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Vaccine mandates in the US are doing more harm than good

BMJ 2015; 351 doi: (Published 26 August 2015) Cite this as: BMJ 2015;351:h4576
  1. Allan S Cunningham, retired pediatrician, Cooperstown, NY, USA
  1. crabarbicus62{at}

Tightening the rules for non-medical exemptions is not justified and will increase parental mistrust and resistance, argues Allan S Cunningham

Since my medical career began in 1962 I have seen the harmful effects of nearly all of the vaccine preventable diseases on the US immunization schedule. I have enthusiastically administered many thousands of vaccine doses and am glad that my children and grandchildren are well vaccinated. However, the current attitudes of public health officials about vaccine mandates and exemptions are arrogant and patronizing.

In the US all 50 states and the District of Columbia require children and adolescents to be vaccinated before they attend school, college, or preschool programs.1 Rhode Island has the most extensive requirements, including mandates for vaccination against hepatitis A and B, Haemophilus influenzae type B, rotavirus, human papillomavirus, and influenza.2 Medical exemptions are granted in all jurisdictions, and religious exemptions are granted everywhere but Mississippi and West Virginia. Only 20 states grant personal exemptions.

The recent US measles outbreak has given rise to a lot of media hyperventilation about vaccine exemptions. There have been calls for outright bans …

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