Tug-of-war with US state-controlled nonmedical vaccine exemptions

All 50 states allow medical exemption from vaccination. Medical vaccination exemptions have been in place for a long time for people who are immunocompromised (with weakened immune system) or for various other conditions that make getting vaccinated dangerous. These are necessary exemptions, however they leave very sick people vulnerable to disease.

Over the last decade many states across the US have been allowing nonmedical exemptions including those for religious rights and philosophical opposition. Your right to nomedical exemption is based on your state’s exemption laws. And in some states there is also the possibility of exemption based on proof of immunity to a disease.

As of 2016, all U.S. states allow a religious exemption to vaccination except California, Mississippi and West Virginia.

The rise of nonmedical exemption is leaving large pockets of unvaccinated individuals in many states–places where there is higher risk and incidence of preventable disease.

Source: CDC 2009-10 through 2015-16 School Year Vaccination Exemptions Trend Report | 2010 data is not available   GIF / Youtube

The good news?

According to the Center for Disease Control (CDC) as a nation we are seeing nonmedical exemptions on the decline. Nationally there were nearly 80,000 kindergarteners with at least one exemption during the 2013-2014 school year. This last school year there were around 72,000.

We are seeing these declines in all states adopting stricter vaccination laws. All 50 states and the District of Columbia now require polio, measles, and rubella vaccinations. However that still leaves out several childhood vaccinations.

The bad news?

Many states have expanded their vaccine exemption laws to allow exemption of MMR andTdap, among other various vaccines. States where medical exemption is higher than ever–Connecticut, Florida, Iowa, Kentucky, Maryland, New York, North Carolina, North Dakota, Ohio, Oklahoma, and Virginia are seeing spikes in disease due to higher exemptions.

Mississippi, California, and West Virginia still allow philosophical/religious exemptions.

North Dakota is one of the easiest states to claim a nonmedical exemption. Some schools hand out the exemption forms at the beginning of the year. These exemptions went from 0.8% to 3% last year.

Connecticut’s nonmedical exemptions rose from 0.8% to 1.7% in the last six years.

I could go on all day.

In 2016 the American Academy of Pediatrics issued a statement urging all states to eliminate nonmedical vaccine exemptions.

We saw a 3,000 drop in nonmedical exemptions in California when the state eliminated personal belief exemptions in 2015. That’s a big number considering most of these exemptions were claimed in concentrated communities.

Vermont also dropped this exemption in 2015.

Parents across America are taking advantage of nonmedical exemptions for a number of reasons. Philosophical beliefs are high on the list. These beliefs tend to be that vaccination is unnecessary/harmful.

Fear is powerful and contagious.

So is disease.

Did you check out the graphic above? Hit play. I live in one of those expanding bubbles. So do my kids. They are vaccinated, and while vaccines are very effective they are not 100% effective. Therefore when preventable disease spreads they aren’t guaranteed safe.

This affects everyone.

Be educated.

Get involved.


National Vaccination Education Center

Center for Disease Control

American Academy of Pediatrics

Edwards, Kathryn M. Edwards and  Jesse M. Hackell. “Countering Vaccine Hesitancy. From the American Academy of Pediatrics. August 2016.


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