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October 25, 2000

Effects and Ethics of Sanctions on Childhood Immunization Rates

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(16):2056-2057. doi:10.1001/jama.284.16.2053

To the Editor: Dr Kerpelman and colleagues1 found that monetary sanctions increased the rate of age-appropriate immunization for children in Georgia, although they provide little information to explain these findings. By contrast, we2 found that such incentives did not increase the vaccination rate for children in Maryland, which we attributed to inconsistent state policies, faulty implementation, and a flawed conceptual framework that ignored the role of providers on influencing vaccination rates.

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