How citizenship and a state’s vaccine waiver policy differ across the U.S.

Passports may be obsolete in some provinces.

Provincial officials in Ontario say that the province — like New Zealand and Alaska — does not provide vaccination waivers for children under seven years old.

In a statement released on Friday, the Ministry of Health called the current practice “inconsistent with best practices,” particularly when it comes to children receiving vaccines.

While an American girl can probably get a vaccination waiver even if she is still in the sixth grade, it is important for children under seven to receive all their vaccines before reaching that age in order to be protected against infections such as measles, mumps and rubella. Children under seven who do not have a vaccination certificate do not have to attend school.

The New Zealand vaccination waiver program was a bit different than the ones most jurisdictions use. In Canada, parents could get a waiver for vaccines if they had a health care professional’s recommendation. The waiver system in New Zealand had a one-off exemption for travel to any country where the recommended vaccines for the measles, mumps and rubella, which had not been immunized against.

In the United States, where vaccination is a requirement for entering school, parents have long had the option to exempt their children from vaccinations for philosophical or religious reasons. According to the U.S. Centers for Disease Control and Prevention, 91 percent of Americans aged 19 and older — nearly all but about 3 percent of the country’s children — have gotten all their shots for the five diseases. A small percentage of parents take a stand against immunization on grounds that the vaccines cause health problems.

A data point to check: In Canada, one out of every three children who received an oral vaccine — namely the chickenpox vaccine — still got at least one problem after the vaccine. Canadian researchers used data from 2004 to 2015, and found the risk of side effects increases after a vaccine is administered. The vaccine just contained enough chickenpox virus to cause a mild cold for the first week, and then left problems ranging from fevers and occasional diarrhea up to a handful of cases of meningitis, according to the data.

The Canadian study also found that children in the United States had a slightly lower risk of side effects after vaccination than their Canadian counterparts.

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