-Caveat Lector-

----- Original Message -----
From: Science-Week <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Wednesday, July 14, 1999 6:45 AM
Subject: SW BULLETIN July 14, 1999

HEALTH CONSEQUENCES OF EXEMPTIONS FROM IMMUNIZATION LAWS
Immunizations are among the most cost-effective and successful
public health interventions, and all jurisdictions in the US have
introduced and actively enforce laws that require proof of
immunization for school entrance. However, state immunization
laws permit certain exemptions, e.g., for individuals who are
immunocompromised, have allergic reactions to vaccine
constituents, or have moderate or severe illness. Also, 48 states
permit religious exemptions, and 15 states allow philosophical or
personal exemptions, with such exemptions defined differently by
each state. D.A. Salmon et al (Centers for Disease Control, US)
now report a study to quantify the risk of contracting measles
among individuals claiming religious and/or philosophical
exemptions from immunization (exemptors) compared with vaccinated
persons, and to examine the risk that exemptors pose to the
nonexempt population. The authors report that on average,
exemptors were 35 times more likely to contract measles than were
vaccinated persons. Depending on assumptions concerning the
degree of mixing between exemptors and non-exemptors, the
incidence of measles infection in non-exempt individuals would
increase by 5.5 percent to 30.8 percent. The authors suggest
their data indicate the need for systematic review of vaccine-
preventable incidents to examine the effect of exemptors, and the
need for increased surveillance of the number of exemptors and
cases among them, and the need for research to determine the
reasons why individuals claim exemptions.
(J. Amer. Med. Assoc. 7 Jul 99)

Are religious exemptions to immunization a good way to reduce the
populations of religious groups? Do True Believers deserve to be
left on their own to sicken and die? Do they have the right to
infect the rest of us? What infectious diseases wouldn't you
mind catching from your True Believer neighbors? Why?  --Ric

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