KEYWORDS:
Religious exemptions, anti-vaccination sentiment, Community Vaccination Survey.

BACKGROUND:
Ashland, (19,522 population), in southern Oregon, hosts a thriving theatric and artistic culture. Ashland also has a high rate of religious exemption to immunization requirements, with 11% of children in public schools having an exemption in 2001, as compared to 2.7% for the state. Oregon's religious exemption to vaccination allows for personal belief as well as organized religious doctrine. The Oregon Immunization Program and Jackson County Public Health are studying the factors behind this high exemption rate. Questions of concern include; 1) effect of different media exposure; 2) perceptions of community norms; 3) personal accounts of adverse reactions; and 4) use of alternate healthcare providers.

OBJECTIVE:
The Community Vaccination Survey was developed to determine factors behind parental and community non-acceptance of vaccination in public schools.

METHOD:
Study families were defined as having a exempt child in grades 1 to 8, together with a random sample of non-exemptors. The survey was sent to all families, with a follow-up for non-responders. Survey results, exemption status, and other factors will be geocoded and mapped.

RESULT:
Preliminary results include that exemptors are more likely to use the internet, have both a medical doctor and an alternate care provider, and are more likely to know personally of a child (supposedly) hurt by vaccination. Non-exemptors view others as less questioning of vaccines.

CONCLUSION:
Preliminary conclusions indicate that community anti-vaccination sentiment depends on several factors, including 1) parent's exposure to personal accounts of vaccine risk, 2) perception of local support in questioning vaccines; and 3) receiving a mixed message about vaccines from any of a spectrum of healthcare providers.

LEARNING OBJECTIVES:
Participants will learn about design of the Community Vaccination Survey and the factors related to community-based anti-vaccination sentiment. Discussion will involve how pockets-of-need can be identified, and how to adapt these methods for other communities.