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Rule Change Led to Short-Term Drop in Nonmedical Exemptions

32 percent decrease in NMEs in Michigan seen immediately after rule change, but rebound seen in subsequent years

TUESDAY, Aug. 17, 2021 (HealthDay News) — Implementation of a change in the state Administrative Rules in Michigan led to a short-term decline in nonmedical exemption (NME) rates for vaccination, according to a study published online Aug. 17 in Pediatrics.

Nina B. Masters, Ph.D., M.P.H., from the University of Michigan in Ann Arbor, and colleagues used vaccination data from 2011 to 2018 to evaluate sociodemographic predictors of NMEs before and after the Michigan Administrative Rule change, effective Jan. 1, 2015, which required parents to attend an in-person vaccine education session before obtaining an NME.

The researchers found that the rates of NMEs decreased by 32 percent immediately after the rule change. However, in subsequent years, NME rates rebounded, increasing by 26 percent by 2018, although there was a reduction in income disparities in NME rates after the rule change. Across the state, there were distinct geographic patterns in philosophical, religious, and medical vaccine exemptions, which mainly persisted after 2015, indicating that despite the rule change, NME clusters remain a concern.

“In addition to state regulation of vaccine exemptions, interventions should be aimed to counter growing levels of vaccine hesitancy through education, building confidence in vaccines and government, curbing misinformation, educating doctors about the importance of vaccination, minimizing missed opportunities, and increasing affordability,” the authors write. “These recommendations are particularly important against a backdrop of the coronavirus disease 2019 pandemic, which has led to reduced ambulatory care visits, causing a precipitous drop in pediatric vaccination rates.”

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