2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T8b8,Childhood vaccination rates have declined in many US states, contributing to outbreaks of vaccine-preventable diseases and raising concerns about policy effectiveness amid growing vaccine hesitancy. To evaluate the association between state repeal of nonmedical vaccine exemptions and kindergarten vaccination rates. This cross-sectional study used annual state-level kindergarten vaccination and exemption data from the Centers for Disease Control and Prevention for school years 2011 through 2023. A staggered difference-in-differences design compared states that repealed nonmedical exemptions with states that maintained such policies. The study included kindergarten students in US public and private schools across 37 to 43 states, depending on the outcome measure. Total repeal of nonmedical vaccine exemptions in California (2015), New York (2019), Maine (2019), and Connecticut (2021). Partial repeal in Vermont (2015) and Washington (2019) was analyzed separately. State-level kindergarten vaccination rates for diphtheria-tetanus-acellular pertussis (DTaP), hepatitis B, measles-mumps-rubella (MMR), and poliovirus (polio) vaccines; rates of medical and nonmedical exemptions. Among 4 states with total repeal affecting approximately 2.8 million kindergarten students, repeal of nonmedical exemptions reduced overall exemption rates by 3.2 (95% CI, 1.9-4.4) percentage points within 3 years. Compared with nonrepeal states, vaccination rates rose by 4.1 (95% CI, 3.3-4.9) percentage points for DTaP, 2.8 (95% CI, 2.1-3.5) percentage points for hepatitis B, 4.0 (95% CI, 3.1-4.9) percentage points for MMR, and 3.8 (95% CI, 2.9-4.6) percentage points for polio. Minimal substitution toward medical exemptions occurred, an increase of only 0.4 (95% CI, 0.04-0.7) percentage points. Partial repeal of nonmedical exemptions demonstrated smaller, less persistent increases in vaccination rates. State repeal of nonmedical vaccine exemptions was associated with increased kindergarten vaccination rates with minimal substitution toward medical exemptions. These findings suggest that nonmedical exemption repeal played a role in maintaining vaccination coverage in repeal states during a period of heightened vaccine hesitancy.31:Td8c, Importance Childhood vaccination rates have declined in many US states, contributing to outbreaks of vaccine-preventable diseases and raising concerns about policy effectiveness amid growing vaccine hesitancy. Objective To evaluate the association between state repeal of nonmedical vaccine exemptions and kindergarten vaccination rates. Design, Setting, and Participants This cross-sectional study used annual state-level kindergarten vaccination and exemption data from the Centers for Disease Control and Prevention for school years 2011 through 2023. A staggered difference-in-differences design compared states that repealed nonmedical exemptions with states that maintained such policies. The study included kindergarten students in US public and private schools across 37 to 43 states, depending on the outcome measure. Exposures Total repeal of nonmedical vaccine exemptions in California (2015), New York (2019), Maine (2019), and Connecticut (2021). Partial repeal in Vermont (2015) and Washington (2019) was analyzed separately. Main Outcomes and Measures State-level kindergarten vaccination rates for diphtheria-tetanus-acellular pertussis (DTaP), hepatitis B, measles-mumps-rubella (MMR), and poliovirus (polio) vaccines; rates of medical and nonmedical exemptions. Results Among 4 states with total repeal affecting approximately 2.8 million kindergarten students, repeal of nonmedical exemptions reduced overall exemption rates by 3.2 (95% CI, 1.9-4.4) percentage points within 3 years. Compared with nonrepeal states, vaccination rates rose by 4.1 (95% CI, 3.3-4.9) percentage points for DTaP, 2.8 (95% CI, 2.1-3.5) percentage points for hepatitis B, 4.0 (95% CI, 3.1-4.9) percentage points for MMR, and 3.8 (95% CI, 2.9-4.6) percentage points for polio. Minimal substitution toward medical exemptions occurred, an increase of only 0.4 (95% CI, 0.04-0.7) percentage points. Partial repeal of nonmedical exemptions demonstrated smaller, less persistent increases in vaccination rates. Conclusions and Relevance State repeal of nonmedical vaccine exemptions was associated with increased kindergarten vaccination rates with minimal substitution toward medical exemptions. These findings suggest that nonmedical exemption repeal played a role in maintaining vaccination coverage in repeal states during a period of heightened vaccine hesitancy. