HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Web of Science (5) Citing Articles via Google Scholar Google Scholar Articles by Salmon, D. A. Articles by Halsey, N. A. Search for Related Content PubMed PubMed Citation Articles by Salmon, D. A. Articles by Halsey, N. A. Related Collections Health Law Immunization/Vaccines School Health Public Health Practice Other Child and Adolescent Health Government

Daniel A. Salmon, PhD, MPH, Jason W. Sapsin, JD, MPH, Stephen Teret, JD, MPH, Richard F. Jacobs, MD, FAAP, Joseph W. Thompson, MD, Kevin Ryan, JD, MA and Neal A. Halsey, MD

Daniel A. Salmon and Neal A. Halsey are with the Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Jason W. Sapsin and Stephen Teret are with the Center for Law and the Public’s Health, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Richard F. Jacobs is with the College of Medicine, University of Arkansas for Medical Sciences, Little Rock. Joseph W. Thompson is with the Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences. Kevin Ryan is with the Arkansas Center for Health Improvement, College of Medicine, University of Arkansas for Medical Sciences.

Correspondence: Requests for reprints should be sent to Daniel A. Salmon, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Rm E5543, Baltimore, MD 21205 (e-mail: dsalmon{at}jhsph.edu).

Compulsory vaccination has contributed to the enormous success of US immunization programs. Movements to introduce broad "philosophical/personal beliefs" exemptions administered without adequate public health oversight threaten this success. Health professionals and child welfare advocates must address these developments in order to maintain the effectiveness of the nation’s mandatory school vaccination programs.

We review recent events regarding mandatory immunization in Arkansas and discuss a proposed nonmedical exemption designed to allow constitutionally permissible, reasonable, health-oriented administrative control over exemptions. The proposal may be useful in political environments that preclude the use of only medical exemptions. Our observations may assist states whose current nonmedical exemption provisions are constitutionally suspect as well as states lacking legally appropriate administrative controls on existing, broad non-medical exemptions.