A Spatiotemporal and Sociodemographic Analysis of Nonmedical Vaccine Exemptions for Texas Kindergarteners

Across the United States, rates of nonmedical vaccine exemptions for schoolchildren have risen. Public health research has linked certain sociodemographic and school characteristics to higher nonmedical exemption rates. In Texas, analysis of change in nonmedical exemption rates and of associated risk factors has not been done at the school district level. This thesis analyzes data from the 2017 American Community Survey, the Texas Education Agency, and the Immunizations Epidemiology branch of the Texas Department of State Health Services to establish relationships between nonmedical exemption rates, sociodemographic characteristics, and school or school district characteristics. The data support our hypotheses: that nonmedical exemption rates in Texas are rising, and that they are positively associated with the proportion of non-Hispanic Caucasian students, median family income, educational attainment, rural schools, private schools, and charter schools. However, the exact details of the mechanisms influencing these trends and relationships have yet to be elucidated.