It is our intention with this article to explore these areas in more detail. In addition to gathering adequate support from voters and lawmakers, both state and federal legislatures must ensure that any law that restricts citizens’ choice concerning vaccinations is consistent with state and federal constitutions, state and federal laws and, in turn, legal precedent established by state and federal courts. raises substantial challenges on legislative and judicial fronts. 10 – 12Īlthough the public health agenda of eliminating nonmedical exemptions has an intuitive appeal, changing state law across the U.S. 2, 3 Major national medical organizations have endorsed this strategy for several years now. 8, 9 Modifying state childhood vaccination exemption laws through legislation including removing nonmedical exemptions or making them more difficult to obtain is one frequently proposed strategy for increasing vaccination rates. For the 2022 school year, both California and Louisiana instituted COVID-19 vaccination school entry requirements for students. 6 A January 2022 survey found that only 1 in 3 children aged 5-11 had received at least their first COVID-19 shot 7 the proportion was higher, though far from perfect, among adolescents aged 12-17 at 3 in 5. 4 Further, hesitancy surrounding COVID-19 vaccination has been widespread across the U.S., 5 especially among parents vaccinating their children. 1 Indeed, following the scale up of COVID-19 vaccination during the pandemic, the highest hospitalization and mortality rates have been among those unvaccinated. 1 – 3 While hesitancy is not the only reason for vaccine-preventable disease outbreaks (e.g., waning host immunity following immunization), from a public health perspective this is perhaps the most important criterion, because outbreaks are often started and sustained by persons choosing not to vaccinate. The COVID-19 pandemic combined with the re-emergence of childhood vaccine-preventable infectious diseases in the past few decades has exemplified the impact that vaccine hesitancy has on the public’s health (we use the term “hesitancy” in this article broadly to include individuals who are unsure about vaccinating themselves or others, as well as individuals who refuse to vaccinate themselves or others.).
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