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Poliomyelitis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Poliomyelitis (condition). Clinician-written summaries and actionable practice insights. Updated daily.\",\"url\":\"https://www.reachrx.ai/hub/tag/condition/Poliomyelitis\",\"breadcrumb\":{\"@type\":\"BreadcrumbList\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https://www.reachrx.ai\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Research Hub\",\"item\":\"https://www.reachrx.ai/hub\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Conditions\",\"item\":\"https://www.reachrx.ai/hub/tag/condition\"},{\"@type\":\"ListItem\",\"position\":4,\"name\":\"Poliomyelitis\",\"item\":\"https://www.reachrx.ai/hub/tag/condition/Poliomyelitis\"}]}}"}}]],["$","$L2f",null,{"title":"Poliomyelitis: Research & Clinical Takeaways","description":"Discover peer-reviewed research on Poliomyelitis with concise clinician summaries and next-step guidance.","papers":[{"doi":"10.1016/s2213-2600(26)00260-2","pmid":"42594935","title":"A Pox on Fools: The Grifters and Cynics Who Want Us To Reject Vaccines","journal_title":"The Lancet Respiratory Medicine","journal_issn":"2213-2600","published_at":"2026-08-13T00:00:00.000Z","url":"https://doi.org/10.1016/s2213-2600(26)00260-2","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-21T06:28:11.269Z","updated_at":"2026-08-21T06:28:11.269Z","tags":[{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"condition","value":"Measles","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"condition","value":"Pertussis","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"condition","value":"Poliomyelitis","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"condition","value":"Vaccine-Preventable Diseases","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"modality","value":"Vaccine","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"study_design","value":"Book Review","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"warning","value":"Study design is classified as 'Book Review'; level of evidence is set to 7 (expert opinion/narrative) accordingly.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"warning","value":"The 'safety_signal' impact flag reflects the documented public health consequences of declining vaccination coverage described in the review, not a pharmacovigilance signal from a clinical trial.","value_numeric":null},{"paper_doi":"10.1016/s2213-2600(26)00260-2","tag_type":"warning","value":"This is a book review, not a clinical study — no patient data, statistics, or experimental methodology are present. Tags and summaries reflect the policy/public health content of the review rather than empirical findings.","value_numeric":null}],"summaries":{"what_studied":"This is a book review of *A Pox on Fools: The Grifters and Cynics Who Want Us To Reject Vaccines* by Thomas Levenson, which examines the history of vaccine scepticism and the political dismantling of US vaccine infrastructure, with RFK Jr's leadership of HHS as its central focus.","key_result":"The book documents specific policy actions since 2025, including appointment of vaccine critics to CDC advisory committees and withdrawal of ~$500 million in mRNA vaccine funding; it argues vaccine scepticism is an existential threat to public health, set against the backdrop of the largest US measles outbreak since 1991.","limitations":"This is a book review, not a primary research study — no empirical data, methods, or outcomes are reported. The reviewed book itself is described as not including original interviews.","practice_takeaway":"Clinicians should be aware of the accelerating erosion of US vaccine infrastructure and be prepared to counter vaccine misinformation with historical context — reminding patients of the concrete harms of vaccine-preventable diseases before outbreaks force the lesson."