All 50 US states allow medical exemptions from school entry immunization requirements. However, the extent to which medical exemptions are granted and the relationship with ease of obtaining these exemptions varies. Some states have recently put in measures to tackle the issue of exemptions.
The U.S. states, according to Nature
, that have put in place obstacles so that parents cannot not so readily excuse their children from receiving vaccinations against diseases are California, Vermont, and Washington.
In these three states, where a parent does not wish their child to receive a vaccination for personal or philosophical reasons, the parent must provide evidence that a health-care practitioner or representative of the state's health department gave them scientific information about the risks and benefits of those vaccinations. This change in law places the onus upon the parent.
The new rules relate to such diseases as whooping cough. Other states are planning similar legislation, with the matter debated in New Jersey and Arizona.
The reason behind the legislation is due to a rise in exemption rates, which averages around 1.5% across the U.S., although the figures in many states is much higher. For example, according to the National Immunization Survey
, Idaho has only a 63.7 percent vaccination rate for the early childhood vaccination schedule (aged 19-35 months).
have been published wish link the existence of personal-belief exemptions, and the ease of getting them, to reduced vaccination rates and increased incidence