Religious Exemptions for Immunization and Risk of Pertussis in New York State, 2000-2011
Religious Exemptions for Immunization and Risk of Pertussis in New York State, 2000-2011
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DOI：
10.1542/peds.2012-3449
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发表时间：
2013-07-01
期刊：
影响因子：
8
通讯作者：
Shaw, Jana
中科院分区：
文献类型：
--
作者：
Imdad, Aamer;Tserenpuntsag, Boldtsetseg;Shaw, Jana
目的：本研究的目的是描述随着时间的推移，宗教疫苗接种豁免率以及与纽约州（NYS）百日咳的相关性。从2000年到2011年，通过纽约州卫生部的学校调查报告的宗教疫苗接种豁免按县进行了审查，并根据纽约州卫生部传染病电子监测系统报告的儿童百日咳发病率评估这些变化。2000-2011年，宗教豁免>= 1疫苗的总体年度平均流行率（+/- SD）为0.4% +/- 0.08%，从2000年的0.23%显著增加到2011年的0.45%（P = 0.001）。宗教豁免的流行率在各县之间差异很大，在研究期间有34个县增加了100%以上。平均豁免流行率>= 1%的县报告的百日咳发病率较高，为33/10万，而豁免率较低的县为20/10万，P <0.001。此外，百日咳疫苗接种的儿童生活在县的高豁免率增加豁免率之间的儿童（P = 0.008）。结论：纽约州各县的宗教豁免的患病率各不相同，在过去十年中增加。与低豁免县相比，豁免率较高的县在豁免和接种疫苗的儿童中报告的百日咳率较高。需要更多的研究来描述纽约州学校之间获得豁免的过程中的差异，并需要教育有关个人选择退出推荐疫苗接种的社区风险。
OBJECTIVE: The objective of this study was to describe rates of religious vaccination exemptions over time and the association with pertussis in New York State (NYS).METHODS: Religious vaccination exemptions reported via school surveys of the NYS Department of Health from 2000 through 2011 were reviewed by county, and the changes were assessed against incidence rates of pertussis among children reported to the NYS Department of Health Communicable Disease Electronic Surveillance System.RESULTS: The overall annual state mean prevalence (+/- SD) of religious exemptions for >= 1 vaccines in 2000-2011 was 0.4% +/- 0.08% and increased significantly from 0.23% in 2000 to 0.45% in 2011 (P = .001). The prevalence of religious exemptions varied greatly among counties and increased by >100% in 34 counties during the study period. Counties with mean exemption prevalence rates of >= 1% reported a higher incidence of pertussis, 33 per 100 000 than counties with lower exemption rates, 20 per 100 000, P < .001. In addition, the risk of pertussis among vaccinated children living in counties with high exemption rate increased with increase of exemption rate among exempted children (P = .008).CONCLUSIONS: The prevalence of religious exemptions varies among NYS counties and increased during the past decade. Counties with higher exemption rates had higher rates of reported pertussis among exempted and vaccinated children when compared with the low-exemption counties. More studies are needed to characterize differences in the process of obtaining exemptions among NYS schools, and education is needed regarding the risks to the community of individuals opting out from recommended vaccinations.