Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA.
J Infect Dis. 2012 Oct 1;206(7):989-92. doi: 10.1093/infdis/jis436. Epub 2012 Aug 29.
All 50 US states allow medical exemptions from school entry immunization requirements. The extent to which medical exemptions are granted and the relationship with ease of obtaining these exemptions has not previously been examined in detail. We evaluated counts and rates of state-level medical exemptions to kindergarten entry requirements over 7 school years (2004-2005 through 2010-2011). During this period, 0.26%-0.41% of enrolled children received medical exemptions. In states with easier medical exemption criteria, medical exemption rates were significantly higher (adjusted incidence rate ratio: 6.4 [95% confidence interval: 2.7-15.6]). Routine evaluation of medical exemption rates is needed to ensure their appropriate use.
全美 50 个州均允许因医疗原因豁免儿童入学时的免疫接种要求。然而，各州给予医疗豁免的程度以及获得这些豁免的难易程度此前尚未得到详细评估。我们评估了过去 7 个学年（2004-2005 学年至 2010-2011 学年）内各州幼儿园入学规定中医疗豁免的数量和比例。在此期间，有 0.26%-0.41%的入学者获得了医疗豁免。在医疗豁免标准较宽松的州，医疗豁免率明显更高（校正发病率比：6.4[95%置信区间：2.7-15.6]）。需要对医疗豁免率进行常规评估，以确保其合理使用。
