Increasing rates of unvaccinated young children with “personal belief exemptions” from vaccination requirements are becoming worrisome, according to research presented here at the American Public Health Association (APHA) 139th Annual Meeting.
Recent concern about vaccine safety appears to be gaining strength, and state regulations requiring parents to vaccinate their children before they can attend public schools vary. In California, obtaining a personal belief exemption could not be easier — parents are only required to sign their name to a 2-sentence standard exemption statement on the back of the vaccination requirement form.
In evaluating data on the rates of exemptions from the California Department of Public Health, the state’s Department of Education and the US Census, researchers found that in 2010, the state had about 11,500 kindergartners with personal belief exemptions, representing a 25% increase over the previous 2 years.
The increasing rate indicates that, for kindergartners who have adhered to vaccination schedules, exposure to children with personal belief exemptions is about 2.3 per 100 children.
Because children with the exemptions tend to be found in clusters, the rate of children with exemptions who are exposed to other children who also have exemptions — a higher-risk combination — was 15.6 per 100 in 2010, said lead author Alison Buttenheim, PhD, MBA, from the University of Pennsylvania’s Robert Wood Johnson Health & Society Scholars Program in Philadelphia.
“The average kindergartner with a personal belief exemption attends a school where the exemption rate is 15 per 100, and we see that figure increasing all the time,” she reported.
Previous data from the fall of 2008 showed that 10% of the nearly half-million kindergartners in California attended schools where personal belief exemption rates exceeded 5%, and as many as 61% of kindergartners with 1 or more personal belief exemptions (n = 9196) attended schools where the personal exemption rate exceeded 5%. Among those, a third attended schools where the personal belief exemption rate exceeded 20%.
In a separate study conducted by the same team, the researchers investigated the concerns that parents have about vaccines by evaluating data on the specific vaccines received by 168 patients at a pediatric practice in Philadelphia where the practitioner, though pro-vaccine, is known to accommodate parents who seek alternative vaccination options.
Although not necessarily indicative of the larger population, the results give a snapshot of the types of issues that may underlie vaccination concerns. The results indicated that as many as 40% of parents had more than one concern.
The leading concern was that the vaccines “overtax” the immune system (16%). “This was commonly expressed as the parents feeling the schedule just represented too many shots that could overburden the system,” Dr. Buttenheim said.
Other reasons for concern included the rarity of vaccine-preventable diseases (10%), a preference for natural immunity (7%), and autism (5%).
Dr. Buttenheim noted that increasing rates of personal belief exemptions have coincided with sharp increases in measles cases.
“Measles cases were very low in the US until 2008, when rates jumped up. Things calmed down again but then they jumped up again in 2010. We are very close to 200 cases in the US this year…. Meanwhile, this a disease that we thought we had eradicated,” she said.
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