title: No more kidding around: restructuring non-medical childhood immunization exemptions to ensure public health protection.
abstract: Professor Silverman's article examines the complex challenges faced by U.S. policymakers attempting to balance the public health protections of mandatory childhood immunization programs with the legal, religious, philosophical, and practical concerns raised by permitting non-medical exemptions under the programs. The article begins with a discussion of the history of childhood immunization programs, and continues by describing the inconsistency of enforcement of state immunization laws and exemptions. The author analyzes recent cases from New York, Wyoming, and Arkansas, and discusses how these decisions both pose threats to these programs' public health protections, while also offering insight into potential problems for other state vaccination programs. Professor Silverman concludes by advocating that states adopt an "informed refusal" approach to vaccination exemption as a way of improving immunity protections, while respecting the autonomy rights of those who wish to opt out of the program.
authors.affiliation: Department of Medical Humanities, Southern Illinois University School of Medicine, Springfield, IL, USA. rsilverman@siumed.edu
authors.forename: Ross D
authors.initials: RD
authors.lastname: Silverman
mesh_terms: D002648:Child; D002662:Child Health Services / Q000331:legislation & jurisprudence*; D006801:Humans; D017589:Immunization Programs / Q000331:legislation & jurisprudence*; D035846:Law Enforcement; D016365:Liability, Legal; D037141:Mandatory Programs / Q000331:legislation & jurisprudence*; D026684:Personal Autonomy; D011050:Policy Making; D011635:Public Health Administration / Q000331:legislation & jurisprudence*; D012068:Religion and Medicine; D012574:Schools / Q000331:legislation & jurisprudence; D013219:State Government; D035521:Supreme Court Decisions; D020458:Third-Party Consent / Q000331:legislation & jurisprudence; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*; D014481:United States; D014611:Vaccination / Q000331:legislation & jurisprudence*