ABSTRACTVACCINE HESITANCY IN PARENTS/GUARDIANS OF SCHOOL-AGE CHILDREN: A QUALITATIVE REVIEW AND CASE-STUDY ANALYSIS IN MICHIGANByDaniel Dutkiewicz IIBackground: Non-medical vaccination exemption rates for kindergartners increased from 4.9% to 5.4% across the state of Michigan and increased from 7.3% to 11.6% in Grand Traverse County (MI) over the 3-year period covering the 2011/12, 2012/13, and 2013/14 school years.Objectives: This thesis seeks to interpret the results of the 2015 Michigan Department of Health and Human Services (MDHHS) administrative rule change modifying complexity of non-medical exemption filing procedures across Michigan and the 2015 special effort by local school and health officials to reduce the proportion of students with non-medical exemptions and incomplete vaccination records in Traverse City Area Public Schools (TCAPS).Study Design: This thesis utilizes a combination review/cross-sectional design to interpret the results of the MDHHS rule change and special effort by local officials in Traverse City.Results: 31.5% decrease in non-medical exemption rates across 73 counties, plus city of Detroit, and 66.27% reduction in total number of students with non-medical exemptions or incomplete vaccination records in TCAPS appear to 1. be consistent with previously observed inverse associations between complexity of non-medical exemption filing procedures and non-medical exemption rates and 2. further validate Peretti-Watel et al.’s theoretical approach to vaccine hesitancy.Conclusion: Increasing complexity of non-medical vaccination filing procedures at state level and requiring school-entry immunization requirement compliance at local level may motivate passively and actively hesitant parents/guardians to fully vaccinate their school-age child/children in Michigan.
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