263489 Assessing factors and gaps in the implementation of philosophical exemptions to school immunization requirements

Wednesday, October 31, 2012 : 1:30 PM - 1:50 PM

Andy Baker-White, JD, MPH , Network for Public Health Law - Mid-States Region, University of Michigan School of Public Health, Ann Arbor, MI
Several states exempt students from school immunization requirements based on a parent's philosophical or personal belief against vaccinations. The availability of philosophical exemption has ebbed and flowed over the years. In 1990, 22 states allowed philosophical exemptions; by 2000, the number fell to 14 with many states abolishing the exemption. Currently, 20 states have laws authorizing philosophical or personal belief exemptions. A number of other states, including Kansas and South Dakota, are now considering legislation to add this type of exemption. A 2006 review of Arkansas' philosophical exemption in the American Journal of Preventive Medicine found that the number of granted exemptions increased from 529 to 1145 over a four-year period. During that same period the percentage of exemptions that were non-medical exemptions (e.g., philosophical exemptions) rose from 79% to 95%. Another 2006 study in the Journal of the American Medical Association concluded that philosophical and easily granted exemptions are associated with an increased incidence of pertussis. Public health law researchers have also investigated the restrictiveness of state law (i.e., the extent to which state law discourages or prevents an exemption) for non-medical exemptions. This presentation will examine how philosophical exemption laws in different states (e.g., Michigan and Wyoming) have been interpreted and implemented, explore the various state and local actors that manage philosophical exemption requests, and recommend changes to philosophical exemptions laws to better protect students and public health.

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

Learning Objectives:
Describe the extent to which schools and health departments play a role in the implementation of philosophical exemptions. Assess the features of state philosophical laws that may discourage parents from requesting a philosophical exemption as a matter of convenience. Explain the public health policy gaps found in laws allowing philosophical exemptions for school immunization requirements.

Keywords: Law, School Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As part of the Network for Public Health Law I have provided direct legal technical assistance to public health officials, practitioners, attorneys, policymakers, and advocates. I have also developed and provided trainings and other resources on the use of law as a tool for promoting and protecting public health. I have a special interest in public health legal authority, the powers and duties of public health agencies, and the preemption of public health authority.
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.