AAP Supports Elimination of Nonmedical Vaccine Exemptions

child being vaccinated
pediatric vaccination
Routine childhood immunization is poised to prevent 42,000 early deaths and 20 million cases of disease.

Nonmedical exemption laws for vaccinations have failed and should be eliminated, according to a press release from the American Academy of Pediatrics (AAP).1

“It’s clear that states with more lenient exemptions policies have lower immunization rates, and it’s these states where we have seen disease outbreaks occur as the rates slip below the threshold needed to maintain community immunity,” Geoffrey R. Simon, MD, lead author of the medical exemptions policy statement from the AAP said in the press release. “Non-medical exemptions to immunizations should be eliminated.”

The policy statement draws a distinction between nonmedical and medical exemptions to immunizations, noting that “it is critical to design childhood immunization exemption policies so that they clearly serve the best interests of both the individual child and the community.” 2

High community immunization rates protect vulnerable individuals, including children who cannot be vaccinated because of medical problems or because they are too young to be vaccinated. The AAP statement recommends public health authorities release immunization rate data for individual schools and communities, so that parents can make decisions about their children’s safety in those settings.

In the United States 2009 birth cohort, routine childhood immunization will prevent about 42,000 early deaths and 20 million cases of disease, and will, according to the report, save $13.5 billion in direct costs and $68.8 billion in societal costs. According to the AAP, the recommended immunization schedule is the only one that has been tested for safety and effectiveness. Non-standard schedules have not been evaluated.

Officials with the AAP urged physicians to address the specific concerns individual parents may have about vaccines, noting that one-on-one contact with an informed clinician is the “single most important influence” on parents’ acceptance of vaccines.


  1. American Academy of Pediatrics Publishes New Policies to Boost Child Immunization Rates [press release]. Elk Grove Village, IL. American Academy of Pediatrics. August 29, 2016.
  2. American Academy of Pediatrics. Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance. Pediatrics. 2016; doi:10.1542/peds.2016-2145.