Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut.
Yale Institute for Global Health, New Haven, Connecticut.
JAMA Netw Open. 2022 Feb 1;5(2):e2146467. doi: 10.1001/jamanetworkopen.2021.46467.
In 2015, California passed Senate Bill No. 277 (SB 277) and became the first state in more than 30 years to eliminate nonmedical exemptions to mandatory childhood immunizations for school entry. One concern that emerged was that the law created an incentive for parents to remove children from brick-and-mortar schools to bypass the immunization requirements.
To assess the trends in homeschooling rates after the elimination of nonmedical exemptions to the requirement of childhood immunizations for school entry.
DESIGN, SETTING, AND PARTICIPANTS: This preintervention-postintervention cross-sectional study calculated homeschooling rates as the number of students in kindergarten through grade 8 (K-8) enrolled through each of California's 3 homeschooling mechanisms (independent study program, private school affidavit, and private school satellite program) divided by all K-8 students enrolled in the same academic year. Data on homeschooling rates were obtained from the California Department of Education. Interrupted time series analyses were conducted using a linear regression model in which the outcome variable was the percentage of students enrolled in a homeschool program before and after SB 277. Data were collected and analyzed from October 3, 2012, to October 2, 2019.
Passage of SB 277, which eliminated nonmedical exemptions to childhood immunizations for school entry.
Homeschooling rates for K-8 students.
Among the students included in the analysis, the homeschooling enrollment for K-8 students in California increased from 35 122 students (0.8%) during the 2012-2013 school year to 86 574 students (1.9%) during the 2019-2020 school year; however, the implementation of SB 277 was not associated with an increase in the percentage of students enrolled in homeschooling programs in California beyond the secular trend. The increase in homeschooling was greatest for the lower grade levels: kindergarten homeschooling enrollment increased from 2068 students (0.4%) in the 2012-2013 school year to 10 553 students (1.9%) in the 2019-2020 school year, whereas the grade 8 homeschool enrollment rate increased from 5146 students (1.0%) in the 2012-2013 school year to 10 485 students (2.0%) in the 2019-2020 school year. Independent study programs accounted for 20 149 students (45.3%) of homeschooling enrollment, private school affidavits accounted for 19 333 students (43.5%), and private school satellite programs accounted for 4935 students (11.1%) during the 2015-2016 school year.
The findings of this study suggest that legislative action to limit nonmedical exemptions for compulsory vaccination for school entry is not associated with removal of students from classroom-based instruction in brick-and-mortar institutions.
2015 年，加利福尼亚州通过了参议院法案 277 号（SB 277），成为 30 多年来第一个取消儿童入学强制性免疫接种非医学豁免的州。出现的一个担忧是，该法律为家长提供了将孩子从实体学校转移以规避免疫接种要求的动机。
评估取消儿童入学免疫接种非医学豁免后 homeschooling 率的趋势。
设计、设置和参与者：这项干预前-干预后横断面研究通过以下方式计算 homeschooling 率：通过加利福尼亚州的 3 种 homeschooling 机制（独立学习计划、私立学校宣誓书和私立学校卫星计划）注册的幼儿园至 8 年级（K-8）学生人数除以同一年学术的所有 K-8 学生人数。 homeschooling 率的数据来自加利福尼亚州教育部。使用线性回归模型进行中断时间序列分析，其中因变量为 SB 277 之前和之后注册 homeschool 计划的学生的百分比。数据于 2012 年 10 月 3 日至 2019 年 10 月 2 日收集和分析。
通过 SB 277，取消儿童入学免疫接种的非医学豁免。
K-8 学生的 homeschooling 率。
在所分析的学生中，加利福尼亚州 K-8 学生的 homeschooling 入学人数从 2012-2013 学年的 35122 名（0.8%）增加到 2019-2020 学年的 86574 名（1.9%）；然而，SB 277 的实施并没有在加利福尼亚州增加注册 homeschool 计划的学生百分比超出了世俗趋势。 homeschooling 的增长在较低年级最大：幼儿园 homeschooling 入学人数从 2012-2013 学年的 2068 名（0.4%）增加到 2019-2020 学年的 10553 名（1.9%），而 8 年级 homeschooling 入学率从 2012-2013 学年的 5146 名（1.0%）增加到 2019-2020 学年的 10485 名（2.0%）。独立学习计划占 homeschooling 入学人数的 20149 名（45.3%），私立学校宣誓书占 19333 名（43.5%），私立学校卫星计划占 2015-2016 学年的 4935 名（11.1%）。
本研究的结果表明，限制儿童入学强制性疫苗接种非医学豁免的立法行动与将学生从实体机构的课堂教学中转移无关。
