AMA Supports Tighter Limitations on Immunization Opt-outs

CHICAGO — Addressing the re-emergence of vaccine-preventable diseases in the U.S. requires states to move toward barring non-medical exemptions to immunization mandates, according to a new policy adopted by the nation’s physicians at the annual meeting of the American Medical Assoc.

Under new policy, the AMA will seek more stringent state immunization requirements to allow exemptions only for medical reasons.

Immunization programs in the U.S. are credited with having controlled or eliminated the spread of epidemic diseases, including smallpox, measles, mumps, rubella, diphtheria, and polio. Immunization requirements vary from state to state, but only two states bar non-medical exemptions based on personal beliefs.

“When people are immunized, they also help prevent the spread of disease to others, said AMA board member Dr. Patrice Harris. “As evident from the recent measles outbreak at Disneyland, protecting community health in today’s mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience.”

The new AMA policy recommends that states establish a decision mechanism that involves qualified public-health physicians to determine which vaccines will be mandatory for admission to schools and other public venues. States should grant exemptions only to these mandated vaccines for medical reasons.

In recognition that highly transmissible diseases could pose significant medical risks for vulnerable patients and the healthcare workforce, the new AMA policy also states that physicians and other health professionals who have direct patient-care responsibilities have an obligation to accept immunization unless there is a recognized medical reason.

The AMA also intends to support the dissemination of materials on vaccine efficacy to states as part of the effort to eliminate non-medical exemptions.