}},{"doi":"10.1001/jamapediatrics.2025.4185","pmid":"41143818","title":"State Repeal of Nonmedical Vaccine Exemptions and Kindergarten Vaccination Rates","journal_title":"JAMA Pediatrics","journal_issn":"2168-6203","published_at":"2025-10-27T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12560026/","source_score":167,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-10","doi":"10.1001/jamapediatrics.2025.4185","days":"14","issn":"2168-6203","rank":"3","field":"Clinical Medicine","score":"167","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1001/jamapediatrics.2025.4185","title":"State Repeal of Nonmedical Vaccine Exemptions and Kindergarten Vaccination Rates.","journal":"JAMA pediatrics","methods":"","results":"Among 4 states with total repeal affecting approximately 2.8 million kindergarten students, repeal of nonmedical exemptions reduced overall exemption rates by 3.2 (95% CI, 1.9-4.4) percentage points within 3 years. Compared with nonrepeal states, vaccination rates rose by 4.1 (95% CI, 3.3-4.9) percentage points for DTaP, 2.8 (95% CI, 2.1-3.5) percentage points for hepatitis B, 4.0 (95% CI, 3.1-4.9) percentage points for MMR, and 3.8 (95% CI, 2.9-4.6) percentage points for polio. Minimal substitution toward medical exemptions occurred, an increase of only 0.4 (95% CI, 0.04-0.7) percentage points. Partial repeal of nonmedical exemptions demonstrated smaller, less persistent increases in vaccination rates.","abstract":"$30","keywords":[],"pubmed_id":"41143818","conclusions":"","publication_date":"2025-10-27T00:00:00"},"crossref":{"DOI":"10.1001/jamapediatrics.2025.4185","URL":"https://doi.org/10.1001/jamapediatrics.2025.4185","ISSN":["2168-6203"],"link":[{"URL":"https://jamanetwork.com/journals/jamapediatrics/articlepdf/2840422/jamapediatrics_bald_2025_oi_250058_1766435170.07416.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"56","type":"journal-article","issue":"1","score":1,"title":["State Repeal of Nonmedical Vaccine Exemptions and Kindergarten Vaccination Rates"],"author":[{"given":"Anthony","family":"Bald","sequence":"first","affiliation":[{"name":"Harvard Kennedy School, Cambridge, Massachusetts"},{"name":"Department of Economics, California State University, Fullerton, Fullerton"}]},{"given":"Samantha","family":"Gold","sequence":"additional","affiliation":[{"name":"Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, New York"}]},{"given":"Y. Tony","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC"}]}],"issued":{"date-parts":[[2026,1,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"180","created":{"date-time":"2025-10-27T15:31:20Z","timestamp":1761579080000,"date-parts":[[2025,10,27]]},"indexed":{"date-time":"2026-01-15T09:38:34Z","timestamp":1768469914778,"date-parts":[[2026,1,15]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamapediatrics/fullarticle/2840422"}},"subtitle":[],"deposited":{"date-time":"2026-01-05T16:00:49Z","timestamp":1767628849000,"date-parts":[[2026,1,5]]},"issn-type":[{"type":"print","value":"2168-6203"}],"published":{"date-parts":[[2026,1,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1016/j.vaccine.2022.06.033","key":"poi250058r2","year":"2022","issue":"32","author":"Gambrell","volume":"40","first-page":"4574","unstructured":null,"article-title":"Estimating the number of US children susceptible to measles resulting from COVID-19-related vaccination coverage declines.","journal-title":"Vaccine","doi-asserted-by":"publisher"},{"DOI":"10.2105/AJPH.2013.301538","key":"poi250058r3","year":"2014","issue":"2","author":"Yang","volume":"104","first-page":"371","unstructured":null,"article-title":"A longitudinal analysis of the effect of nonmedical exemption law and vaccine uptake on vaccine-targeted disease rates.","journal-title":"Am J Public Health","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJM200102013440511","key":"poi250058r4","year":"2001","issue":"5","author":"Albert","volume":"344","first-page":"375","unstructured":null,"article-title":"The last smallpox epidemic in Boston and the vaccination controversy, 1901-1903.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":"10.1080/14760584.2019.1562344","key":"poi250058r5","year":"2019","issue":"2","author":"Bednarczyk","volume":"18","first-page":"175","unstructured":null,"article-title":"Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes.","journal-title":"Expert Rev Vaccines","doi-asserted-by":"publisher"},{"DOI":"10.2105/AJPH.2004.046193","key":"poi250058r6","year":"2005","issue":"5","author":"Salmon","volume":"95","first-page":"778","unstructured":null,"article-title":"Public health and the politics of school immunization requirements.","journal-title":"Am J Public Health","doi-asserted-by":"publisher"},{"DOI":"10.1377/hlthaff.2014.1428","key":"poi250058r7","year":"2015","issue":"8","author":"Bradford","volume":"34","first-page":"1383","unstructured":null,"article-title":"Some