Exemptions from mandatory immunization after legally mandated parental counseling

摘要: BACKGROUND: The success of health care provider counseling–based interventions to address vaccine hesitancy is not clear. In 2011, Washington State implemented Senate Bill 5005 (SB5005), requiring counseling and a signed form from licensed obtain an exemption. Evaluating the impact intervention can provide important insight into population-level that focus on interpersonal communication by provider. METHODS: We used segmented regression interaction aggregation indices assess SB5005 immunization coverage exemption rates in school years 1997–1998 through 2013–2014. RESULTS: After was implemented, there significant relative decrease 40.2% (95% confidence interval: −43.6% −36.6%) rates. This translates absolute reduction 2.9 percentage points −4.2% −1.7%) There were increases for all vaccines required entrance, with exception hepatitis B vaccine. probability kindergarteners without exemptions would encounter (interaction index) decreased, other such (aggregation also decreased after SB5005. Moreover, associated decline geographic clustering exemptors. CONCLUSIONS: States United jurisdictions countries should consider adding parental as requirement obtaining vaccination requirements.