Daniel A Salmon1, Neal A. Halsey
1, Lawrence H. Moulton
1, Ann C Klassen
2, Stephen Teret
2, Susan Lett
3, Pejman Talebian
3, Lesley Chace
4, Bryan M. Norman
5, and M. Patricia DeHart
6. (1) Division of Disease Control, International Health, Johns Hopkins School of Public Health, 615 N. Wolfe Street, Suite 5515, Baltimore, MD, USA, (2) Bloomberg School of Public Health, The Johns Hopkins University, 624 N Broadway, Room 745, Baltimore, MD, USA, (3) Massachusetts Department of Health, State Laboratory Institute, 305 South Street, Jamaica Plain, Massachusetts, USA, (4) Immunization Program, CO Dept of Public Health & Envir, PSD-IMM-A4, 4300 Cherry Creek Drive South, Denver, CO, USA, (5) Section of Vaccine-Preventable and TB Disease Elimination, Missouri Department of Health and Senior Services, 930 Wildwood, P.O. Box 570, Jefferson City, MO, USA, (6) Maternal and Child Health, Assessment Section, Washington State Department of Health, NewMarket Industrial Campus Bldg. 10, PO Box 47835, Olympia, WA, USA
KEYWORDS:
School Immunization Laws, Exemptions
BACKGROUND:
Unimmunized children in schools are at increased risk of acquiring vaccine preventable diseases and transmitting infections to the community. The rate of exemptions to school immunization requirements is increasing in many states. There is great variation in state implementation of laws, and the ease of obtaining an exemption is associated with exemption rates. Schools have a critical role in the exemption process; but the role of school nurses/personnel has not been studied.
OBJECTIVE(S):
1) Determine if variations in local policies are associated with exemption rates;
2) Determine if the knowledge, attitudes and beliefs (KABs) of school nurses are associated with exemption rates.
METHOD(S):
A survey administered to a stratified random sample of 1,000 school nurses in four states (MA, CO, MO, WA). The survey includes examination of implementation procedures and questions about the KABs of school nurses.
RESULT(S):
Preliminary data from one state indicate that some schools permit philosophical exemptions although the state does not officially permit philosophical exemptions and that many schools do not provide information to parents requesting an exemption about the risks of children not being vaccinated. Some nurses believe that (1) Children should only be immunized against serious diseases; (2) Varicella is often not considered a serious disease; (3) Children receive more immunizations than are good for them; and (4) Children’s immune systems could be weakened by too many vaccines. The complete survey will be analyzed to determine if exemption rates are associated with school nurses’ KABs or school policies in implementing exemptions.
CONCLUSIONS(S):
Findings from this study will assist in developing strategies for administering exemptions so that individual rights and public health needs are optimally balanced.
LEARNING OBJECTIVES:
To understand the role of schools in implementing immunization requirement and how the school and/or nurse can effect the rate of exemptions.
See more of Immunization Exemptions for School Entry: Attitudes, Beliefs, and Consequences
See more of The 36th National Immunization Conference
