The share of kindergartners whose parents opted out of state immunization requirements more than doubled in the decade that ended in 2008, peaking at 7.6 percent in the 2008-9 school year, according to the state’s Health Department, raising alarm among public health experts. But last year, the Legislature adopted a law that makes it harder for parents to avoid getting their children vaccinated, by requiring them to get a doctor’s signature if they wish to do so. Since then, the opt-out rate has fallen fast, by a quarter, setting an example for other states with easy policies.
For despite efforts to educate the public on the risks of forgoing immunization, more parents are choosing not to have their children vaccinated, especially in states that make it easy to opt out, according to a study published on Thursday in The New England Journal of Medicine.
The opt-out rate increased fastest in states like Oregon and Arizona — and Washington, before its law changed — where it was easy to get an exemption. In such states, the rate rose by an average of 13 percent a year from 2006 to 2011, according to the study. In states that made it harder to get an exemption from vaccination, such as Iowa and Alabama, the opt-out rate also rose, but more slowly, by an average of 8 percent a year.
Jonathan Bell, a naturopathic doctor in Washington State who encourages his patients to vaccinate their children. Those who opt out, he said, tend to distrust the public health establishment because of what they see as its unsavory connections with the pharmaceutical industry. “The argument is, ‘Oh no, I’m putting off vaccines,’ ” he said. “ ‘I’m part of a group that’s smart enough to understand the government is a pawn of big pharma.’ ”
This is a spot of good news. We can reverse some of the decline by making opting out less easy. Making an effort to opt out would require more thought and possibly a chance for intervention by health care personnel to persuade parents of the value of vaccination.
Another way to stop the decline would be to make getting recommended vaccinations easier. In some places, routine vaccinations carry costs or are inconvenient to get.