I need a topic for a seminar paper for my child health law class. I am looking for anything in the area of child health law that has enough research on it that it won't be a hassle to write, but is still intriguing enough that it could get published. Any ideas would be greatly appreciated.
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This topic is currently being adjudicated and has a lot of info available~ Laws that Require Vaccinations BackgroundThe United States Department of Health and Human Services has set as one of its Healthy People 2010 objectives an 80% vaccination rate among U.S. children ages 19 to 35 months (12). In 2000, over one-quarter of young children age 19 to 35 months were not fully up-to-date on all recommended doses of five key vaccines. Rates ranged from a low of 64% in Texas to a high of 83% in Iowa and North Carolina (7). In addition, although disparities in vaccination coverage among racial and ethnic groups has been successfully reduced, coverage levels of children in areas of concentrated poverty remain significantly lower than national and statewide levels (6, 11). The U.S. Task Force on Community Preventive Services recommends interventions in the following areas to effectively increase vaccination coverage rates: intervention strategies to increase demand for vaccinations; intervention strategies to enhance access to vaccination services; and provider-based interventions (2). Vaccination requirements for child care or school attendance are recommended as a strategy to increase community demand for vaccinations (2). Policies Strengthen and standardize state laws preventing children from attending school (K-12 and college), child care, and Head Start programs without proof of immunizations. Exclusionary laws require that current vaccination status be on file with schools, child care, and/or Head Start programs before children can attend. The laws requiring immunization in the U.S. date back to the early 19th century. More recently, efforts were made in the 1970s to broaden and more strictly enforce laws as a result of an increase in the number of cases of measles (10). No national immunization law exists; instead, each state enacts its own laws. As a result, states vary in their vaccination requirements for school entry. All 50 states have laws requiring vaccination against diphtheria, measles, rubella, and polio prior to attendance in K-12. Washington, DC and 49 of the 50 states require tetanus vaccination, 44 states and DC require pertussis vaccination, and 48 states and DC require mumps vaccination (9). In addition, 48 states have requirements for vaccination prior to Head Start enrollment. Only 32 states have requirements for immunization prior to college attendance (5). As states strengthen and standardize their school immunization laws, reconsider the complexity of the exemption process. All state laws have exemptions for children with medical contra-indications to immunizations. In addition, 48 states allow religious exemptions. Sixteen states have philosophic exemptions (9). The process for obtaining religious or philosophic exemptions varies from state to state. During the 1997-1998 school year, throughout the U.S. less than 1% of entering students had any kind of exemptions. However, seven states had an exemption rate greater than 1%. An analysis of this data suggests that states with the simplest procedures for exemption had the highest rates of exemption. Importantly, health implications are associated with exemptions. For example, children with personal exemptions were 22 times more likely to have measles during the years 1987-1998 and nearly 6 times more likely to have pertussis (5). 3. As states implement school immunization laws, consider enforcement issues. As part of the evaluation of the effectiveness of school immunization laws, states might consider their approaches to enforcement (13). Is it intended to prevent initial enrollment in school/child care, or is it intended to exclude current attendees from continuing to be enrolled in school? What process will be used to evaluate noncompliance with the law? Which agency will be responsible for conducting audits to ensure effective implementation of the statute? Experience suggests it is administratively simpler to prevent initial enrollment than to provisionally admit students and have to monitor compliance.
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