{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:09:43Z","timestamp":1792627783126,"version":"4.5.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T00:00:00Z","timestamp":1489017600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ethnicities"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:p>This paper analyses exemptions to general law through the prism of vaccine waivers in the United States. All US states legally require the vaccination of children prior to school or daycare entry; however, this obligation is accompanied with a system of medical, religious, and\/or philosophical exemptions. Nonmedical exemptions became subject of discussion after the 2015 Disneyland measles outbreak in California, which unequivocally brought to light what had been brewing below the surface for a while: a slow but steady decline in vaccination rates in Western societies, resulting in the reoccurrence of measles outbreaks. This can be traced back to an increasing public questioning of vaccines by a growing anti-vaccination movement. In reaction to the outbreak and the public outrage it generated, several states proposed\u2014and some already passed\u2014bills to eliminate nonmedical exemptions.<\/jats:p>\n                  <jats:p>I analyze two questions. First, can legal exemptions from mandatory childhood vaccination schemes for parents who are opposed to vaccination (still) be justified? Second, should legal exemptions be limited to religious objections to vaccination, or should they also be granted to secular objections? Although the argument in the paper starts from the example of the US, it seeks to provide a more general philosophical reflection on the question of exemptions from mandatory childhood vaccination.<\/jats:p>","DOI":"10.1177\/1468796817692629","type":"journal-article","created":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T01:44:10Z","timestamp":1489110250000},"page":"220-241","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["On religious and secular exemptions: A case study of childhood vaccination waivers"],"prefix":"10.1177","volume":"17","author":[{"given":"Roland","family":"Pierik","sequence":"first","affiliation":[{"name":"Paul Scholten Centre for Jurisprudence, Faculty of Law, University of Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,3,9]]},"reference":[{"key":"bibr1-1468796817692629","doi-asserted-by":"publisher","DOI":"10.3201\/eid1903.121360"},{"key":"bibr2-1468796817692629","volume-title":"Culture and Equality: An Egalitarian Critique of Multiculturalism","author":"Barry B","year":"2001"},{"key":"bibr3-1468796817692629","doi-asserted-by":"crossref","unstructured":"Byington CL, Clayton EW and Edwards KM (2016) Childhood vaccine exemptions: A broader perspective is required.\n                      Pediatrics\n                      137(4): e20160189.","DOI":"10.1542\/peds.2016-0189"},{"issue":"2","key":"bibr4-1468796817692629","first-page":"353","volume":"37","author":"Calandrillo SP","year":"2004","journal-title":"University of Michigan Journal of Law Reform"},{"key":"bibr5-1468796817692629","volume-title":"Diversity in Europe: Dilemmas of Diffential Treatment in Theory and Practice","author":"Calder G","year":"2011"},{"key":"bibr6-1468796817692629","doi-asserted-by":"publisher","DOI":"10.5553\/NJLP\/221307132015044003002"},{"key":"bibr7-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1172"},{"issue":"7789","key":"bibr8-1468796817692629","first-page":"136","volume":"342","author":"Deer B","year":"2011","journal-title":"British Medical Journal"},{"key":"bibr9-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1057\/9780230390898"},{"key":"bibr10-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1Q318"},{"key":"bibr11-1468796817692629","unstructured":"Forst R (2012) Toleration. In: Zalta EN (ed)\n                      The Stanford Encyclopedia of Philosophy\n                      (Summer 2012 Edition). https:\/\/plato.stanford.edu\/archives\/sum2012\/entries\/toleration\/."},{"issue":"963","key":"bibr12-1468796817692629","first-page":"963","volume":"87","author":"Greene A","year":"2009","journal-title":"Texas Law Review"},{"issue":"22","key":"bibr13-1468796817692629","first-page":"12","volume":"17","author":"Haverkate M","year":"2012","journal-title":"Euro Surveillance"},{"key":"bibr14-1468796817692629","unstructured":"Izadi E (2015) The U.S. just recorded its first confirmed measles death in 12 years.\n                      The Washington Post\n                      , July 2. Retrieved from http:\/\/www.washingtonpost.com\/news\/to-your-health\/wp\/2015\/07\/02\/the-u-s-just-recorded-its-first-confirmed-measles-death-in-12-years\/."},{"key":"bibr15-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.3077"},{"key":"bibr16-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1007\/s11572-014-9328-z"},{"key":"bibr17-1468796817692629","unstructured":"Khazan O (2014) Wealthy L.A. schools\u2019 vaccination rates are as low as South Sudan\u2019s.\n                      The Atlantic\n                      , 16 September. Retrieved from https:\/\/www.theatlantic.com\/health\/archive\/2014\/09\/wealthy-la-schools-vaccination-rates-are-as-low-as-south-sudans\/380252\/."},{"key":"bibr18-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1017\/S1352325213000141"},{"key":"bibr19-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1007\/s10982-015-9236-y"},{"key":"bibr20-1468796817692629","doi-asserted-by":"crossref","DOI":"10.1353\/book.16005","volume-title":"Vaccine: The Debate in Modern America","author":"Largent MA","year":"2012"},{"key":"bibr21-1468796817692629","volume-title":"Why Tolerate religion?","author":"Leiter B","year":"2013"},{"key":"bibr22-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780199535446.001.0001"},{"key":"bibr23-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1079"},{"key":"bibr24-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-9833.2011.01531.x"},{"key":"bibr25-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.0384"},{"key":"bibr26-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(02)00627-8"},{"key":"bibr27-1468796817692629","unstructured":"McGreevy P (2015) Not enough signatures: Vaccine opponents fall short in ballot effort.\n                      Los Angels Times\n                      , 30 September. Retrieved from http:\/\/www.latimes.com\/local\/political\/la-me-pc-vaccine-law-foes-fall-short-in-petition-drive-for-referendum-20150930-story.html."},{"key":"bibr28-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.07.048"},{"key":"bibr29-1468796817692629","unstructured":"Murdoch J (2007)\n                      Freedom of Thought, Conscience and Religion: A Guide to the Implementation of Article 9 of the European Convention of Human Rights\n                      : Council of Europe Human Rights Handbooks. Retrieved from http:\/\/www.echr.coe.int\/LibraryDocs\/DG2\/HRHAND\/DG2-EN-HRHAND-09(2007).pdf."},{"key":"bibr30-1468796817692629","unstructured":"Nagourney A (2015) California mandates vaccines for schoolchildren.\n                      New York Times,\n                      30 June, A19."},{"key":"bibr31-1468796817692629","unstructured":"Navin M (forthcoming) Prioritizing religion in vaccine exemption policies. In: Vallier K and Weber M (eds)\n                      Religious Exemptions\n                      . New York: Oxford University Press, pp. 1-17."},{"key":"bibr32-1468796817692629","volume-title":"Values and Vaccine Refusal: Hard Questions in Epistemology, Ethics and Health Care","author":"Navin M","year":"2016"},{"key":"bibr33-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn263"},{"key":"bibr34-1468796817692629","doi-asserted-by":"crossref","unstructured":"Opel DJ, Kronman MP, Diekema DS, et al. (2016) Childhood vaccine exemption policy: The case for a less restrictive alternative.\n                      Pediatrics\n                      137(4): e20154230.","DOI":"10.1542\/peds.2015-4230"},{"key":"bibr35-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1086\/522868"},{"key":"bibr36-1468796817692629","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1353"},{"key":"bibr37-1468796817692629","doi-asserted-by":"crossref","unstructured":"Pierik R (2017) Mandatory vaccination: An unqualified defense.\n                      Journal of Applied Philosophy\n                      1\u201318. Epub ahead of print 18 May 2016. 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