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Assessment of Exemptions from Vaccination in California, 2015-2027

Authors: Paul Delamater*, University of North Carolina - Chapel Hill
Topics: Medical and Health Geography, Spatial Analysis & Modeling, Applied Geography
Keywords: vaccination, vaccines, spatial analysis
Session Type: Paper
Presentation File: No File Uploaded


As the magnitude and frequency of vaccine preventable disease outbreaks increasing in the United States, a number of states have recently modified their school-entry vaccination policies and requirements. California banned nonmedical exemptions from school-entry vaccine mandates in 2015 and added additional scrutiny to medical exemptions in 2019. This analysis used a grade-cohort model to estimate the potential effects of these regulations on students in California's school system with any form of exemption, as well as those with nonmedical exemptions, medical exemptions, and who are exempt from requirements, over the period of 2015 to 2027. The findings show that persistent vaccine refusal and the provision of alternate pathways for parents to avoid vaccination have lessened the impact of California's new regulations. If recent trends hold in upcoming years, the overall effects could end up being small to moderate in magnitude. This study demonstrates how California's ban on nonmedical exemptions and inclusion of additional scrutiny on medical exemptions could end up having a relatively small overall impact statewide, especially if no further legislative actions occur and current trends of vaccine hesitancy extend into the future.

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