state vaccination laws contribute to greater exemption rates and disease outbreaks in the United States.","journal-title":"Health Aff (Millwood)","doi-asserted-by":"publisher"},{"DOI":"10.1377/hlthaff.2013.0239","key":"poi250058r8","year":"2013","issue":"7","author":"Blank","volume":"32","first-page":"1282","unstructured":null,"article-title":"Exempting schoolchildren from immunizations: states with few barriers had highest rates of nonmedical exemptions.","journal-title":"Health Aff (Millwood)","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jhealeco.2021.102480","key":"poi250058r9","year":"2021","issue":null,"author":"Churchill","volume":"78","first-page":null,"unstructured":null,"article-title":"How important is the structure of school vaccine requirement opt-out provisions? Evidence from Washington, DC’s HPV vaccine requirement.","journal-title":"J Health Econ","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.296.14.1757","key":"poi250058r10","year":"2006","issue":"14","author":"Omer","volume":"296","first-page":"1757","unstructured":null,"article-title":"Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.15585/mmwr.mm7341a3","key":"poi250058r11","year":"2024","issue":"41","author":"Seither","volume":"73","first-page":"925","unstructured":null,"article-title":"Coverage with selected vaccines and exemption rates among children in kindergarten—United States, 2023–24 school year.","journal-title":"MMWR Morb Mortal Wkly Rep","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamapediatrics.2021.4251","key":"poi250058r12","year":"2022","issue":"1","author":"DeSilva","volume":"176","first-page":"68","unstructured":null,"article-title":"Association of the COVID-19 pandemic with routine childhood vaccination rates and proportion up to date with vaccinations across 8 US health systems in the Vaccine Safety Datalink.","journal-title":"JAMA Pediatr","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2025.8952","key":"poi250058r13","year":"2025","issue":"8","author":"Dong","volume":"334","first-page":"730","unstructured":null,"article-title":"Trends in county-level MMR vaccination coverage in children in the United States.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jeconom.2021.03.014","key":"poi250058r19","year":"2021","issue":null,"author":"Goodman-Bacon","volume":"225","first-page":"254","unstructured":null,"article-title":"Difference-in-differences with variation in treatment timing.","journal-title":"J Econom","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jeconom.2020.12.001","key":"poi250058r20","year":"2021","issue":"2","author":"Callaway","volume":"225","first-page":"200","unstructured":null,"article-title":"Difference-in-differences with multiple time periods.","journal-title":"J Econom","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jeconom.2020.09.006","key":"poi250058r21","year":"2021","issue":"2","author":"Sun","volume":"225","first-page":"175","unstructured":null,"article-title":"Estimating dynamic treatment effects in event studies with heterogeneous treatment effects.","journal-title":"J Econom","doi-asserted-by":"publisher"},{"DOI":"10.1093/restud/rdae007","key":"poi250058r22","year":"2024","issue":"6","author":"Borusyak","volume":"91","first-page":"3253","unstructured":null,"article-title":"Revisiting event-study designs: robust and efficient estimation.","journal-title":"Rev Econ Stud","doi-asserted-by":"publisher"},{"DOI":"10.1257/aer.20181169","key":"poi250058r23","year":"2020","issue":"9","author":"De Chaisemartin","volume":"110","first-page":"2964","unstructured":null,"article-title":"Two-way fixed effects estimators with heterogeneous treatment effects.","journal-title":"Am Econ Rev","doi-asserted-by":"publisher"},{"DOI":"10.1162/rest_a_01414","key":"poi250058r24","year":"2024","issue":null,"author":"De Chaisemartin","volume":null,"first-page":"1","unstructured":null,"article-title":"Difference-in-differences estimators of intertemporal treatment effects.","journal-title":"Rev Econ Stat","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamapediatrics.2015.4856","key":"poi250058r26","year":"2016","issue":"6","author":"Delamater","volume":"170","first-page":"619","unstructured":null,"article-title":"California Senate Bill 277’s grandfather clause and nonmedical vaccine exemptions in California, 2015–2022.","journal-title":"JAMA Pediatr","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2017.9242","key":"poi250058r27","year":"2017","issue":"9","author":"Delamater","volume":"318","first-page":"863","unstructured":null,"article-title":"Change in medical exemptions from immunization in California after elimination of personal belief exemptions.