title: Public health and the politics of school immunization requirements.
abstract: Compulsory vaccination has contributed to the enormous success of US immunization programs. Movements to introduce broad "philosophical/personal beliefs" exemptions administered without adequate public health oversight threaten this success. Health professionals and child welfare advocates must address these developments in order to maintain the effectiveness of the nation's mandatory school vaccination programs. We review recent events regarding mandatory immunization in Arkansas and discuss a proposed nonmedical exemption designed to allow constitutionally permissible, reasonable, health-oriented administrative control over exemptions. The proposal may be useful in political environments that preclude the use of only medical exemptions. Our observations may assist states whose current nonmedical exemption provisions are constitutionally suspect as well as states lacking legally appropriate administrative controls on existing, broad non-medical exemptions.
authors.affiliation: Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Rm E5543, Baltimore, MD 21205, USA. dsalmon@jhsph.edu
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Salmon
authors.forename: Jason W
authors.initials: JW
authors.lastname: Sapsin
authors.forename: Stephen
authors.initials: S
authors.lastname: Teret
authors.forename: Richard F
authors.initials: RF
authors.lastname: Jacobs
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Thompson
authors.forename: Kevin
authors.initials: K
authors.lastname: Ryan
authors.forename: Neal A
authors.initials: NA
authors.lastname: Halsey
mesh_terms: D001131:Arkansas; D002648:Child; D006801:Humans; D007114:Immunization / Q000331:legislation & jurisprudence* / Q000523:psychology; D011634:Public Health; D045808:Refusal to Participate / Q000523:psychology*; D012068:Religion and Medicine; D012574:Schools; D014481:United States