If parents no longer have the personal beliefs of vaccinations for children, they may be able to avoid this by asking for religious exemptions for their children, according to a new study.
The researchers found that the number of kindergartens with religious exemptions from vaccination after banning personal beliefs in Vermont suddenly rose - from 0.5% to nearly 4%.
This kind of increase means that many parents who wanted to avoid vaccination just switched tactics, said Dr.Paul Offit, who is a pediatric infectious disease specialist and hasn’t taken part in this study.
"Either parents in Vermont are becoming very religious all of the sudden, or they are using religious exceptions as a replacement," said Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.
He said that vaccinations are only a public health strategy if enough people are vaccinated, and the more than sevenfold increase in religious exceptions among kindergarteners is alarming. Offit noted that exceptions were probably concentrated on specific communities.
As a result of the comeback of old childhood illnesses such as mumps and measles in recent years, some U.S states have tightened their vaccine exemptions laws. Some states where children were previously allowed not to be vaccinated because of certain "personal beliefs" of the parents do not do this anymore.
Vermont is one of them who eliminated its exception due to personal belief in 2016.
But parents in Vermont can still ask for exemptions based on religious beliefs – which is the case in Washington, D.C. and other 45 U.S states.
The new study, published online on 4 November in the journal Pediatrics, was designed to examine how the exemption patterns have changed since the policy took effect.
Overall, the nonmedical exemptions among kindergarteners fell - from 5.7% to 3.7%, as the results showed.
For policymakers, this could be a clear success, said Dr. Joshua Williams, senior researcher of the study. However, the overall decline was driven by a sharp rise in religious exemptions.
From 2011 to 2016, the average share of kindergarteners with religious exemptions was 0.5%. But it rose to 3.7% by 2018.
Are exemptions a religious issue for some people?
At present, 15 states allow exceptions due to personal beliefs. Williams said it is not clear, if they would see the same shift that Vermont did if they eliminated those exceptions.
However, other evidence suggests that they could.
Looking at all U.S states, researchers found that the rate of religious exemptions depends on whether a state permits exceptions based on personal beliefs. In states where both were allowed, there were only a quarter of the kindergarteners with religious exemptions, compared to states where only religious exemptions were allowed.
Offit said, "I believe this means that this is not a religious issue for most people."
In fact, according to Williams, all major religions are now supporting vaccination.
According to the National Conference of State Legislatures, exemptions are currently not allowed in five states for medical reasons. These include New York and California, where major measles outbreaks led lawmakers to tighten their rules.
According to Offit, the experience in Vermont "could be considered as an argument to eliminate all nonmedical exemptions".
But some determined parents may find ways to avoid that too. After California abolished nonmedical exemptions, over the next two years, medical exemptions increased in areas previously experiencing a relatively high rate of nonmedical opt-outs. This was the result of a recent study.
Overall, vaccination rates in U.S children are still high. Government figures show that in children born in 2015, only 1.3% had not received any vaccines until the age of 2, although this was a small increase from over a few years ago.
According to Williams majority of U.S parents, consider vaccines both effective and safe. He suggested that more of them are "making their voices heard" when lawmakers are considering changes to the vaccine-exemption policies.
"The voice of the parents should be heard, and they should contact their elected representatives, in order to make our communities healthier for everyone," Williams said.
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