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jhealeco.2011.06.003","key":"poi250058r28","year":"2011","issue":"5","author":"Abrevaya","volume":"30","first-page":"966","unstructured":null,"article-title":"Effectiveness of state-level vaccination mandates: evidence from the varicella vaccine.","journal-title":"J Health Econ","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jhealeco.2021.102464","key":"poi250058r29","year":"2021","issue":null,"author":"Hair","volume":"78","first-page":null,"unstructured":null,"article-title":"Personal belief exemptions for school-entry vaccinations, vaccination rates, and academic achievement.","journal-title":"J Health Econ","doi-asserted-by":"publisher"},{"DOI":"10.1257/pol.20170067","key":"poi250058r31","year":"2019","issue":"1","author":"Carpenter","volume":"11","first-page":"95","unstructured":null,"article-title":"Direct and spillover effects of middle school vaccination requirements.","journal-title":"Am Econ J Econ Policy","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2019.7924","key":"poi250058r32","year":"2019","issue":"1","author":"Pingali","volume":"322","first-page":"49","unstructured":null,"article-title":"Associations of statewide legislative and administrative interventions with vaccination status among kindergartners in California.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamanetworkopen.2023.54710","key":"poi250058r33","year":"2024","issue":"2","author":"Correira","volume":"7","first-page":null,"unstructured":null,"article-title":"School vaccine coverage and medical exemption uptake after the New York State repeal of nonmedical vaccination exemptions.","journal-title":"JAMA Netw Open","doi-asserted-by":"publisher"},{"DOI":"10.1542/peds.2018-3301","key":"poi250058r34","year":"2019","issue":"6","author":"Delamater","volume":"143","first-page":null,"unstructured":null,"article-title":"Elimination of nonmedical immunization exemptions in California and school-entry vaccine status.","journal-title":"Pediatrics","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.2023.16995","key":"poi250058r35","year":"2023","issue":"16","author":"Delamater","volume":"330","first-page":"1585","unstructured":null,"article-title":"Kindergarten vaccination status in California after changes to medical exemption policy.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.labeco.2025.102715","key":"poi250058r36","year":"2025","issue":null,"author":"Abouk","volume":"96","first-page":null,"unstructured":null,"article-title":"Promoting public health with blunt instruments: evidence from vaccine mandates.","journal-title":"Labour Econ","doi-asserted-by":"publisher"},{"DOI":"10.1111/risa.14090","key":"poi250058r37","year":"2023","issue":"10","author":"Ferranna","volume":"43","first-page":"2053","unstructured":null,"article-title":"The benefits and costs of U.S. employer COVID-19 vaccine mandates.","journal-title":"Risk Anal","doi-asserted-by":"publisher"},{"DOI":"10.1207/s15324796abm3202_10","key":"poi250058r39","year":"2006","issue":"2","author":"Rutter","volume":"32","first-page":"127","unstructured":null,"article-title":"An implementation intentions intervention to increase uptake of mammography.","journal-title":"Ann Behav Med","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.vaccine.2022.08.060","key":"poi250058r40","year":"2022","issue":"43","author":"Jacobson","volume":"40","first-page":"6235","unstructured":null,"article-title":"Can financial incentives and other nudges increase COVID-19 vaccinations among the vaccine hesitant? A randomized trial.","journal-title":"Vaccine","doi-asserted-by":"publisher"},{"DOI":"10.1257/pol.20210393","key":"poi250058r41","year":"2024","issue":"1","author":"Alsan","volume":"16","first-page":"394","unstructured":null,"article-title":"Experimental evidence on the effectiveness of nonexperts for improving vaccine demand.","journal-title":"Am Econ J Econ Policy","doi-asserted-by":"publisher"},{"DOI":"10.1257/pandp.20231112","key":"poi250058r43","year":"2023","issue":null,"author":"Ho","volume":"113","first-page":"653","unstructured":null,"article-title":"The