title: United States private schools have higher rates of exemptions to school immunization requirements than public schools.
abstract: OBJECTIVE
  To compare medical, religious, and personal belief immunization exemption rates between private and public schools in US.
  
  
  METHODS
  Exemption rates were calculated using the Centers for Disease Control and Prevention School Immunization Assessment Surveys for the 2009-2010 school year excluding states with incomplete survey data. Standardized exemption rates weighted on enrollments in public and private schools were calculated. Differences in exemption rates between public and private schools were tested using Wilcoxon signed rank test.
  
  
  RESULTS
  The overall state exemption rate was higher in US private than public schools, 4.25% (SD 4.27) vs 1.91% (1.67), P = .0001 and private schools had higher exemption rates for all types of exemptions; medical 0.58% (0.71) vs 0.34% (0.34) respectively (P = .0004), religious 2.09% (3.14) vs 0.83% (1.05) respectively (P = .0001), and personal belief 6.10% (4.12) vs 2.79% (1.57), respectively (P = .006). Overall exemption rates were significantly higher in states that allowed personal belief exemptions.
  
  
  CONCLUSIONS
  Exemption rates were significantly higher in US private than in public schools. Children attending private schools may be at higher risk of vaccine-preventable diseases than public school children.
authors.affiliation: Department of Pediatrics, Pediatric Infectious Diseases, SUNY Upstate Golisano Children's Hospital, Syracuse, NY. Electronic address: shawja@upstate.edu.
authors.forename: Jana
authors.initials: J
authors.lastname: Shaw
authors.affiliation: New York State Department of Health, Albany, NY.
authors.forename: Boldtsetseg
authors.initials: B
authors.lastname: Tserenpuntsag
authors.affiliation: School of Public Health, Albany, NY.
authors.forename: Louise-Anne
authors.initials: LA
authors.lastname: McNutt
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Neal
authors.initials: N
authors.lastname: Halsey
mesh_terms: D001294:Attitude to Health; D002648:Child; D006291:Health Policy; D006801:Humans; D007114:Immunization / Q000592:standards*; D017149:Private Sector / Q000592:standards*; D017150:Public Sector / Q000592:standards*; D012068:Religion and Medicine; D012570:School Admission Criteria; D012574:Schools / Q000592:standards*; D014481:United States; D014611:Vaccination / Q000592:standards*