States, like Wisconsin, that allow philosophical exemptions from vaccinations have higher rates of whooping cough, a recent study from the University of Georgia found.

Wisconsin was one of 21 states where rates of whooping cough increased from 2013 to 2014, according to Centers for Disease Control and Prevention data.

Meanwhile, the use of philosophical waivers in Wisconsin has risen from 3.8 percent to 4.3 percent since 2011, according to data from Wisconsin Department of Health Services. 

Published in the August issue of the journal “Health Affairs,” a University of Georgia study found the standardized form parents are allowed to use in some states to exempt their child from vaccines leads to higher rates of preventable disease in those states. 

Unlike medical exemptions, philosophical exemptions like the ones offered in Wisconsin don’t need a physician’s approval and are up to the parent’s discretion.

Diane McHugh, the coordinator for the Dane County Immunization Coalition through Public Health Madison and Dane County, said there are three main reasons parents choose to opt for philosophical exemptions.

One is the rumored link between the Measles, Mumps and Rubella (MMR) vaccine and autism, a claim McHugh said has been debunked by hundreds of studies. Additionally, she said some people believe in natural remedies and do not want to put foreign substances in their child’s body. In other cases, McHugh said some people do not have time to get a vaccine, so they sign the exemption form instead.

“We try to discourage waivers as much as possible, but Wisconsin has a very permissive ruling on waivers,” she said.

Most states have medical and religious exemptions, but not all have a philosophical exemption like Wisconsin does, McHugh said.

Wisconsin had 1,437 total cases of confirmed and probable whooping cough cases in 2014, according to McHugh.

In June, California issued a law requiring vaccinations for every child. University of Georgia study author David Bradford said the state’s measles outbreak created a rapid political response to only allow medical exemptions in the state.

Bradford said if states want to limit exemptions and maximize immunizations, they should eliminate both philosophical exemption forms and the standardized form parents can use for all vaccine exemptions.

Instead, he said, parents should have to request to be exempt from each individual vaccine, instead of all vaccines at once.

“States that have that policy have lower exemption [rates],” Bradford said. “If you’re going to make [parents] make a request for every exemption, they tend to not go through with it.”

Bradford said celebrities play a significant role in influencing public opinion on vaccines.

Jenny McCarthy and Jim Carrey, for example, cite a poorly done study from a British medical journal correlating the MMR vaccine with autism, he said. The study has since been withdrawn from the journal. Bradford said anecdotal stories from entertainment figures are persuasive to people.

“We’re wired to hear a compelling story and believe it,” he said. “That really gives celebrities who have no credible basis for what they’re saying undue influence.”