A selective view of childhood vaccine exemption policy is presented by Opel et al in Pediatrics.1 Their primary premise is that recent attempts to restrict nonmedical vaccine exemptions are scientifically and ethically problematic.1 The authors suggest that rather than working to eliminate all nonmedical exemptions for vaccines, the focus should be on exemptions related to measles, which they see as a unique vaccine-preventable disease. The authors provide information on the highly contagious nature of the measles virus, provide accurate safety and efficacy data about the measles vaccine, and discuss the ethics of the least-restrictive alternative (LRA). They use this information to argue that only measles should be restricted from nonmedical vaccine exemptions. However, we disagree with their interpretations and seek to provide an alternative approach.

First, the authors point to the contagiousness of measles as distinctive among infectious diseases. They refer to the high R0 of measles...

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