Pertussis outbreaks in Utah and Arizona appeared in conservative Mormon communities that opposed vaccination. Whooping cough once killed four thousand children annually in the US is still with us. Alameda County California reported 80 cases in 1998. After long hospitalization, the child survived. Currently, all 50 states require children to be vaccinated before enrolling in school.
Exemptions apply for children whose parents' religious beliefs prohibit vaccinations.
Some children are exempt for medical reasons, which must be certified by their doctors. The safety of various vaccines, particularly DPT continues to be the subject of debate. Although endorsed by the American Academy of Pediatrics and the U.S. Public Health Service, many parents and health providers consider the DPT vaccine to be risky. Manufacturers are less willing to produce vaccines for fear of lawsuits by parents of injured children. There is an active anti vaccine movement in this country as the next section will illustrate.