Geographic, organizational, and individual variation in non-medical exemptions to kindergarten vaccination requirements in the US.

Kindergarten vaccine requirements prevent the spread of communicable diseases, including measles, but require high participation to achieve herd immunity. Recently, rates of non-medical exemptions to kindergarten vaccine requirements have increased, along with outbreaks of vaccine-preventable disease. Understanding common characteristics among geographic areas, organizations, and individuals with high non-medical exemption rates is crucial in developing interventions to increase vaccine uptake and protect children from vaccine-preventable disease. This systematic review aims to quantitatively summarize the direction and magnitude of the associations between geographic, organizational, and individual variation in non-medical exemptions.