Majority of Vaccination Bills Propose Increasing Exemptions, But Most Enacted Limit Exemptions

A content analysis of proposed and enacted legislation between 2011 and 2017 that would directly affect states’ immunization exemption laws identified 175 bills related to vaccination policies, 53 percent of which would increase access to vaccine exemption, with the remaining limiting exemption laws. Yet, although more antivaccination legislation was introduced during the study period, bills that limited vaccine exemptions were significantly more likely to be enacted. For example, 12 of the 13 bills signed into law (92 percent) limited access to vaccine exemptions. The study also found Republican legislators were more likely to promote bills that increased people’s access to vaccine exemptions. The four states that had at least 10 proposed bills that would increase access to vaccine exemptions during the study period included New Jersey (32), New York (28), West Virginia (15) and Mississippi (12). Currently, all states allow medical exemptions to vaccination; however, all but three states — West Virginia, Mississippi and California — allow vaccine exemptions for religious or possibly even ideological reasons.

“Public health and medical societies can be influences on legislators, so this study should act as an alarm that the majority of bills in state legislatures are anti-vaccination,” said Neal D. Goldstein, PhD, MBI, assistant research professor of epidemiology and biostatistics at the Drexel University Dornsife School of Public Health. “Even though the ones that make it to law are pro-vaccination, the fact that these antivaccination bills are even introduced is concerning. Organizations like the AAP [American Academy of Pediatrics] have a specific role to play in ensuring that evidence-based bills are supported, and nonevidence-based bills are dismissed.”