Vaccine Exemptions Drop After Legally Mandated Parental Counseling

Rates of vaccine exemptions among students in Washington fell significantly after the state required parental counseling, as indicated by a study published online in the Journal Pediatrics.

“This features the significance of more stringent policies for acquiring immunization exemptions,” the authors wrote. All states enable parents to exempt their children from required kindergarten vaccines for medicinal reasons.

Twenty-nine also permit religious exemptions and 18 permits both religious and personal belief exemptions, as indicated by the study. In 2011, Washington passed a law requiring families to talk about vaccine risks and benefits with a health care provider to acquire a nonmedical exemption.

Scientists set out to determine the effect of the law by examining Washington State Department of Health information from the 1997– 1998 through 2013– 2014 school years.

They found a relative reduction in exemption rates of 40.2% and an absolute decrease of 2.9 percentage points. There additionally were decreases in the probability that kindergartners would encounter a classmate with an exception.

The authors said the reduction in exemptions might be because of parents’ trust in doctors or the additional effort required acquiring an exemption. After the law went effective, around 10% of students were granted conditional school entrance and did not meet the vaccine necessities. Specialists prescribed focusing on enforcement and suggested that different states follow suit in enacting stricter policies.

“Our discoveries feature the significance of evidence-informed legislation to diminish the risk of vaccine-preventable diseases,” they wrote. “States in the U.S. and jurisdictions in other countries should consider including parental counseling as a necessity for obtaining exemptions to vaccination requirements.”

The American Academy of Pediatrics (AAP) recommends eliminating nonmedical exceptions. California did as such in a 2015 effort led by Democratic State Senator Richard J. Container, MD, MPH, FAAP. In the law’s first year, 96% of California kindergartners were vaccinated, as indicated by a commentary Dr. Dish wrote in the response to the Washington study.

While initial outcomes are positive, Dr. Pan noted: “there are additional reports of some doctors monetizing their license selling medicinal exemptions.”

He called for clearly characterized standards and sanctions for doctors who are benefitting. He additionally urged pediatricians to stand up to antivaccine groups and advocate for more effective vaccine policies. “Educating the public population that vaccines are safe and effective isn’t sufficient,” Dr. Pan wrote.

“To protect our children and groups, child-health advocates must organize pro-science parents who think about public safety in their group to campaign for laws to reestablish community immunity. Vaccines work. Each child needs community immunity. For our children’s safety, we should fight back.”


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