We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Commentary |

Prudent Personal Belief Exemption Policies

Edgar K. Marcuse, MD, MPH
Arch Pediatr Adolesc Med. 2012;166(12):1093-1094. doi:10.1001/archpediatrics.2012.806.
Text Size: A A A
Published online


Personal belief exemptions (PBEs) from school enrollment immunization requirements are permitted in 19 states. In the 2011-2012 legislative year, bills to tighten or eliminate PBEs have been introduced in 3 states while bills to expand or allow PBEs have been proposed in 8 states (D. Peterson, BS, written communication, March 2012). Bills expanding or allowing PBEs have often been introduced by those opposed to all immunization mandates, while those that tighten or eliminate PBEs are usually supported by immunization advocates. Too often the ensuing debates generate more heat than light. Prudent PBE policies have the potential to facilitate thoughtful, informed vaccine decision-making by parents, sustain public support for immunization programs, and, thereby, help to realize the full potential of modern vaccinology to improve both individual and public health. Seeking to eliminate PBEs will likely foster an adversarial relationship between immunization advocates and vaccine-hesitant parents, increase claims for religious or medical exemptions, and make for more challenging public discussion of the optimal balance between individual freedom of choice and protecting the public health.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption
Graphic Jump Location

Figure. Immunization coverage and philosophic exemptions: Coverage with 4:3:1:3 Series—2010. (ie, ≥4 doses diphtheria, tetanus, and pertussis; ≥3 doses poliovirus; ≥1 dose measles, mumps, and rubella; and ≥3 doses Haemophilus influenzae type b vaccine). Data from US National Immunization Survey 2010.3.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

1 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles