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JAMA Pediatr. 2017 Sep 1;171(9):893-896. doi: 10.1001/jamapediatrics.2017.1868.

Achieving an Optimal Childhood Vaccine Policy.

Author information

Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington.
Department of Pediatrics, University of Washington School of Medicine, Seattle.
Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
Departments of Epidemiology and Global Health, Emory University School of Public Health, Atlanta, Georgia.
Emory Vaccine Center, Atlanta, Georgia.
Department of Health Policy and Management, Indiana University Fairbanks School of Public Health, Indianapolis.
Indiana University McKinney School of Law, Indianapolis.
Public Health-Seattle and King County, Seattle, Washington.
Department of Epidemiology, University of Washington School of Public Health, Seattle.
Department of Medicine, University of Washington School of Medicine, Seattle.
Pediatric Institute and Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.


Policies to remove parents' ability to opt-out from school immunization requirements on the basis of religious or personal beliefs (ie, nonmedical exemptions) may be a useful strategy to increase immunization rates and prevent outbreaks of vaccine-preventable disease. However, there is uncertainty about the effectiveness of this strategy and the range of possible outcomes. We advocate for a more deliberative process through which a broad range of outcomes is scrutinized and the balance of values underlying the policy decision to eliminate nonmedical exemptions is clearly articulated. We identify 3 outcomes that require particular consideration before policies to eliminate nonmedical exemptions are implemented widely and outline a process for making the values underlying such policies more explicit.

[Indexed for MEDLINE]

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