Vaccine Exemption Rate Corresponds With Disease Outbreaks

A rise in vaccine nonmedical exemptions (NMEs) is related to an uptick in measles, mumps, and rubella (MMR) outbreaks, a new analysis has found.

Children who are not vaccinated against MMR are 35 times more likely to contact measles than vaccinated children. Similarly, those who are not vaccinated against diphtheria, tetanus, and acellular pertussis are 3 times as likely to contract pertussis than vaccinated children.

IF YOU LIKE THIS, READ MORE...

Flu Vaccination More Likely in Children With a Provider Recommendation

Few HPV Vaccine Recipients Receive All 3 Doses

To examine the association between NME and vaccination rate, the researchers examined the Spearman correlation between these rates for 17 US states that allow NMEs and 3 control states that prohibited NMEs during the 2016-2017 school year.

Results of the analysis showed that in states where the NME rates were high, MMR vaccination rates were low. Conversely, the states that prohibit NMEs had the highest MMR vaccination rate and lowest rate of vaccine-preventable diseases.

Results of a secondary analysis of all 50 US states and the District of Columbia showed similar results when compared with states that allow NMEs.

“Our study did not specifically focus on physician-based interventions; however, several studies suggest that patient education does in fact increase vaccine uptake,” said study co-author Melissa S. Nolan, assistant professor of epidemiology at the University of South Carolina, via email. “Additionally, we highlight in a supplement table in our article a few state-wide policies that enhance physician education on how to talk with patients about the benefits of vaccine and note their positive effects.”

For example, Oregon allows NMEs and, in 2014, passed legislation requiring parents to watch an educational video online or get an education certificate at a doctor’s office before being able to obtain an NME. This led to a decrease in NMEs from 2014 to 2016.

“One of the reasons I wrote my new book, Vaccines Did Not Cause Rachel’s Autism, was to provide the information and talking points for pediatricians and health care providers,” said study co-author Peter Jay Hotez, MD, PhD, professor and dean of the National School of Tropical Medicine at Baylor and director of the Texas Children’s Hospital Center for Vaccine Development, via email.

—Amanda Balbi

Reference:

Olive JK, Hotez PJ, Damania A, Nolan MS. The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties [published online June 12, 2018]. PLoS. https://doi.org/10.1371/journal.pmed.1002578.

Listen to our podcast with Dr Julia Piwoz about pertussis vaccination: