"I think all eligible children should receive recommended vaccines, but I also recognize the right of parents to make this choice – to the extent that it does not cause harm in others," said Dr. Gregory Poland, professor of medicine, infectious disease, molecular pharmacology and experimental therapeutics at Mayo Clinic and Foundation. "For this reason, I think it is imperative that anyone seeking an exemption for any reason should be required to have adequate education and counseling about vaccines and have an opportunity to have questions answered and misperceptions debunked.
"Many children have been terribly harmed and families and communities scarred by the oft times capricious and uninformed rejection of vaccines based on false information."
While parental counseling may improve vaccination rates, Omer believes that the results of his study identify an area where state policies could help. He notes that the length of the exemptions that are granted has an effect on the rates of such exemptions. States that only offered temporary medical exemptions had lower rates of exemptions than those that offered only permanent medical exemptions.
"I would say at the state level, the states should consider only having temporary exemptions," Omer said. "A great proportion of contraindications to vaccines are temporary and having that renewable requirement makes more sense."
For example, children may have temporary illnesses that preclude vaccination – such as childhood leukemia that can go into remission after treatment. However, in a state that grants only permanent exemptions, that child might never be required to get vaccinated. If other children in that area are also forgoing vaccinations, the aggregate number of these children may begin to compromise herd immunity.
Experts agree that physicians should pay strict attention to the guidelines set forth by the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the American Academy of Family Physicians.