Medical Examiner

Exemption Abuse

Too many kindergarteners aren’t getting vaccinated.

kindergarten children vaccines.

The new wave of conscientious objectors to vaccination.

Photo by Susanne Dittrich/Fuse/Thinkstock

Connecticut has an interesting conundrum. Though the state has great vaccination rates—98.53 percent, and no measles outbreaks, thank you very much—it’s seeing a disconcerting trend. Since the 2003–2004 school year, per the Hartford Courant, the number of requests for religious exemptions from the school-attendance vaccination requirement has tripled. It’s theoretically conceivable that the Nutmeg State has had a huge uptick in conversions to a religious faith that preaches that vaccines are immoral. But, as my colleague Miriam Krule has pointed out, these faiths are tiny, few, and far between. The likelier explanation is that a small but swelling number of Connecticuters is using the state’s religious exemption to keep its kids from getting vaccinated for nonreligious reasons. And this has some of the state’s lawmakers concerned.


Connecticut isn’t alone. Figures from the Centers for Disease Control and Prevention show that in the 2009–2010 school year, 2,100 Florida kindergarteners (1 percent) had religious exemptions to vaccination. (Like Connecticut, Florida doesn’t offer a philosophical exemption.) By the 2013–2014 school year, that number had jumped to 3,991, or 1.7 percent of kindergarteners.

Arizona saw the percentage of kindergarteners exempted from vaccinations for philosophical reasons jump from 2.8 percent in the 2009–2010 school year to 4.7 percent in 2013–2014.

In the same time window, Maine kindergarteners with nonmedical exemptions from vaccination went from 3 percent to 5.2 percent. Wisconsin went from 3.1 percent to 4.8 percent. And Oregon went from 5.2 percent to a whopping 7 percent of kindergarteners unvaccinated because of their parents’ religious or philosophical convictions. (And let’s be real here: As Krule detailed, being anti-vax is not about religion.)


And it’s not just hippy-dippy liberal states. Idaho saw its percentage of kindergarteners unvaccinated for nonmedical reasons swell from 3.5 percent in the 2009–2010 school year to 6.1 percent in the 2013–2014 school year. In Kansas the proportion grew from 0.8 percent to 1.9 percent. Granted, this growth involves a far smaller number of students than the changes in Oregon and Wisconsin; in 2009–2010 the number of Kansas kindergartners with nonmedical exemptions was 304, and in 2013–2014 it was 527. But still: An increase of more than 100 percent is eye-popping. Kansas, for shame!


So what’s a lawmaker to do?

Matt Ritter, a Connecticut state representative, said he and his colleagues are planning to put together legislation in the next week making it harder to get a religious exemption.


“Connecticut basically requires you to just check a box and sign it,” he said. “It’s certainly a rather simplistic form for what’s probably a complicated issue.”

He said he might look at legislation that requires religious exemption forms to get notarized or that requires parents to talk to a doctor about the benefits of vaccination before getting their exemptions. The state may also look to have schools disclose their vaccination rates to parents. This wouldn’t be unprecedented; a Los Angeles Times op-ed calling for a higher opt-out bar said that Washington state’s opt-out rates dropped 25 percent when parents had to provide a doctor’s note “saying they’d been educated on the issue.”

Oregon has moved on this. In March of 2014, a new law went into effect requiring parents to talk to a health care provider or watch an “online interactive educational module” on vaccines before they can claim a religious exemption.

Other states (looking at you, Idaho) may want to follow Washington and Oregon’s lead.

Read more of Slate’s coverage of vaccines.