Public Health

Why medical reasons should be the only exemptions from vaccinations

As the debate around vaccinations continues to rage in the public, outbreaks of dangerous preventable diseases have continued to increase. For public health experts, the question has become, “Should individuals be given exemptions from required immunizations for non-medical reasons?” Physicians provided some answers with policy passed at the 2015 AMA Annual Meeting.

Immunization programs in the Unites States are credited with having controlled or eliminated the spread of epidemic diseases, including smallpox, measles, mumps, rubella, diphtheria and polio. Immunization requirements vary from state to state, but only two states bar non-medical exemptions based on personal beliefs.

“When people are immunized they also help prevent the spread of disease to others," AMA Board of Trustees Member Patrice A. Harris, MD, said in a news release. “As evident from the recent measles outbreak at Disneyland, protecting community health in today’s mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience.”

Policies adopted at the meeting call for immunization of the population—absent a medical reason for not being vaccinated—because disease exposure, importation, infections and outbreaks can occur without warning in communities, particularly those that do not have high rates of immunization. That begins with health care professionals involved in direct patient care, who have an obligation to accept vaccinations to prevent the spread of infectious disease and ensure the availability of the medical workforce.

Other policies include:

  • Supporting the development and evaluation of educational efforts, based on scientific evidence and in collaboration with health care providers, that support parents who want to help educate and encourage their peers who are reluctant to vaccinate their children
  • Disseminating materials about the effectiveness of vaccines to states
  • Encouraging states to eliminate philosophical and religious exemptions from state immunization requirements
  • Recommending that states have an established decision mechanism that involves qualified public health physicians to determine which vaccines will be mandatory for admission to school and other identified public venues

These policies aim to minimize the risk of outbreaks and protect vulnerable individuals from acquiring preventable but serious diseases.