“Although their intent is heightened protection of their children/patients from harm, the result is the opposite.  Alternative “schedules” are completely untested for immunogenicity or safety.”

One limitation of this study is that it was conducted in New York.  There is wide variability in the resistance to vaccination among states.

Bottomline: Their has been an increase in the use of non-standard vaccine schedules.  This is contributing to community vulnerability to vaccine preventable diseases.

A related story: “Disneyland” Measles Outbreak (from USA Today) and from NY Times (1/21/15): Measle cases linked to Disneyland (& unvaccinated students).  1/28/15 Measles in Arizona reaches ‘critical point’

Related blog posts:

Vaccine Safety -Put into Perspective

Posted on by

For anyone concerned about vaccine safety, putting the risks into perspective may be helpful:

“The most dangerous aspect of giving your child vaccines is driving to the office to get them,” according to Paul Offit, chief of infectious disease at Children’s Hospital of Philadelphia, in Vaccine Safety Article from USA Today.

With regard to exemptions, a recent study has shown that private schools have higher vaccine exemption rates (4.25%) than public schools (1.91%) (J Pediatr 2014; 165: 129-33).  Using CDC data for 35 states (& district of Columbia), the authors noted that there were 48,931 exemptions in 2009-2010 with only 7146 for medical reasons.  For individual states, Hawaii had the highest private school exemption rate at 14.88% and Washington had the highest public school exemption rate at 6.08%.

The authors note that parents with “higher income and educational levels expressed more concerns about vaccine safety.”  However, they state that “parents who object to immunizations have been considered ‘free riders’ as they take advantage of the benefit created by children who assume any potential risk of adverse reactions.”

In a brief summary, Sarah Long, an infectious disease expert and associate editor of The Journal of Pediatrics, questions how these parents can be “so mistrustful of doctors…and yet so confident in their own musings? At the same time that they are attempting to advantage their children by attendant a private school, they are putting their children in harm’s way.”

Related blog posts: