Individual Rights vs. the Public Good: How Do State Exemption Policies Impact Childhood Vaccination Rates?

Growing hotspots of unvaccinated children corroborate with states that have highly permissive vaccination policies. State-based nonmedical exemption (NME) policies such as religious or philosophical exemptions make it easy for parents to opt out of vaccinating their children thus lowering herd immunity and increasing the risk of outbreaks. Recent studies have revealed that Phoenix is the metropolitan area with the highest number of nonmedical exemptions in the country with vaccination rates below herd immunity. This thesis investigates the role of the law in enabling low vaccination rates and develops a set of policy recommendations that lawmakers may use as a tool to restore these rates to herd immunity levels. To do this, an in-depth literature review was performed and supplemented with a case study of California’s policy response to the 2014 Disneyland measles outbreak. This information was synthesized into an in-depth policy analysis addressing the political, social, practical, and economic factors of the issue and four potential policy responses for state lawmakers. Based on the analysis and California’s example, eliminating nonmedical vaccine exemptions was identified as the most effective policy option to reach the intended goal of restoring vaccination rates to herd immunity levels. This policy option is both the most cost-effective and productive in reaching herd immunity but infringes the most on parental rights and will be met with the most significant political pushback. Despite these challenges, lawmakers should take this policy step to protect our community and the most vulnerable among us.