Investigating How States’ Vaccination Exemption Laws Affect Vaccination Rates

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Childhood vaccines play a major role in minimizing the incidence of vaccine-preventable disease. While all states accommodate medical vaccine exemptions, certain states also allow for waivers on the basis of religious or philosophical objections. Certain vaccines have been particularly controversial, with public perceptions linking them to autism and developmental disorders, despite consensus to the contrary in the scientific and medical communities.  This has led some states to add exemptions in recent years, while other states opted to eliminate the exemptions.       

George Washington University Milken Institute School of Public Health Professor Avi Dor and Assistant Research Professor Ali Moughtaderi  received an award from Policies for Action, a program supported by the Robert Wood Johnson Foundation, to study the economics of childhood vaccines. They are investigating if and how changes in states’ vaccination exemption laws affect childhood vaccination rates.

Dor and Moughtaderi are focusing on the main vaccine combinations, including measles- mumps-rubella (MMR) and diphtheria-tetanus-pertussis (DTP), as well as individual vaccines.  To establish the influence of states’ non-medical vaccine exemption requirements on the probabilities of vaccine uptake, they will combine independently collected data on the evolution of philosophical and religious exemptions in state laws with current  survey data on household behavior.

“Our preliminary results suggest that by adopting more restrictive laws, states were able to increase coverage rates for the most controversial vaccines,” Dor says.  “However, our analysis is on-going.”   

“The overarching purpose of the research is to understand whether existing vaccination policies and regulations are compatible with the public health objectives of improving immunization coverage and ultimately population health,” Dor explains.