Child Health

The problem with vaccine exemptions

August 16, 2019 | National

Today, all 50 states and the District of Columbia appropriately have laws requiring school-age children and those in child care facilities to be vaccinated against dangerous and sometimes deadly vaccine preventable diseases. These laws help protect those who cannot get vaccinated because they are too young, have weakened immune systems, or are part of the small portion of the population on whom vaccines are ineffective. However, state rules vary widely in allowable exemptions and enforcement for these laws.

All states allow medical exemptions for children who are too sick to receive vaccines, have weakened immune systems or are allergic to vaccine ingredients. Most states also allow exemptions based on religious beliefs, and some allow exemptions based on personal or philosophical beliefs.

This year, in response to large measles outbreaks that have affected more than half the states, New York and Maine joined California, West Virginia, and Mississippi in prohibiting all but medical exemptions to mandatory vaccines. That may be because California, West Virginia, and Mississippi have both the highest uptake for the combined measles-mumps-rubella (MMR) vaccine and the lowest incidence of vaccine preventable disease. In contrast, states allowing both religious and philosophical exemptions are associated with a decrease in MMR vaccine rates.  

The Children’s Defense Fund, along with all major medical associations and health organizations, supports vaccine exemptions only for legitimate medical reasons, and for years has urged state lawmakers to eliminate religious and personal exemptions. We applaud the states taking important steps to reduce the needless toll of vaccine preventable diseases, and encourage other states to follow suit.

To learn more about gaps in vaccinations, current vaccine policies, the response to recent measles outbreaks, and steps that must be taken to eliminate vaccine preventable diseases, check out CDF’s new issue brief.