Article : Rising Rates of Religious Immunization Exemptions...

Rising Rates of Religious Immunization Exemptions Linked with Higher Pertussis Rates

Deborah Lehman, MD


Reported rates of pertussis increased in both exempt and vaccinated children in communities with high exemption rates.

Almost all states allow religious exemption from school-mandated vaccinations. Recent data from several U.S. communities indicate that rates of religious and personal vaccine exemptions are increasing, and high exemption rates have been tied to rising rates of vaccine-preventable diseases (e.g., pertussis and measles). Investigators compared pertussis incidence between 2000 and 2011 among children (age, <19 years) in New York State counties with high- and low-exemption rates.

The overall mean prevalence of religious exemptions in the 62 counties was 0.78% (range, 0.06%–5.58%). Statewide mean exemption rates nearly doubled during the 12-year study period (from 0.23% to 0.45%; P=0.001). Pertussis incidence was higher in counties with exemption rates ≥1% than in counties with lower exemption rates (33.1/100,000 vs. 20.1/100,000), resulting in an overall increase of 5 cases per 100,000 for each 0.1% increase in exemption rate. The incidence of pertussis in exempt children was 14 times greater than in vaccinated children statewide. Moreover, in high-exemption counties, risk for pertussis increased among all children, irrespective of vaccination status.


Citation(s):

Imdad A et al. Religious exemptions for immunization and risk of pertussis in New York State, 2000–2011. Pediatrics 2013 Jun 3.

 

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