![]() Personal belief exemption rate from mandated school-entry immunizations, California kindergarteners, 2008–2015. In addition, a new, separate religious exemption option was added to the state’s immunization policy in the Governor’s signing statement. The new law required parents to obtain a signature from an authorized health care provider (HCP) stating that the parent had received information about the risks and benefits of immunization. ![]() AB2109, which went into effect in January 2014, made PBEs more difficult to obtain. 1), the California State Assembly passed Assembly Bill 2109 (AB2109) in 2012. After several years of steady increases in PBEs in the state (see Fig. Religious and other types of nonmedical exemptions were not separately delineated or recorded. PBEs were very easy for California parents to obtain prior to 2012, requiring only a parent signature on a preprinted affidavit on the back of the child’s school immunization record. In California, the focus of the present study, nonmedical exemptions are referred to as personal belief exemptions (PBEs). ![]() Recent measles and pertussis outbreaks have focused national attention on these state laws governing exemptions from school-entry immunization mandates. Allowed nonmedical exemptions can be further categorized as personal belief, philosophical, and/or religious. State law in all 50 states provides for medical exemptions to immunization mandates, and most states also provide for nonmedical exemptions. To maintain high rates of immunization coverage, each US state has laws mandating required immunizations for school entry. The routine childhood immunization schedule protects against 17 diseases, and prevents millions of cases of diseases and thousands of deaths in every US birth cohort. ![]()
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