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Special Communication
September 2017

Achieving an Optimal Childhood Vaccine Policy

Author Affiliations
  • 1Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, Washington
  • 2Department of Pediatrics, University of Washington School of Medicine, Seattle
  • 3Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut
  • 4Departments of Epidemiology and Global Health, Emory University School of Public Health, Atlanta, Georgia
  • 5Emory Vaccine Center, Atlanta, Georgia
  • 6Department of Health Policy and Management, Indiana University Fairbanks School of Public Health, Indianapolis
  • 7Indiana University McKinney School of Law, Indianapolis
  • 8Public Health–Seattle and King County, Seattle, Washington
  • 9Department of Epidemiology, University of Washington School of Public Health, Seattle
  • 10Department of Medicine, University of Washington School of Medicine, Seattle
  • 11Pediatric Institute and Department of Bioethics, Cleveland Clinic, Cleveland, Ohio
  • 12Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
JAMA Pediatr. 2017;171(9):893-896. doi:10.1001/jamapediatrics.2017.1868

Policies to remove parents’ ability to opt-out from school immunization requirements on the basis of religious or personal beliefs (ie, nonmedical exemptions) may be a useful strategy to increase immunization rates and prevent outbreaks of vaccine-preventable disease. However, there is uncertainty about the effectiveness of this strategy and the range of possible outcomes. We advocate for a more deliberative process through which a broad range of outcomes is scrutinized and the balance of values underlying the policy decision to eliminate nonmedical exemptions is clearly articulated. We identify 3 outcomes that require particular consideration before policies to eliminate nonmedical exemptions are implemented widely and outline a process for making the values underlying such policies more explicit.

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