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A Longitudinal Analysis of the Effect of Nonmedical Exemption Law and Vaccine Uptake on Vaccine-Targeted Disease Rates.

Authors :
Yang, Y. Tony
Debold, Vicky
Source :
American Journal of Public Health; Feb2014, Vol. 104 Issue 2, p371-377, 7p, 2 Charts, 2 Graphs
Publication Year :
2014

Abstract

Objectives. We assessed how nonmedical exemption (NME) laws and annual uptake of vaccines required for school or daycare entry affect annual incidence rates for 5 vaccine-targeted diseases: pertussis, measles, mumps, Haemophilus influenzae type B, and hepatitis B. Methods. We employed longitudinal mixed-effects models to examine 2001- 2008 vaccine-targeted disease data obtained from the National Notifiable Disease Surveillance System. Key explanatory variables were state-level vaccine-specific uptake rates from the National Immunization Survey and a state NME law restrictiveness level. Results. NME law restrictiveness and vaccine uptake were not associated with disease incidence rate for hepatitis B, Haemophilus influenzae type B, measles, or mumps. Pertussis incidence rate, however, was negatively associated with NME law restrictiveness (b = -0.20; P = .03) and diphtheria-pertussis-tetanus vaccine uptake (b = -0.01; P = .05). Conclusions. State NME laws and vaccine uptake rates did not appear to influence lower-incidence diseases but may influence reported disease rates for higher-incidence diseases. If all states increased their NME law restrictiveness by 1 level and diphtheria-pertussis-tetanus uptake by 1%, national annual pertussis cases could decrease by 1.14% (171 cases) and 0.04% (5 cases), respectively. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00900036
Volume :
104
Issue :
2
Database :
Complementary Index
Journal :
American Journal of Public Health
Publication Type :
Academic Journal
Accession number :
93721908
Full Text :
https://doi.org/10.2105/AJPH.2013.301538