Vaccination exemptions among Kindergartners by state-level 2024 Presidential election result.
Faust, J. S.; Renton, B. H.
Show abstract
ImportancePediatric vaccine exemptions have increased in recent years. How political environments influence these trends is unknown. ObjectiveTo analyze state-level kindergarten vaccination exemption rates from 2009-2024, stratified by 2024 Presidential election results, to assess changes over time. Design, Setting, and ParticipantsThis cross-sectional study used publicly available CDC data on kindergarten vaccination exemptions across all U.S. states and Washington, DC. States were categorized as Donald Trump or Kamala Harris states based on 2024 election results. Previous elections were also assessed. Main Outcomes and MeasuresIncident rates (IRs) of vaccination exemptions (all, medical, and non-medical) were calculated yearly. Incident rate ratios (IRRs) comparing vaccination exemption rates in Harris versus Trump win states were calculated. and Spearman correlations assessed associations between exemption rates and Republican vote share in the four most recent Presidential elections. ResultsAnalysis included 53,997,748 person-years of kindergarten data. By 2023-2024, non-medical exemptions were permitted in 90.2% of states. Exemption rates increased in Trump states but decreased in Harris states during the study period. Most exemptions were non-medical. Conclusions and RelevanceKindergarten vaccination exemptions now diverge by political environment, increasing over time in states won by Trump in 2024 and decreasing in states won by Harris. The findings suggest growing politicization of vaccination practices, warranting targeted public health interventions.
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