With decreasing adherence to childhood vaccination mandates through 'opt-out' exemptions, states are facing public health crises as vaccination rates fall below necessary levels to maintain herd immunity. Evidence of the potential risks to our communities have been demonstrated in pertussis outbreaks in Washington and, most recently, measles outbreaks in Disneyland. Prior to legislation changes, opt-out rates increased fastest in states such as Washington- states with minimal exemption requirements.
What has Washington done to increase vaccination rates among school-aged children in response to these outbreaks? Physicians!
In order for Washington residents to obtain exemption for their child(ren), a written certification must be submitted by the parent or legal guardian stating religious, personal or philosophical objection. The form must also include a signed statement from a healthcare practitioner stating that the benefits and risks of immunization to the child have been reviewed.
This strategy works two fold. Foremost, it is the hope that requiring a conversation with one's primary care provider will provide patients with sound and supported information on the safety and benefits of vaccinations as well as the risks exemptions pose to their child(ren) and also their community. Requiring this visit also pushes the balance of convenience away from getting exemptions.
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