Nonmedical exemptions from school-entry vaccine mandates are receiving increased policy and public health scrutiny. This paper examines how expanding the availability of exemptions influences vaccination rates in early childhood and academic achievement in middle school. We leverage 2003 legislation that granted personal belief exemptions (PBE) in Texas and Arkansas, two states that previously allowed exemptions only for medical or religious regions. We find that PBE decreased vaccination coverage among Black and low-income preschoolers by 16.1% and 8.3%, respectively. Furthermore, we find that those cohorts affected by the policy change in early childhood performed less well on standardized tests of academic achievement in middle school. Estimated effects on test scores were largest for Black students and economically disadvantaged students.

入学疫苗强制要求的非医疗豁免正在受到越来越多的政策和公共卫生审查。本文研究了扩大豁免范围如何影响幼儿期的疫苗接种率和中学的学业成绩。我们利用 2003 年在德克萨斯州和阿肯色州授予个人信仰豁免 (PBE) 的立法，这两个州以前只允许对医疗或宗教地区进行豁免。我们发现 PBE 将黑人和低收入学龄前儿童的疫苗接种覆盖率分别降低了 16.1% 和 8.3%。此外，我们发现受幼儿期政策变化影响的人群在中学学业成绩标准化测试中表现较差。黑人学生和经济上处于不利地位的学生对考试成绩的估计影响最大。