Clusters of Nonmedical Exemptions to Vaccination in Illinois K–12 Schools

Abstract

Vaccination rates in Illinois schools are decreasing as more parents opt for nonmedical exemptions (NMEs). At the local scale, higher levels of exemptions affect herd immunity levels. Few studies have previously conducted or proposed methods to conduct local-scale spatial and temporal cluster pattern analysis. This study used vaccination exemption data from the Illinois School Board of Education’s annual Immunization School Survey for the 2003–2004 and 2013–2014 academic years. The Getis–Ord General G statistic was used to identify cluster detection by individual vaccine at the school level. The Getis–Ord Gi* statistic was used with two different parameter models to identify hot and cold spots. This study found that NMEs are highly clustered. More clusters of high and low NMEs were identified for the 2013–2014 academic year than for 2003–2004. The percentages of schools that were neither hot nor cold averaged 94.0 percent for the 2003–2004 school year and 78.7 percent for the 2013–2014 school year. NME rates in Illinois are rising. The increase in hot and cold spots is evidence that the polarity of vaccination choice is growing. As vaccination exemption rates continue to polarize U.S. society, it is essential for public health efforts to monitor and conduct local-level studies. Key Words: antivaccination, hot spot analysis, medical geography, nonmedical exemption, spatial statistics.