September 2017, Vol 171, No. 9, Pages 823-924
Achieving an Optimal Childhood Vaccine Policy
Douglas J. Opel, MD, MPH; Jason L. Schwartz, PhD; Saad B. Omer, MBBS, PhD; et al.
JAMA Pediatr. 2017;171(9):893-896. doi:10.1001/jamapediatrics.2017.1868
Policies to remove parents’ ability to opt-out from school immunization requirements on the basis of religious or personal beliefs (ie, nonmedical exemptions) may be a useful strategy to increase immunization rates and prevent outbreaks of vaccine-preventable disease. However, there is uncertainty about the effectiveness of this strategy and the range of possible outcomes. We advocate for a more deliberative process through which a broad range of outcomes is scrutinized and the balance of values underlying the policy decision to eliminate nonmedical exemptions is clearly articulated. We identify 3 outcomes that require particular consideration before policies to eliminate nonmedical exemptions are implemented widely and outline a process for making the values underlying such policies more explicit.