impact of large-scale social media advertising campaigns on COVID-19 vaccination: Evidence from two randomized controlled trials.","journal-title":"AEA Pap Proc","doi-asserted-by":"publisher"},{"DOI":"10.1016/j.jhealeco.2017.01.002","key":"poi250058r44","year":"2017","issue":null,"author":"Lawler","volume":"52","first-page":"45","unstructured":null,"article-title":"Effectiveness of vaccination recommendations versus mandates: evidence from the hepatitis A vaccine.","journal-title":"J Health Econ","doi-asserted-by":"publisher"},{"DOI":"10.1073/pnas.1103170108","key":"poi250058r45","year":"2011","issue":"26","author":"Milkman","volume":"108","first-page":"10415","unstructured":null,"article-title":"Using implementation intentions prompts to enhance influenza vaccination rates.","journal-title":"Proc Natl Acad Sci U S A","doi-asserted-by":"publisher"},{"DOI":"10.1001/jama.298.20.2415","key":"poi250058r46","year":"2007","issue":"20","author":"Loewenstein","volume":"298","first-page":"2415","unstructured":null,"article-title":"Asymmetric paternalism to improve health behaviors.","journal-title":"JAMA","doi-asserted-by":"publisher"},{"DOI":"10.1136/bmjgh-2022-008684","key":"poi250058r47","year":"2022","issue":"5","author":"Bardosh","volume":"7","first-page":null,"unstructured":null,"article-title":"The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good.","journal-title":"BMJ Glob Health","doi-asserted-by":"publisher"},{"DOI":"10.1080/21645515.2023.2261176","key":"poi250058r48","year":"2023","issue":"2","author":"Correira","volume":"19","first-page":null,"unstructured":null,"article-title":"Exploring the impact of the New York State repeal of nonmedical vaccination exemptions on student enrollment, absenteeism, and school workload: perspectives from a survey of school administrators.","journal-title":"Hum Vaccin Immunother","doi-asserted-by":"publisher"},{"DOI":"10.1001/jamanetworkopen.2021.46467","key":"poi250058r49","year":"2022","issue":"2","author":"Patel","volume":"5","first-page":null,"unstructured":null,"article-title":"Evaluation of trends in homeschooling rates after elimination of nonmedical exemptions to childhood immunizations in California, 2012–2020.","journal-title":"JAMA Netw Open","doi-asserted-by":"publisher"},{"DOI":"10.1056/NEJMsa0806477","key":"poi250058r51","year":"2009","issue":"19","author":"Omer","volume":"360","first-page":"1981","unstructured":null,"article-title":"Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases.","journal-title":"N Engl J Med","doi-asserted-by":"publisher"},{"DOI":null,"key":"poi250058r30","year":"2019","issue":null,"author":"Richwine","volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r38","year":"2024","issue":null,"author":"Gandhi","volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r42","year":"2024","issue":null,"author":"Campos-Mercade","volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Centers for Disease Control and Prevention. Measles cases and outbreaks: measles (rubeola). Updated August 6, 2025. Accessed August 17, 2025. https://www.cdc.gov/measles/data-research/index.html","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r14","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Jones? JM. Far fewer in U.S. regard childhood vaccinations as important. Gallup News. August 7, 2024. Accessed August 17, 2025. https://news.gallup.com/poll/648308/far-fewer-regard-childhood-vaccinations-important.aspx","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r15","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Centers for Disease Control and Prevention. Vaccination coverage and exemptions among kindergartners. SchoolVaxView. Updated October 2, 2024. Accessed December 17, 2024. https://www.cdc.gov/schoolvaxview/index.html","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r16","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"National Archives. Code of federal regulations: 45 CFR § 46.102. 