In 1998, the Society of Adolescent Health and Medicine (SAHM) advocated for national coverage rates of 90% or greater for measles, mumps, and rubella; hepatitis B; tetanus; and varicella vaccines among adolescents aged 13 years and older and endorsed the importance of state school entry requirements for vaccination among the sixth and seventh graders. Data are clear that state-mandated school immunization requirements have significantly contributed to improving the rates of vaccination coverage among adolescents.  (See full supplment in JAH)

Exemptions to school immunization requirements continue to be a political football in many state legislatures across the United States. Parental concerns about vaccine safety have been responsible for as many as half of nonmedical exemptions to required mandated immunization and likely contribute to increased efforts to expand exemption efforts. However, recent data have demonstrated that all the legislative efforts to expand exemptions have failed, and the majority of bills designed to restrict the types of allowed exemptions have been successful. Unfortunately, mandates did not help achieve Healthy People 2010 adolescent vaccination benchmarks, and mandates alone will not be the only effective strategy for meeting the benchmarks set for 2020 objectives. Thus, alternative solutions and strategies are required.


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