| Titre : | Health consequences of religious and philosophical exemptions from immunization laws : Individual and societal risk of measles. (1999) |
| Auteurs : | D.A. SALMON ; R.T. CHEN ; E.J. GANGAROSA ; M. HABER ; L. PHILLIPS ; N.J. Smith ; National Immunization Program. Centers for Disease Control and Prevention. Atlanta. GA. USA ; Rollins School of Public Health. Emory University. Atlanta. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 282, n° 1, 1999) |
| Pagination : | 47-53 |
| Langues: | Anglais |
| Mots-clés : | Vaccination ; Rougeole ; Virose ; Infection ; Etats Unis ; Amérique ; Epidémiologie ; Mesure risque ; Etude comparée ; Incidence ; Enfant ; Homme ; Adolescent ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST neR0xcck. Diffusion soumise à autorisation]. Context All US states require proof of immunization for school entry. Exemptions are generally offered for medical, religious, or philosophical reasons, but the health consequences of claiming such exemptions are poorly documented. Objectives To quantify the risk of contracting measles among individuals claiming religious and/or philosophical exemptions from immunization (exemptors) compared with vaccinated persons, and to examine the risk that exemptors pose to the nonexempt population. Design, Setting, and Participants Population-based, retrospective cohort study of data from 1985 through 1992, collected by the Measles Surveillance System of the Centers for Disease Control and Prevention, as well as from annual state immunization program reports on prevalence of exemptors and vaccination coverage. The study group was restricted to individuals aged 5 to 19 years. To empirically determine and quantify community risk, a mathematical model was developed that examines the spread of measles through communities with varying proportions of exemptors and vaccinated children. Main Outcome Measures Relative risk of contracting measles for exemptors vs vaccinated individuals based on cohort study data. Community risk of contracting measles derived from a mathematical model. Results On average, exemptors were 35 times more likely to contract measles than were vaccinated persons (95% confidence interval, 34-37). Relative risk varied by age and year. (...) |
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