244895 How many California children are exposed to high school-level rates of personal belief exemptions from childhood vaccines?

Monday, October 31, 2011: 11:35 AM

Alison M. Buttenheim, PhD, MBA , School of Nursing, University of Pennsylvania, Philadelphia, PA
Yelena Baras , History and Sociology of Science, University of Pennsylvania, Philadelphia, PA
Introduction: Personal belief exemptions (PBE) from school vaccination requirements have risen in California in the past decade. Disease outbreaks in the state have been linked to clusters of intentionally unvaccinated children. Schools with a high prevalence of intentionally unvaccinated children are epidemiologic “hotspots” and should be the focus of policy and programmatic interventions. The goals of this study were to calculate (1) the proportion of all kindergarteners and (2) the proportion of all kindergarteners with PBEs who attend schools where PBE prevalence exceeds 5%; and to identify school-level and community-level characteristics associated with PBE prevalence. Methods: School-level data on PBEs from the California Department of Public Health were merged with school and community characteristics from the California Department of Education and the US census. The proportion of all kindergarteners and of all kindergarteners with one or more PBEs attending schools with PBE rates > 5% were calculated. Negative binomial regression was used to estimate the school- and community-level correlates of PBE rates. Results: In fall 2008, 10% of kindergarteners in California (N=495,884) attended schools where the PBE rate exceeded 5%. For the same year, 61% of kindergarteners with one or more PBEs (N=9,196) attended schools with a PBE rate > 5%. Of those, one-third attended schools where the PBE rate exceeded 20%. The school type most highly associated with PBEs was Waldorf schools. Conclusions: More than 50,000 kindergarteners in California attend schools with epidemiologically worrisome rates of PBEs. Policies to limit both the prevalence and clustering of PBEs within schools are needed.

Learning Areas:
Epidemiology
Protection of the public in relation to communicable diseases including prevention or control
Public health or related laws, regulations, standards, or guidelines
Social and behavioral sciences

Learning Objectives:
Describe the exposure of California school children to epidemiologically-significant rates of personal belief exemptions from childhood vaccines when at school.

Keywords: School Health, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI on the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.