Exposure of California kindergartners to students with personal belief exemptions from mandated school entry vaccinations.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Culture* ; Schools* ; Students*; Communicable Disease Control/*statistics & numerical data ; Environmental Exposure/*analysis ; Vaccination/*statistics & numerical data; California ; Child ; Cohort Studies ; Communicable Disease Control/legislation & jurisprudence ; Cross-Sectional Studies ; Humans ; Philosophy, Medical ; Prevalence ; Religion and Medicine ; Vaccination/legislation & jurisprudence

Objectives: Personal belief exemptions (PBEs) from mandated school entry vaccinations have increased in California over the past decade. Infectious disease outbreaks in the state may be associated with the aggregation of intentionally unvaccinated children within schools. We sought to quantify the exposure of California kindergartners to children with PBEs at school.
Methods: We used cross-sectional California Department of Public Health data on 3 kindergarten cohorts to define and calculate multiple measures of exposure to children with exemptions, including interaction and aggregation indices, for the state as a whole (2008-2010) and by county (2010).
Results: In 2010, the PBE rate in California was 2.3 per 100 students, and the school PBE rate for the average kindergartner with a PBE was 15.6 per 100. More than 7000 kindergartners in California attend schools with PBE rates greater than 20 per 100, including 2700 kindergartners with PBEs. Exposure measures vary considerably across counties.
Conclusions: Our results suggest increasing levels of exposure among kindergarten students in California to other kindergartners with PBEs. Our data provide a concrete set of metrics through which public health and education officials can identify high-risk areas as targets for policy and programmatic interventions.

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KM1 CA156715 United States CA NCI NIH HHS; T32 HD007545 United States HD NICHD NIH HHS

Date Created: 20120616 Date Completed: 20121012 Latest Revision: 20211021

20240628

PMC3464858

10.2105/AJPH.2012.300821

22698009