Arkansas Department of Health, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA.
Am J Prev Med. 2012 Jun;42(6):602-5. doi: 10.1016/j.amepre.2012.02.022.
An increase in total vaccine exemptions (medical, philosophic, and religious) occurred in Arkansas after a 2003 legislation added a philosophic category and used a new process for vaccine exemptions. By legislative requirement, the Arkansas Department of Health monitored exemptions through the 2009-2010 school year.
The goal of the study was to determine the prevalence of vaccine exemption in 2003-2010 compared to the number of requests prior to the legislation enacted in 2003.
Exemptions were calculated by school-age category using raw numbers of exemptions, total estimates of the population by age level, enrollment numbers for students in public and private schools, and in enrolled college students born after 1957. Exemptions also were analyzed by school district, grade level, type of exemption, and particular vaccine exemption requested.
Overall exemptions continued to rise each year, with an average increase of 23.1% annually. Medical exemptions declined from an average of 21.3% of all exemptions before to an average of 4.8% thereafter. The greatest increase in number of exemptions was observed among college students. The highest total rate of exemptions per precollegiate student population was <1.3%. When exemption requests were categorized, most (79%) were for exemptions from "all vaccines." The most common single exempted vaccine was MMR (measles, mumps, rubella).
Since philosophic exemptions were codified in 2003 in Arkansas, the number and rate of vaccine exemptions continue to progressively increase. However, vaccine-preventable disease clusters have not yet been linked to or identified in any population with a high rate of vaccine exemptions.
2003 年立法增加了哲学类别，并采用了新的疫苗豁免程序后，阿肯色州的总疫苗豁免（医学、哲学和宗教）增加。根据立法要求，阿肯色州卫生部在 2009-2010 学年期间通过监测豁免情况。
本研究的目的是确定 2003-2010 年疫苗豁免的流行率与 2003 年立法前的请求数量相比。
使用豁免的原始数量、按年龄水平计算的总人口总数估计、公立和私立学校学生的入学人数以及 1957 年后出生的大学生入学人数，按学龄类别计算豁免人数。还按学区、年级水平、豁免类型和特定疫苗豁免请求分析豁免情况。
总体豁免率持续上升，平均每年增长 23.1%。医学豁免率从之前所有豁免的平均 21.3%降至之后的平均 4.8%。豁免人数增幅最大的是大学生。每千名准大学生的豁免率最高为<1.3%。当豁免请求分类时，大多数（79%）是豁免所有疫苗。最常见的单一豁免疫苗是麻疹、腮腺炎、风疹（MMR）。
自 2003 年阿肯色州将哲学豁免纳入法典以来，疫苗豁免的数量和比例继续持续增加。然而，尚未在任何高疫苗豁免率人群中发现或确定疫苗可预防疾病的聚集。
