Abstract:
Background:Kindergarten-entry vaccination requirements have played an important role in controlling vaccine-preventable diseases in the United States. Forty-eight states and the District of Colombia offer nonmedical exemptions to vaccines, ranging in stringency. Methods:We analyzed state-level exemption data from 2011 to 2012 through 2015 to 2016 school years. States were categorized by exemption ease and type of exemption allowed. We calculated nonmedical exemption rates for each year in the sample and stratified by exemption ease, type, and 2 trend categories: 2011-12 through 2012-13 and 2013-14 through 2015-16 school years. Using generalized estimating equations, we created regression models estimating (1) the average annual change in nonmedical exemption rates and (2) relative differences in rates by state classification. Results:The nonmedical exemption rate was higher during the 2013-2014 through 2015-2016 period (2.25%) compared to 2011-2012 through 2012-2013 (1.75%); more importantly, the average annual change in the latter period plateaued. The nonmedical exemption rate in states allowing philosophical and religious exemptions was 2.41 times as high as in states allowing only religious exemptions (incidence rate ratio = 2.41; 95% confidence interval, 1.71-3.41). Conclusions:There was an increase in nonmedical exemption rates through the 2012-2013 school year; however, rates stabilized through the 2015-2016 school year, showing an important shift in trend.
journal_name
Open Forum Infect Disjournal_title
Open forum infectious diseasesauthors
Omer SB,Porter RM,Allen K,Salmon DA,Bednarczyk RAdoi
10.1093/ofid/ofx244subject
Has Abstractpub_date
2017-11-15 00:00:00pages
ofx244issue
2issn
2328-8957pii
ofx244journal_volume
5pub_type
杂志文章abstract::Background. Varicella is a highly contagious vaccine-preventable illness. In 1996, the Advisory Committee for Immunization Practices recommended 1 dose of vaccine for children, and in 2006 it recommended 2 doses; Connecticut required 1 dose for school entry in 2000 and 2 doses for school entry starting in 2011. Conne...
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