1. A Systematic Review on the Effects of Non-Medical Vaccine Exemptions and Public Health
LaTishia Ambroziak

2. (Center for American Progress)
Problem Statement
The problem with school non-medical vaccine exemptions is that there could be an unnecessary outbreak of preventable infectious diseases.
The rise in non-medical exemptions has contributed to recent outbreaks and increased rate of vaccine- preventable diseases, such as measles and whooping cough.
(Center for American Progress)

3. Purpose
The purpose of this research is to see how many states allow non-medical vaccine exemptions and if there have been negative public health outcomes because of these exemptions. Currently the states with the most constrictions for getting a non-medical exemption are West Virginia, Mississippi, and most recently California.

4. Significance
When the percentage of children that are not vaccinated goes down in a city or state they will lose their herd immunity. Herd immunity is when enough people are vaccinated that the bacteria carried by vaccine preventable diseases like measles or polio have no one to latch on to. When herd immunity is loss the community is susceptible to a disease outbreak.

5. Research Questions and Associated Hypotheses
Which states allow non-medical exemptions?
What are the state vaccine exemptions?
Have the states with non-medical exemptions had any outbreaks?

6. Inclusion/Exclusion Criteria
Inclusion Criteria
Exclusion Criteria
Discuss State policies on vaccines
Discuss School exemptions
Vaccine safety
Discuss Type of Exemptions
Articles not accessible
Articles not pertaining to vaccine exemptions
Articles that are not peer-reviewed

7. Reference
-Blank NR, Caplan AL, Constable C Exempting schoolchildren from immunizations: states with few barriers had highest rates of nonmedical exemptions. Health Aff (Millwood). Retrieved from:
-CDC.gov. 29 November Measles Cases and Outbreaks. Retrieved from:
-Daniel A. Salmon and Andrew W. Siegel. Religious and Philosophical Exemptions from Vaccination Requirements and Lessons. Public Health Reports (1974-), Vol. 116, No. 4 (Jul. - Aug., 2001), pp Published by: Association of Schools of Public Health Retrieved from:
-Emily Oshima Lee, Lindsay Rosenthal, Gabriel Scheffler. November 14, The Effect of Childhood Vaccine Exemptions on Disease Outbreaks. Retrieved from:
disease-outbreaks/
-Ha, C., Rios, L. M., & Pannaraj, P. S. (2013). Knowledge, Attitudes, and Practices of School Personnel Regarding Influenza, Vaccinations, and School Outbreaks. Journal Of School Health, 83(8), doi: /josh Retrieved from:
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-Kennedy, A., Brown, C., & Gust, D. (2005). Vaccine Beliefs of Parents Who Oppose Compulsory Vaccination. Public Health Reports (1974- ), 120(3), Retrieved from
-Luthy KE, Beckstrand RL, Meyers CJH Common perceptions of parents requesting personal exemption from vaccination. J Sch Nurs. Retrieved from: