Journal of Pediatrics – July 2014

Journal of Pediatrics
Vol 165 | No. 1 | July 2014 | Pages 1-216

Immunization exemptions leave kindergarten entrants at higher risk for vaccine-preventable diseases
Sarah S. Long, MD
School immunization laws have contributed substantially to the decline in vaccine-preventable disease in the US. Immunization laws are made at the state level: 2 states permit medical exemptions only, 46 states and the District of Columbia permit religious exemptions, and 18 states permit philosophical or personal-belief exemptions. States that do not permit personal-belief exemptions have lower rates of religious exemptions, but religious exemptions have increased in these states, suggesting that some parents might be using religious rather than personal-belief exemptions. It is noteworthy that except for Christian Scientists, opposition to immunization is not part of any organized religious doctrine.

United States Private Schools Have Higher Rates of Exemptions to School Immunization Requirements than Public Schools
Jana Shaw, MD, MPH, Boldtsetseg Tserenpuntsag, DrPH, Louise-Anne McNutt, PhD, Neal Halsey, MD
To compare medical, religious, and personal belief immunization exemption rates between private and public schools in US.
Study design
Exemption rates were calculated using the Centers for Disease Control and Prevention School Immunization Assessment Surveys for the 2009-2010 school year excluding states with incomplete survey data. Standardized exemption rates weighted on enrollments in public and private schools were calculated. Differences in exemption rates between public and private schools were tested using Wilcoxon signed rank test.
The overall state exemption rate was higher in US private than public schools, 4.25% (SD 4.27) vs 1.91% (1.67), P = .0001 and private schools had higher exemption rates for all types of exemptions; medical 0.58% (0.71) vs 0.34% (0.34) respectively (P = .0004), religious 2.09% (3.14) vs 0.83% (1.05) respectively (P = .0001), and personal belief 6.10% (4.12) vs 2.79% (1.57), respectively (P = .006). Overall exemption rates were significantly higher in states that allowed personal belief exemptions.
Exemption rates were significantly higher in US private than in public schools. Children attending private schools may be at higher risk of vaccine-preventable diseases than public school children.