4.6 Article

In the Wake of a Pandemic: Revisiting School Approaches to Nonmedical Exemptions to Mandatory Vaccination in the US

Journal

JOURNAL OF PEDIATRICS
Volume 231, Issue -, Pages 17-23

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2021.01.022

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Funding

  1. NIH NICHD [1K23HD098289-01A1]
  2. Pediatric Critical Care and Trauma Scientist Development Program
  3. American Bar Foundation/APB Access to Justice Scholars Program
  4. HRSA [UH1HP29963]

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Mandatory school vaccination policies can ensure high vaccination rates, but some parents may object and seek exemptions. Different schools, school systems, or local governments have varying policies on what exemptions are allowed.
Mandatory school vaccination policies with exclusion of unvaccinated students can be a powerful tool in ensuring high vaccination rates. Some parents may object to mandatory vaccination policies, claiming exemptions based on medical, religious, or philosophical reasons. Individual schools, school systems, or local or regional governments have different policies with respect to whether, and what kind of, exemptions may be allowed. In the setting of the current pandemic, questions regarding the acceptability of exemptions have resurfaced, as schools and local governments struggle with how to safely return children to school. Anticipating that school attendance will be facilitated by the development of a vaccine, school systems will face decisions about whether to mandate vaccination and whether to permit exemptions. The American Academy of Pediatrics promulgates policy favoring the elimination of nonmedical exemptions generally in schools. This discussion considers whether schools should eliminate nonmedical exemptions to vaccination as proposed in the American Academy of Pediatrics policy, ultimately concluding that broad elimination of exemptions is not justified and advocating a more nuanced approach that encourages school attendance while promoting vaccination and broader public health goals.

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