No amount of objective discussion or scientific data may ever be enough to convince some people that vaccines are indeed safe and effective at wiping out a slew of hellish and deadly diseases. But what does seem to work at convincing people to vaccinate their children? Bureaucratic hassle.
By adding an extra, in-person step to the process of obtaining a vaccination waiver (which allowed a child to forego the necessary vaccinations), Michigan quickly and significantly boosted its vaccination rate, as Kaiser Health News reports.
In the 2013-2014 school year, the state had the fourth highest rate in the country of children entering kindergarten with a vaccine waiver. But just one year after the extended waiver application process went into effect in 2015, the number of waivers issued dropped by 35 percent statewide. Vaccination rates rose accordingly.
By one common metric—looking at kids who got the state-required fourth round of immunizations for diphtheria, tetanus, and pertussis—vaccination rates of Michigan children rose from about 78 percent to 85 percent. The upped rate is around the national average for that vaccination metric.
“The idea was to make the process more burdensome,” Michigan State University health policy specialist Mark Largent, who has written extensively about vaccines, told KHN. “Research has shown that if you make it more inconvenient to apply for a waiver, fewer people get them.”
Waivers may be medically necessary if a child has a severe allergy or has a compromised immune system, but such cases are the minority. Most of the people getting waivers do so based on ideological reasons or false (and repeatedly debunked) ideas about vaccines being unsafe.
But according to Largent, it’s not necessary to get into messy debates with vaccine opponents. “Moral claims and ideology don’t matter as much when it’s inconvenient,” he explains.
State legislators added the inconvenience factor after outbreaks of whooping cough and measles hit Michigan children. At the time, parents who didn’t want to vaccinate their kids could easily apply for a waiver over the Internet, by mailing in a form, or even via phone call in some places. But in a quiet, unfussy ruling in December of 2014, the state’s Joint Committee on Administrative Rules changed the waiver application process to require that parents consult in person with a county health educator before a waiver would be granted.
The rule change went unnoticed until it took effect in January 1, 2015. Vaccine opponents were displeased. “We were not aware of the rule until the day it happened,” Suzanne Waltman, president of Michigan for Vaccine Choice (an anti-vaccine organization), told KHN. “We thought it was a stealth move.”