Lai Yun-Kuang, Nadeau Jessica, McNutt Louise-Anne, Shaw Jana
Albany School of Public Health, State University of New York, University at Albany, Albany, NY, United States.
Institute for Health and the Environment, University at Albany, State University of New York, Albany, NY, United States.
Vaccine. 2014 Dec 12;32(52):7070-6. doi: 10.1016/j.vaccine.2014.10.077. Epub 2014 Nov 6.
School immunization requirements have ensured high vaccination rates and have helped to control vaccine-preventable diseases. However, vaccine exemptions have increased in the last decade. This study compared New York State private versus public schools with respect to medical and religious exemption rates.
This retrospective study utilizes New York State Department of Health Immunization Survey data from the 2003 through 2012 academic years. Schools were categorized as private or public, the former further categorized by religious affiliation. Rates of medical and religious vaccine exemptions were compared by school category.
From 2003 to 2012, religious exemptions increased in private and public schools from 0.63% to 1.35% and 0.17% to 0.29% (Spearman's R: 0.89 and 0.81), respectively. Among private schools, increases in religious exemption rates during the study period were observed in Catholic/Eastern Orthodox, Protestant/Other Christian, Jewish, and secular schools (Spearman's R=0.66, 0.99, 0.89, and 0.93), respectively. Exemption rate ratios in private schools compared to public schools were 1.39 (95% CI 1.15-1.68) for medical and 3.94 (95% CI: 3.20-4.86) for religious exemptions. Among private school students, all school types except for Catholic/Eastern Orthodox and Episcopal affiliates were more likely to report religious exemptions compared to children in public schools.
Medical and religious exemption rates increased over time and higher rates were observed among New York State private schools compared to public schools. Low exemption rates are critical to minimize disease outbreaks in the schools and their community.
学校免疫要求确保了高疫苗接种率，并有助于控制疫苗可预防疾病。然而，在过去十年中疫苗豁免情况有所增加。本研究比较了纽约州私立学校与公立学校在医疗豁免率和宗教豁免率方面的情况。
这项回顾性研究利用了纽约州卫生部2003年至2012学年的免疫调查数据。学校被分为私立或公立，私立学校进一步按宗教派别分类。按学校类别比较医疗和宗教疫苗豁免率。
从2003年到2012年，私立学校和公立学校的宗教豁免率分别从0.63%增至1.35%和从0.17%增至0.29%（斯皮尔曼相关系数R分别为0.89和0.81）。在私立学校中，天主教/东正教、新教/其他基督教、犹太教和非宗教学校在研究期间宗教豁免率均有增加（斯皮尔曼相关系数R分别为0.66、0.99、0.89和0.93）。私立学校与公立学校相比，医疗豁免率比值为1.39（95%置信区间1.15 - 1.68），宗教豁免率比值为3.94（95%置信区间：3.20 - 4.86）。在私立学校学生中，除天主教/东正教和圣公会附属学校外，所有学校类型的学生报告宗教豁免的可能性均高于公立学校的儿童。
随着时间推移，医疗和宗教豁免率有所上升，且纽约州私立学校的豁免率高于公立学校。低豁免率对于尽量减少学校及其社区的疾病爆发至关重要。
