Joshua T.B. Williams
Religious exemption rates are increasing in the United States and appear to be associated with the availability of personal belief exemptions, researchers reported in Pediatrics.
They found that states that allow only medical and religious belief vaccine exemptions have a higher proportion of children starting kindergarten with religious exemptions than states that also offer personal belief exemptions. Specifically, researchers noted a significant increase in religious exemptions in Vermont following that state’s removal of personal belief exemptions.
According to Joshua T.B. Williams, MD, assistant professor of pediatrics at the University of Colorado School of Medicine, and colleagues, although major religions support vaccination, 45 states allow religious vaccine exemptions and 15 allow exemptions for personal beliefs.
Williams told Infectious Diseases in Children that although individual-level behaviors were not examined in their study, previous research suggests that parents may seek religious exemptions when personal belief exemptions are eliminated.
“In the case of Vermont, our study suggests that eliminating personal belief exemptions did decrease the overall rate of kindergarteners with nonmedical exemptions,” he said. “Policymakers in other states wishing to decrease their exemption rates could follow Vermont’s approach. This approach might obscure reasons parents choose to exempt their children from vaccines and could create stigma for religious communities or leaders who support them. Instead, policymakers could create stronger policies that preserve transparency in the exemption process but make them more difficult for parents to obtain.”
The researchers analyzed data on vaccine exemptions for kindergarteners entering school between 2011 and 2018. Data were collected by the CDC and encompassed 295 state-years. Following the analysis, Williams and colleagues compared the average number of children with religious exemptions in states that allow both religious and personal belief exemptions with children who live in states that allow religious exemptions only.
States that allowed both religious and personal belief vaccine exemptions were less likely to have children with religious vaccine exemptions (RR = 0.25; 95% CI, 0.16-0.38).
The researchers identified an increase in the rate of religious vaccine exemptions following a policy change in Vermont that abolished personal belief vaccine exemptions, with the rate rising from 0.5% to 3.7%. Among all states, the increase in religious exemptions between the 2011-2012 and 2017-2018 school year was significant, the researchers wrote (P = .04).
“As opportunities arise, it will be important for the vast majority of parents in America who believe vaccines are safe and effective to speak up, contact their elected representatives and make their voices heard,” Williams said. “Such efforts will work toward making our communities healthier for everyone.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.