Health Officers Express Concerns About Medical Exemptions for Vaccines

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For schools, local health jurisdictions described a narrow role in provision of support and technical assistance.
For schools, local health jurisdictions described a narrow role in provision of support and technical assistance.

HealthDay News & mdash; After the passage of Senate Bill 277 (SB277) in California, which eliminated nonmedical vaccine exemptions for school entry, health officers and immunization staff reported concerns including an increase in medical exemptions, according to a study published online Oct. 29 in Pediatrics.

Salini Mohanty, Dr.P.H., from the University of Pennsylvania School of Nursing in Philadelphia, and colleagues conducted 34 semistructured interviews with 40 health officers and immunization staff from 35 of 61 local health jurisdictions in California to describe their experience addressing medical exemption requests.

The researchers found four main themes that emerged in relation to medical exemptions: the role of stakeholders; reviewing medical exemptions that schools had received; medical exemptions perceived as problematic; and frustration and concern over medical exemptions. For schools, local health jurisdictions described a narrow role in provision of support and technical assistance. Only five of the jurisdictions reported actively tracking medical exemptions that schools received; as a result, one jurisdiction was facing a lawsuit. Medical exemptions listing family history of allergies and autoimmune disease as contraindications for immunization and physicians charging high fees for medical exemptions were reported. Concerns were expressed about the increase in medical exemptions after the implementation of SB277.

"Our results reveal the translation of health policy into public health practice and some of the consequences of the implementation of SB277, including an increase in medical exemptions," the authors write.

One author disclosed ties to the pharmaceutical industry.

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