Holroyd Taylor A, Howa Amanda C, Proveaux Tina M, Delamater Paul L, Klein Nicola P, Buttenheim Alison M, Limaye Rupali J, Omer Saad B, Salmon Daniel A
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Hum Vaccin Immunother. 2021 Jul 3;17(7):1986-1993. doi: 10.1080/21645515.2020.1857202. Epub 2021 Jan 25.
In 2015, California passed Senate Bill 277 eliminating all nonmedical exemptions to school vaccinations. We aimed to explore school-level modes of SB277 enforcement, characterize vaccination knowledge, attitudes, and beliefs of school officials, and identify whether school vaccination policies are associated with medical exemptions being granted. Surveys were mailed to a stratified random sample of 1,450 schools in California. School personnel (n = 752) reported their medical training, vaccination beliefs, enforcement of vaccination policies, and school rates of medical exemptions. Multiple logistic regression was used to assess whether school policies are associated with the likelihood of medical exemption requests being granted. Nurses were more likely than non-nurses to hold beliefs recognizing the importance of vaccination. A school where the survey respondent was a nurse was more likely to have granted a medical exemption request compared to a school where the respondent was not a nurse (OR 2.11, 95% CI 1.34-3.36). The training of school officials and school-level practices may impact the enforcement of medical exemptions. Equipping school officials as competent sources of vaccine information for concerned parents will be valuable in improving parental vaccine uptake.
2015年，加利福尼亚州通过了参议院第277号法案，取消了所有非医学原因的学校疫苗接种豁免。我们旨在探索参议院第277号法案的学校层面执行模式，描述学校工作人员的疫苗接种知识、态度和信念，并确定学校疫苗接种政策是否与获批的医学豁免相关。我们向加利福尼亚州1450所学校的分层随机样本邮寄了调查问卷。学校工作人员（n = 752）报告了他们的医学培训、疫苗接种信念、疫苗接种政策的执行情况以及学校的医学豁免率。我们使用多元逻辑回归来评估学校政策是否与获批医学豁免申请的可能性相关。护士比非护士更有可能持有认可疫苗接种重要性的信念。与受访者不是护士的学校相比，受访者是护士的学校更有可能批准医学豁免申请（比值比2.11，95%置信区间1.34 - 3.36）。学校工作人员的培训和学校层面的做法可能会影响医学豁免的执行。让学校工作人员成为为忧心忡忡的家长提供可靠疫苗信息的来源，对于提高家长的疫苗接种率将非常有价值。
