In areas where vaccine exemptions are high, exempting parent respondents to a survey were very likely to have views that vaccine-preventable diseases are not severe and that developing immunity through illness is more beneficial than vaccination, according to a study published in PLoS ONE.

Heidi L. Pottinger, DrPH, of the Mel and Enid Zuckerman College of Public Health at the University of Arizona in Tucson, and colleagues conducted a survey-based analysis to understand and compare exemptor and non-exemptor views on pediatric vaccination.

The investigators distributed surveys to parents with children attending elementary school in high-exemption areas of Arizona (>10%); 404 surveys were collected from 9 schools in 2 counties.

Continue Reading

Of the total, 141 were exemptors (261 were non-exemptors).  These participants were more inclined to worry about vaccine-related side effects and know someone with a vaccine-preventable disease but less inclined to report such diseases as serious.

In addition, the surveys suggested that exemptor parents felt it was more beneficial for a child to build immunity to disease through illness rather than to undergo vaccination. Compared with non-exemptor parents, exemptor parents were found to be more distrustful of physicians and vaccine-related information, and they more often received health care from naturopathic providers.

Related Articles

“[There] is a great need for development and provision of tailored educational materials and efforts that not only cite sources which the target audience trusts, but are also tested for impact prior to implementation,” noted the authors. “Arizona may need to consider other alternatives, such as more stringent requirements for [personal belief exemptions] and/or imposing processing fees to discourage high rates of personal belief exemptions.”


Pottinger HL, Jacobs ET, Haenchen SD, Ernst KC. Parental attitudes and perceptions associated with childhood vaccine exemptions in high-exemption schools. PLoS ONE. 2018;13(6):e0198655.