Vaccination Policies and Rates of Exemption from Immunization, 2005–2011

We computed the annual change in the rates of nonmedical exemptions from school immunization requirements and compared these rates between states that allow philosophical exemptions and states that allow only religious exemptions. We also compared states with respect to how difficult it is to obtain nonmedical exemptions because of certain administrative procedures. We used data compiled by the Centers for Disease Control and Prevention (CDC) for school years 2005–2006 through 2010–2011.1 State-specific categories of difficulty in obtaining exemptions were based on several factors: whether completion of a standardized form was permissible, as opposed to a letter from a parent; where the parent obtained the form (i.e., school vs. health department); whether the form had to be notarized; and whether a letter from a parent, if required, needed to be worded a specific way, resulting in extra effort on the part of the parent.