Medical Exemptions to Vaccination - Riverside County, California, 2016-2019
Kaiser, C.; Geiger, T.; Lynch, C.; Rivera, A.
Show abstract
ObjectivesTo review the nature and clinical reasoning of medical exemptions to vaccination received in Riverside County, CA after California Senate Bill 277 eliminated personal belief exemptions statewide. Methods614 deduplicated medical exemptions to vaccination from 156 providers were reviewed from August 2016 to August 2019. Exemptions covering all vaccines were additionally coded for number and category of medical justification. Results81.3% of reviewed exemptions were for all vaccines, 91.0% were permanent or indefinite, and 74.9% were for all vaccines and permanent or indefinite. Of the 490 evaluated all-vaccine exemptions, a median of two and maximum of ten justifications were cited per exemption, most often a family history of autoimmune disease other than allergy. Three providers wrote more than 70 exemptions each. ConclusionsThe number and nature of the exemptions reviewed here raise concerns over their impact on immunization rates, and future policies may need to ensure additional oversight.
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