Database of State Vaccine Exemption Laws

Background: Increasingly, addressing the controversies involving vaccine-related practice, safety and policy options have become pressing legal and public health questions and require examination of vaccination laws.

Setting: Nationwide regulatory environment.

Population: Current U. S. vaccination statutes and regulations from 50 states and the District of Columbia.

Project Description: The legal search strategy to identify relevant laws involved an extensive evaluation of the validity and precision of numerous combinations of Lexis search terms prior to selecting the best combination.  A four-member research team searched the Lexis Academic database to retrieve laws and worked with an IT consulting firm to create a web-based ProstgreSQL platform to house, code and evaluate laws. All potentially relevant state laws were reviewed and grouped into three basic relevance categories and then coded according to one or more general topics such as vaccination requirements, exemptions, recordkeeping, tracking, disclosure and financing.  Laws addressing vaccination requirements and exemptions were further coded according to dozens of parameters such as notarization, documentation, approval processes and penalty provisions. 

Results/Lessons Learned: This project, funded by the Robert Wood Johnson Foundation, created a comprehensive and publicly available repository and searchable database of approximately 2,000 laws.  The repository is keyword searchable, contains downloadable PDF’s of each law and a codebook with background information on the project, coding method details and instructions for searching and downloading the database. The database is intended to be a resource for those needing access to vaccination laws as well as for those interested in conducting cross-sectional and longitudinal investigations. Examples of state-level analyses of potential policy relevance that combine coded laws in the database with secondary data include examining the relationship between various medical and non-medical vaccine exemption laws, use of exemptions, vaccine uptake, communicable disease incidence and variation in parental, medical and school official attitudes, decisions and behaviors.