Yet, even state mandates don't mean every child will be vaccinated. Every state allows a medical exemption for children, and 48 states plus the District of Columbia also allow either religious or philosophical exemptions, while some allow exemptions for both reasons, Stokley said.
Only West Virginia and Mississippi do not allow non-medical exemptions, she added.
Instead of mandates, many states require that schools or public health departments inform parents about the diseases the vaccines protect against and the current vaccine recommendations. However, the study found states that offered education had no better vaccine rates than those that didn't.
That doesn't mean education doesn't matter, Stokley said.
And though vaccine mandates appear to work, "state requirements are just one strategy to increase immunization," Byington noted.
Other strategies that can boost vaccination rates include ensuring that kids have access to vaccines and making sure that pediatricians advise parents about the shots, she said. Research has shown that parents trust pediatricians regarding vaccines and are more likely to get their kids vaccinated if the pediatrician recommends it.
For middle schoolers, the vaccines protect against several serious, and even deadly, diseases, including diphtheria, a highly contagious bacterial disease that effects the respiratory system and can lead to swelling of the heart muscle tissue, heart failure and death; tetanus, a bacteria found in the soil that can enter the body through a deep cut and lead to months of serious, painful
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