Eliminating nonmedical exemptions: a radical shift in how childhood vaccine mandates govern.

Document Type

Article

Publication Date

1-2023

Publication Title

Expert review of vaccines

Abstract

INTRODUCTION: Every state in the US has had school vaccine mandates for decades, and all except West Virginia and Mississippi offered nonmedical exemptions (NMEs) in addition to medical exemptions. Several states recently eliminated NMEs, and others have attempted to do so. These efforts are transforming America's immunization governance.

AREAS COVERED: What we call the 'mandates & exemptions' regime of vaccination policy from the 1960s and 1970s functioned to orient parents toward vaccination, but did not coerce or punish them for not vaccinating. The article identifies how policy tweaks in the 2000s - including education requirements and other bureaucratic burdens - delivered enhancements to the 'mandates & exemptions' regime. Finally, the paper illustrates how the recent elimination of NMEs, first in California and then in other states, represents a radical transformation of America's vaccine mandates.

EXPERT OPINION: Today's 'unencumbered vaccine mandates' (mandates without exemptions) directly govern and punish non-vaccination, unlike the 'mandates & exemption' regime that aimed to make it harder for parents to avoid vaccination. This kind of policy change introduces new problems for implementation and enforcement, especially within America's underfunded public health system, and in the context of post-COVID public health political conflicts.

Volume

22

Issue

1

First Page

671

Last Page

680

DOI

10.1080/14760584.2023.2232446

ISSN

1744-8395

PubMed ID

37432038

Link to Full Text

Share

COinS