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Public Health and the Politics of School Immunization Requirements

Daniel A. Salmon, PhD, MPH, Jason W. Sapsin, JD, MPH, Stephen Teret, JD, MPH, Richard F. Jacobs, MD, FAAP, Joseph W. Thompson, MD, Kevin Ryan, JD, MA and Neal A. Halsey, MD

Daniel A. Salmon and Neal A. Halsey are with the Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Jason W. Sapsin and Stephen Teret are with the Center for Law and the Public’s Health, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Richard F. Jacobs is with the College of Medicine, University of Arkansas for Medical Sciences, Little Rock. Joseph W. Thompson is with the Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences. Kevin Ryan is with the Arkansas Center for Health Improvement, College of Medicine, University of Arkansas for Medical Sciences.



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  		FIGURE 1—— Potential nonmedical vaccination exemption scenarios (with state examples in italics) and level of public health protection/legal security.

Note. The degree of public health protection is based on administrative procedures that may limit the number and clustering of exemptions. The degree of legal security is based on the potential for constitutional invalidity.

 




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