Rising Rates of Religious Immunization Exemptions Linked with Higher Pertussis Rates

Almost all states allow religious exemption from school-mandated vaccinations. Recent data from several U.S. communities indicate that rates of religious and personal vaccine exemptions are increasing, and high exemption rates have been tied to rising rates of vaccine-preventable diseases (e.g., pertussis and measles). Investigators compared pertussis incidence between 2000 and 2011 among children (age, <19 years) in New York State counties with high- and low-exemption rates.

The overall mean prevalence of religious exemptions in the 62 counties was 0.78% (range, 0.06%–5.58%). Statewide mean exemption rates nearly doubled during the 12-year study period (from 0.23% to 0.45%; P=0.001). Pertussis incidence was higher in counties with exemption…