Arkansas Division of Health data on immunization exemptions granted were linked to Department of Education data for all school attendees (grades K through 12) during 2 school years before the legislation (2001–2002 and 2002–2003 [Years 1 and 2, respectively]) and 2 years after philosophical exemptions were available (2003–2004 and 2004–2005 [Years 3 and 4, respectively]). Changes in numbers, types, and geographic distribution of exemptions granted are described.
The total number of exemptions granted increased by 23 % (529 to 651) from Year 1 to 2; by 17 % (total 764) from Year 2 to 3 after philosophical exemptions were allowed; and by another 50 % from Year 3 to 4 (total 1145). Nonmedical exemptions accounted for 79 % of exemptions granted in Years 1 and 2, 92 % in Year 3, and 95 % in Year 4. Importantly, nonmedical exemptions clustered geographically, suggesting concentrated risks for vaccine-preventable diseases in Arkansas communities.
Legislation allowing philosophical exemptions from school immunization requirements was linked to increased numbers of parents claiming nonmedical exemptions, potentially causing an increase in risk for vaccine-preventable diseases. Continued education and dialogue are needed to explore the balance between individual rights and the public’s health.