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Geographic hot spot analysis of vaccine exemption clustering patterns in Michigan from 2008 to 2017
Duduzile P Mashinini1, Kieran J Fogarty1, Rachel C Potter2
1College of Health and Human Services, 1903 West Michigan Ave, Western Michigan University, Kalamazoo, MI 49008, United States.
Objective:
This study explored vaccine exemption clustering in Michigan and examined whether vaccine exemptions clustered by exemption type (medical, religious, and philosophical). Furthermore, the study investigated whether Michigan's nonmedical vaccine exemption policy change had an impact on type-specific vaccine exemption clusters following its implementation.
Methods:
The study used the ArcGIS optimized hot spot analysis tool to visually examine vaccine exemption clustering by type in Michigan. The study analyzed secondary kindergarten vaccine exemption data from 2301 elementary school buildings in Michigan for years spanning 2008 to 2015 and 2016 to 2017 post policy change.
Results:
Clustering of vaccine exemptions by type was present both before and after implementation of the policy with fewer statistically significant features and differences regarding the distribution of hot spot clusters following the policy change.
Conclusion:
Considering the heterogeneity in vaccine exemption hot spot clustering by type can help to inform public health officials to areas/communities at high risk for vaccine preventable disease outbreaks. Such analysis can allow for the implementation of vaccine exemption interventions that are exemption type specific and tailored for a given area, thus maximizing impact and making best use of limited public health resources. This analysis was also able to showcase the impact of Michigan's nonmedical vaccine exemption policy on vaccine exemption hot spot clusters.
Insights
Vaccine exemptions in Michigan show clustering by type. A policy change impacted cluster distribution, highlighting areas for targeted public health interventions against vaccine-preventable diseases.
Area of Science:
- Public Health
- Epidemiology
- Geographic Information Systems (GIS)
Background:
- Vaccine exemptions can lead to clusters, increasing risks of vaccine-preventable diseases.
- Understanding exemption patterns is crucial for public health planning.
- Michigan's policy change on nonmedical vaccine exemptions provides a case study for examining shifts in clustering.
Purpose of the Study:
- To explore vaccine exemption clustering in Michigan by type (medical, religious, philosophical).
- To investigate the impact of Michigan's nonmedical vaccine exemption policy change on these clusters.
- To identify high-risk areas for targeted public health interventions.
Main Methods:
- Utilized ArcGIS optimized hot spot analysis to visualize vaccine exemption clustering.
- Analyzed secondary kindergarten vaccine exemption data from 2301 elementary schools in Michigan.
- Compared data from 2008-2015 (pre-policy) and 2016-2017 (post-policy).
Main Results:
- Vaccine exemptions clustered by type both before and after the policy change.
- Fewer statistically significant hot spot clusters were observed after the policy implementation.
- The study demonstrated the policy's impact on the distribution of vaccine exemption clusters.
Conclusions:
- Heterogeneity in vaccine exemption clustering by type informs public health officials about high-risk areas for disease outbreaks.
- Type-specific interventions can be tailored to geographic areas, maximizing impact and resource allocation.
- The analysis successfully showcased the influence of Michigan's nonmedical vaccine exemption policy on exemption hot spot clusters.
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