Exemption from Immunizations in the United States
Registered nurse 2nd Lt. Rebeccah Collins vaccinates Alexia Woods, 12, for chicken pox and meningitis during the Carl R. Darnall Army Medical Center School Physicals and Immunization Clinic at Fort Hood, Texas. Photo by Jeri Chappelle, CRDAMC Public Affairs
Every state mandates a set of immunizations in order for a child to enter public school. Some also require immunizations as the student gets older. The list varies slightly but a pertussis (whooping cough) immunization is required in all states.
Not every student in public will have all their immunizations. Every state also provides for conditions of exemption from one or more of the mandated immunizations.
The medical exemption is the easiest to understand. A physician certifies that the student has had the illness, or that there are medical reasons for the child being unable to receive the immunization. An allergy to one of the vaccine’s ingredients would be an example of the latter.
Most states also provide for a religious exemption. The method of requesting this sort of exemption and the proof required varies by state. The exemption is granted to students whose religious beliefs do not allow immunizations. There are very few organized religions that hold this belief.
Twenty states allow a third type of exemption from immunization. It is called a philosophical or personal exemption. The request and the proof varies by state. In general, the state requires the parents or guardians to assert that they have a personal or philosophical objection to immunization. Several of these states have modified their laws recently to provide that the parents be counseled by a physician to the benefits and risks of immunizations in order to receive the exemption.
The states permitting some sort of personal or philosophical exemption from immunizations are: Arizona, Arkansas, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, Missouri, New Mexico, North Dakota, Ohio, Oklahoma, Pennsylvania, Texas, Utah, Vermont, Washington and Wisconsin.
The Centers for Disease Control (CDC) collect and publish data on a number of reportable illnesses in the United States. The finalized data is available on line for 1996 to 2008. The preliminary data for these illnesses is available from 2009 to 2011, and monthly data for 2012 through May. Since pertussis (whooping cough) is in the news, the CDC pertussis case counts provide a basis for analyzing the effects of personal exemptions on case counts for the years 2005 through 2011.
- From 2005 to 2011, the average number of yearly pertussis cases in the United States was 17,801.
- The twenty states that allow the personal / philosophical exemption reported an average of 11,192 pertussis cases per year. That is 63 percent of the national average.
- Exemption states ranked first, second and third in pertussis case counts for the years 2005,2008, 2009 and 2010.
- In 2007, exemption states accounted for 54 percent of the total pertussis cases reported in the United States. This is the lowest percentage in the period studied.
- In 2010, exemption states accounted for 72 percent of the total reported cases. This is the highest percentage in the period studied.
- In the four years where exemption states reported the top three pertussis case counts, they account for 27 to 42 percent of the national total.
- Texas holds the most top three rankings, ranking in five out of seven years.
- California had the most reported cases of pertussis in four of the seven years. All four years, the state reported the highest number of cases in the nation.
- Minnesota ranked in the top three for three of the seven years.
Pertussis cases are surging in 2012. Year to date, the number of reported cases is up 44 percent from the same period in 2011.
The last year with this level of illness was 2010. In that year, California had a whooping cough epidemic. The states of Washington, Texas Ohio and Michigan also had large numbers of cases.
Data analyzed at that time indicated that the pertussis outbreaks in those states were centered in counties where the residents were above average in income. Many were also home to major universities and large academic communities.
- California
- Michigan, centered in the wealthy Detroit suburbs and around Ann Arbor
- Ohio, centered around Columbus
- Texas, centered around Austin
Prepared by Charles Simmins from CDC data. Click for a larger image.
In 2012, through May 5, 2012, six of the nine states reporting over 200 cases of whooping cough are exemption states. They account for fifty percent of all pertussis cases nationwide. The CDC reports that through week 18, ending May 5, there were 8,159 pertussis cases reported in 2012. That is a 44 percent increase over the same period in 2011.
the attachments to this post:
us week 18 2012 pie chart
This entry was posted on Friday, May 11th, 2012 at 8:00 am and is filed under Original writing, Analysis, Medicine, Original writing. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.