2025. Accessed September 1, 2025. https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/section-46.102","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r17","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"National Conference of State Legislatures. State non-medical exemptions from school immunization requirements. Updated August 13, 2024. Accessed December 17, 2024. https://www.ncsl.org/health/state-non-medical-exemptions-from-school-immunization-requirements","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r18","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Baker? A, Callaway? B, Cunningham? S, Goodman-Bacon? A, Sant’Anna? PHC. Difference-in-differences designs: a practitioner’s guide.? arXiv. Preprint posted online March 17, 2025. Accessed March 20, 2025. doi:10.48550/arXiv.2503.13323","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":null,"key":"poi250058r25","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Freyaldenhoven? S, Hansen? C, Pérez Pérez? J, Shapiro? JM. Visualization, identification, and estimation in the linear panel event-study design. Working paper 29170. National Bureau of Economic Research. Accessed September 1, 2025. http://www.nber.org/papers/w29170","article-title":null,"journal-title":null,"doi-asserted-by":null},{"DOI":"10.1101/2025.08.11.25333447","key":"poi250058r50","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Correira? JW, Morrison? KT, Doll? MK. Homeschooling trends before and after the New York state repeal of nonmedical vaccination exemptions.? medRxiv. Preprint posted online August 13, 2025. doi:10.1101/2025.08.11.25333447?","article-title":null,"journal-title":null,"doi-asserted-by":"crossref"}],"short-title":[],"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Pediatrics"],"published-print":{"date-parts":[[2026,1,1]]},"reference-count":51,"published-online":null,"references-count":51,"short-container-title":["JAMA Pediatr"],"is-referenced-by-count":3},"unpaywall":{"doi":"10.1001/jamapediatrics.2025.4185","is_oa":true,"title":"State Repeal of Nonmedical Vaccine Exemptions and Kindergarten Vaccination Rates","updated":"2026-01-10T04:46:20+00:00","published_date":"2025-10-27","best_oa_location":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12560026/","pmh_id":"oai:pubmedcentral.nih.gov:12560026","url_for_pdf":null,"url_for_landing_page":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12560026/"}}},"created_at":"2026-01-14T18:30:49.575Z","updated_at":"2026-01-21T12:05:26.220Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"age_group","value":"child","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"condition","value":"Hepatitis B","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"condition","value":"Measles","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"condition","value":"Pertussis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"condition","value":"Poliomyelitis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"study_design","value":"Cross-Sectional","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"warning","value":"Design described as cross-sectional with a difference-in-differences approach; labeled as cross-sectional for tagging simplicity.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"warning","value":"Outcomes are state-level aggregates; individual-level effects are not reported.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.4185","tag_type":"warning","value":"Population size is approximate (~2.8 million kindergarteners) as reported; exact N not provided.","value_numeric":null}],"summaries":{"what_studied":"Annual state-level kindergarten vaccination and exemption data from 2011–2023 were analyzed using a staggered difference-in-differences, comparing states that repealed nonmedical exemptions with states that kept them. Total repeal occurred in California (2015), New York (2019), Maine (2019), and Connecticut (2021); partial repeal in Vermont (2015) and Washington (2019).","key_result":"Across four total-repeal states (~2.8 million kindergarteners), overall exemptions fell by 3.2 percentage points within 3 years (95% CI, 1.9–4.4). Versus nonrepeal states, vaccination rose: DTaP +4.1 (95% CI, 3.3–4.9), hepatitis B +2.8 (95% CI, 2.1–3.5), MMR +4.0 (95% CI, 3.1–4.9), and polio +3.8 (95% CI, 2.9–4.6); medical exemptions increased only 0.4 points (95% CI, 0.04–0.7). Partial repeals showed smaller, less durable gains.","practice_takeaway":"Repealing nonmedical vaccine exemptions was associated with higher kindergarten vaccination coverage and minimal substitution to medical exemptions. During a period of heightened vaccine hesitancy, repeal appeared to help maintain coverage in repeal states."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Poliomyelitis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Poliomyelitis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Poliomyelitis"}}}]]

Papers