Improving Nonmedical Vaccine Exemption Policies: Three Case Studies

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Some communities that exempt parents from vaccine mandates have recently reformed their exemption policies by eliminating nonmedical exemptions, allowing nonmedical exemptions only for parents who object to vaccination for religious reasons, or making exemptions more difficult to obtain. We argue against eliminating nonmedical exemptions because there are weighty moral reasons to offer these exemptions and because eliminating them will likely have unfortunate social and political consequences. We also argue against allowing nonmedical exemptions only for parents who object to vaccination for religious reasons, on the grounds that doing so is likely to be unfair or ineffective. We conclude that nonmedical exemptions should (continue to) be available to people who object for both religious and secular reasons, and that the best way to decrease exemption rates is to make the application process more burdensome. We illustrate our arguments with examples of recent policy changes in three US states.