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Research Letter
February 12, 2014

Legislative Challenges to School Immunization Mandates, 2009-2012

Author Affiliations
  • 1Rollins School of Public Health, Emory University, Atlanta, Georgia
  • 2Immunization Action Coalition, St Paul, Minnesota
  • 3Task Force for Global Health, Decatur, Georgia
  • 4School of Medicine, Emory University, Atlanta, Georgia
JAMA. 2014;311(6):620-621. doi:10.1001/jama.2013.282869

School immunization mandates, implemented through state-level legislation, have played an important role in maintaining high immunization coverage in the United States. Immunization mandates permit exemptions that vary from state to state in terms of type of exemption (eg, religious, personal belief, medical), and administrative ease of obtaining these exemptions. Certain types of exemptions (especially personal belief exemptions) and the ease of obtaining them are predictive of high rates of vaccine exemptions and increased disease risk among exemptors themselves and in the communities in which they reside.1,2

Legislation has been proposed in recent years to modify exemptions to school immunization requirements. We analyzed such legislation at the state level.