KEYWORDS:
Childhood Immunization, Health Policy, Law, Religious and Moral Exemptions, Herd Immunity

BACKGROUND:
While public health advocates have been successful in raising childhood vaccination rates to record levels, there is increasing concern about concomitant increases in rates at which parents are opting to apply on behalf of their children for exemption from mandatory vaccination requirements. Currently, less than one-third of all states offer a moral objection exemption from childhood vaccination. However, recent court decisions and activities in state legislatures, coupled with increased interest in and advocacy for broader exemptions on the grounds of individual and parental autonomy, threaten to further undermine public health efforts. This presentation will examine these court decisions and legislative activities, and propose a new approach to handling childhood vaccination requirements that would better protect the public health. This presentation will also address the proposal's political and public policy challenges.

OBJECTIVE(S):
1. To discuss the legal foundations of exemptions to U.S. childhood vaccination policy; 2. To describe current common law, legislative and administrative actions concerning mandatory vaccination, including expansion of moral exemptions to childhood immunization; 3. To assess the potential legal, political and public health impacts of changing current childhood vaccination laws to better protect the public in cases of infectious disease outbreak.

METHOD(S):
Review and analysis of recent legal decisions, legislative and regulatory activities, scientific studies and popular media reports.

RESULT(S):
This presentation will demonstrate a rising public interest in vaccination exemption and the threat current broadly-interpreted and weakly-enforced exemption policies pose to future U.S. immunization rates.

CONCLUSIONS(S):
It may be necessary to narrow current vaccination exemptions to reduce the risk of significant future outbreaks of vaccine-preventable diseases.

LEARNING OBJECTIVES:
To understand the legal, political and ethical justifications for - and challenges posed to the public's health by - current childhood vaccination exemptions.