Exposure of California Kindergartners to Students With Personal Belief Exemptions From Mandated School Entry Vaccinations

Alison M. Buttenheim · Malia Jones · Yelena Baras

31 citations0/0 files storedAmerican Journal of Public Health

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Vaccine Coverage and Hesitancy School Health and Nursing Education Virology and Viral Diseases

Abstract

OBJECTIVES: Personal belief exemptions (PBEs) from mandated school entry vaccinations have increased in California over the past decade. Infectious disease outbreaks in the state may be associated with the aggregation of intentionally unvaccinated children within schools. We sought to quantify the exposure of California kindergartners to children with PBEs at school. METHODS: We used cross-sectional California Department of Public Health data on 3 kindergarten cohorts to define and calculate multiple measures of exposure to children with exemptions, including interaction and aggregation indices, for the state as a whole (2008-2010) and by county (2010). RESULTS: In 2010, the PBE rate in California was 2.3 per 100 students, and the school PBE rate for the average kindergartner with a PBE was 15.6 per 100. More than 7000 kindergartners in California attend schools with PBE rates greater than 20 per 100, including 2700 kindergartners with PBEs. Exposure measures vary considerably across counties. CONCLUSIONS: Our results suggest increasing levels of exposure among kindergarten students in California to other kindergartners with PBEs. Our data provide a concrete set of metrics through which public health and education officials can identify high-risk areas as targets for policy and programmatic interventions.

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References

1988The Dimensions of Residential Segregation 2009Epidemiology and Prevention of Vaccine-Preventable Diseases 2009Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases 2010Parental Vaccine Safety Concerns in 2009 1999The immunization system in the United States — The role of school immunization laws 2008Geographic Clustering of Nonmedical Exemptions to School Immunization Requirements and Associations With Geographic Clustering of Pertussis 2010Measles Outbreak in a Highly Vaccinated Population, San Diego, 2008: Role of the Intentionally Undervaccinated 2004Underimmunization Among Children: Effects of Vaccine Safety Concerns on Immunization Status

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2019Associations of Statewide Legislative and Administrative Interventions With Vaccination Status Among Kindergartners in California 2013Addressing heterogeneous parental concerns about vaccination with a multiple-source model 2013Practical approaches to vaccine hesitancy issues in the United States: 2013 2015MMR vaccination status of children exempted from school-entry immunization mandates

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