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A Longitudinal Analysis of the Effect of Nonmedical Exemption Law and Vaccine Uptake on Vaccine-Targeted Disease Rates.
- 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]
- Subjects :
- VACCINATION policies
MMR vaccines
DPT vaccines
HEPATITIS B vaccines
ANALYSIS of variance
CHILD care
CONCEPTUAL structures
DEMOGRAPHY
REPORTING of diseases
DRUG utilization
ELEMENTARY schools
ETHNIC groups
HAEMOPHILUS diseases
HAEMOPHILUS influenzae
HEPATITIS B
LEGISLATION
LONGITUDINAL method
MEASLES
MINORITIES
MULTIVARIATE analysis
MUMPS
PARENTS
REGRESSION analysis
RELIGION
RESEARCH funding
SURVEYS
WHOOPING cough
SOCIOECONOMIC factors
EDUCATIONAL attainment
INTER-observer reliability
DISEASE incidence
REPEATED measures design
RETROSPECTIVE studies
THERAPEUTICS
CHILDREN
VACCINES
VACCINATION
Subjects
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