In June, New York became the fifth state to require its schoolchildren to be vaccinated despite their parents’ religious beliefs or philosophical objections.
Amid a surge in measles cases nationwide this year, legislators and community leaders are debating ways to boost the number of kids who are up to date on their school-mandated shots. Many have focused on restricting or eliminating vaccination exemptions based on religion or personal opinions, which are common and have been offered by school districts across the United States for decades.
But three recent academic studies suggest this might not be the most effective way to improve childhood vaccination rates. In fact, the research indicates banning these exemptions could backfire.
Scholars studied student vaccination rates in California, the nation’s most populous state, and discovered that when parents cannot get an exemption based on their personal beliefs, some seek other ways for their children to stay in school while skipping one or more vaccinations. The researchers also learned that while California lawmakers have targeted personal belief exemptions, which are used by a relatively small group of students, a larger group of children is being allowed to enter kindergarten on a “conditional status” basis with incomplete vaccinations.
In 2014 — the year before California passed a law eliminating vaccine exemptions based on personal beliefs, including religious beliefs — 13,254 California kindergarteners used these exemptions to forgo vaccinations. Meanwhile, another 36,411 kindergarteners were admitted to school on a conditional basis, according to the research.
Paul L. Delamater, the lead researcher on one of the three studies and the co-author of another, says helping conditional status students finish getting their shots would be a more effective way to boost vaccination rates than banning personal belief exemptions.
Also, he says, it likely would be easier to encourage the parents of conditional status students to get their kids up to date than it would be to convince parents who want their children to be able to opt out of the vaccine requirement.
“Trying to focus on parents who are not vaccine hesitant first may be a good way forward,” says Delamater, a fellow at the Carolina Population Center who’s also an assistant professor at the University of North Carolina at Chapel Hill. “I think parents with real vaccine hesitancy are going to search for ways to not vaccinate their children.”