Learning Objectives for this Presentation:
By the end of the presentation participants will be able to understand principal reasons why Utah parents claim personal exemption to immunization and articulate strategies for program interventions.

Background:
Utah is one of 20 states that allow exemption to immunization for medical, religious, or personal beliefs. The percentage of all exemptions claimed in Utah has increased from 1.2% in 1997 to 3.0% in 2004. Nationally, Utah has the youngest median age, larger family sizes, and the highest birthrate. These factors combined with an increasing exemption rate and decreasing overall immunization rates create a critical risk in the community for outbreaks of vaccine-preventable diseases.

Objectives:
1. Determine why parents claim personal exemption to immunization.
2. Identify and implement strategies to decrease exemptions and increase immunizations.


Methods:
During Fall 2004 and Spring 2005, the Utah Immunization Program conducted the Personal Exemption Survey statewide. Surveys were administered by local health department staff to each parent/guardian. The response rate for the survey was 71.3% (N=1,565). Statistical analyses were performed using Microsoft Access and SAS 9.1.

Results:
The majority of parents (75.2%) claiming an exemption for their child had some college education or were college graduates. The most common reason why parents (46.3%) claimed a personal exemption was that immunization requirements conflict with their philosophical beliefs. Nearly two-thirds (65.3%) indicated they have specific concerns about the safety of vaccines. Parents also offered specific comments concerning side effects, adverse reactions (autism, chronic disease), and vaccine ingredients.

Conclusions:
Parents claim personal exemptions for various reasons; however, there are key factors why parents choose to not immunize their children. When claiming an exemption it appears that parents may be influenced less by education and more by personal beliefs about immunizations. Program strategies to address exemptions should acknowledge parental beliefs and concerns in order to decrease exemptions and increase immunizations.