BACKGROUND Senate Bill 277 (SB277) banned nonmedical exemptions from school-entry vaccination requirements for children attending classroom-based schools in California, but excluded homeschooled children from vaccination requirements. Thus, it was hypothesized that more parents would choose to homeschool to avoid vaccination requirements in response to SB277. There is limited literature on the vaccine attitudes, beliefs, and behaviors among the homeschooling population in the US, despite an overall increase in homeschooling nationwide and documented vaccine-preventable disease outbreaks within the homeschooled child population. METHODS Between November 2018 and January 2019, we conducted a cross-sectional online survey among homeschooling parents with at least one child in grades K-8 who is currently enrolled in one of the legally-acceptable mechanisms to homeschool in California: (1) home-based private school satellite program (PSP), or (2) public or charter independent study program (ISP) with no classroom-based instruction. RESULTS Among 140 homeschooling parents from 8 schools in California, 71% reported that their youngest child in grade K-8 was up-to-date on immunizations at kindergarten-entry and 56% reported that they made the decision to homeschool their child after the implementation of SB277. Compared to homeschooling parents whose child was up-to-date at kindergarten entry, homeschooling parents whose child was not up-to-date at kindergarten entry reported higher concerns over vaccine safety and effectiveness, more frequently cited immunization mandates as a reason to homeschool, and were more likely to report having considered moving out of California due to immunization mandates. CONCLUSION There was variation in vaccine attitudes and beliefs within the homeschooling population in this sample. Immunization mandates were a factor in the decision to homeschool for some parents in this sample, supporting the hypothesis that vaccine-hesitant parents considered homeschooling as a way to avoid immunization mandates such as SB277. Future studies should explore the complexities around vaccine attitudes, beliefs and behaviors among homeschooling populations.

中文翻译：

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加州在家上学的父母：与孩子疫苗接种状况相关的态度、信仰和行为。

背景 参议院第 277 号法案 (SB277) 禁止对加州课堂学校的儿童进行入学疫苗接种要求的非医疗豁免，但将在家上学的儿童排除在疫苗接种要求之外。因此，据推测，更多家长会选择在家上学，以避免针对 SB277 的疫苗接种要求。尽管全国范围内在家上学的人数总体有所增加，并且有记录表明在家上学的儿童群体中爆发了疫苗可预防的疾病，但有关美国在家上学人群对疫苗的态度、信念和行为的文献仍然有限。方法 2018 年 11 月至 2019 年 1 月期间，我们对在家上学的家长进行了一项横断面在线调查，这些家长至少有一名 K-8 年级的孩子，目前正在加州合法接受的家庭上学机制之一注册：(1) 在家上学基于私立学校卫星计划 (PSP)，或 (2) 公共或特许独立学习计划 (ISP)，无课堂教学。结果 在加州 8 所学校的 140 名在家上学的家长中，71% 的家长表示，他们最小的 K-8 年级孩子在幼儿园入学时已接种最新疫苗，56% 的家长表示，他们在孩子上学后就决定在家上学。 SB277 的实施。与孩子在幼儿园入学时处于最新状态的在家上学的父母相比，孩子在幼儿园入学时未处于最新状态的在家上学的父母对疫苗安全性和有效性表示更高的担忧，更频繁地引用免疫强制作为在家上学的原因，并且更有可能报告称由于免疫接种规定而考虑搬出加利福尼亚州。结论 在该样本中，在家上学的人群对疫苗的态度和信念存在差异。在该样本中，免疫强制是一些家长决定在家上学的一个因素，这支持了这样的假设：对疫苗犹豫不决的父母认为在家上学是避免诸如 SB277 之类的免疫强制的一种方式。未来的研究应该探索在家上学人群中疫苗态度、信念和行为的复杂性。