AAP supports medical, rejects nonmedical, immunization exemptions

1. The American Academy of Pediatrics (AAP) acknowledges the many benefits of childhood immunization, both direct and indirect. These include herd immunity as a result of high immunization rates, direct protection of the immunized individual, prevention of death and disease epidemics, and cost savings into the billions.

2. The AAP supports regulations that require certification of immunization in order to attend schools or childcare, as well as medically indicated exemptions for the rare few who require them. The AAP advocates for the elimination of nonmedical exemptions to immunization due to public health, individual, and ethical concerns.

Statement Rundown: Routine vaccination during childhood has far-reaching public health implications, from direct protection of the individual to billions in societal savings. There are a rare few who, due to medical reasons, are unable to receive certain vaccinations. These few rely on herd immunity, which occurs when almost all who are eligible for vaccination receive them, minimizing the risk of illness and spread of disease in a community. To achieve herd immunity, vaccination rates must be at least 90%, and sometimes >95% for some highly contagious diseases. All 50 states, the District of Columbia, and Puerto Rico have laws and regulations requiring proof of immunization status for all children entering schools and daycare. These same areas also have laws dictating medical and nonmedical exemptions to immunization regulations. These exemptions vary in their depth, breadth, and enforcement. Research has shown that areas in which nonmedical exemptions are more easily sought have lower vaccination rates and therefore erode herd immunity. The AAP supports laws requiring vaccination for school and daycare attendance, as well as medical exemptions for those few who have contraindications to vaccination. However, because nonmedical exemptions erode herd immunity, and have empirically proven negative public health consequences, the AAP does not support this type of exemption and encourages states to eliminate such policies. The AAP recommends dissemination of community-based immunization rates to schools and day care centers, as well as herd immunity strength analysis based on this data. Finally, the AAP encourages schools, daycares and other qualified centers to comply with regulations and require appropriate documentation of immunization or exemption.

Click to read the policy statement, published today in Pediatrics

Relevant Reading: Personal belief exemptions from school vaccination requirements

Image: PD

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