Dissertation
Understanding policy changes in the US states: Vaccine exemptions during the US 2019 Measles outbreak
Washington State University
Doctor of Philosophy (PhD), Washington State University
05/2023
DOI:
https://doi.org/10.7273/000007091
Abstract
During the U.S. 2019 measles outbreak, four states succeeded in removing a vaccine exemption, ten states proposed removing a vaccine exemption but were unsuccessful, and seven states proposed adding a new vaccine exemption. This dissertation examined what public policy components enabled some states to remove vaccine exemptions while others were not able to remove a vaccine exemption or add an exemption. This research used a mixed methods approach and identified components from five public policy theories of change (punctuated equilibrium, narrative framework, policy diffusion, multiple streams theory, and advocacy coalition). Data were collected to examine correlations on seven components, which included focusing event, diffusion of policy changes, agenda setting, group monopolies, framing of the problem, bounded rationality, and venue shopping. Qualitative interviews were conducted with 11 public health officials and legislators.
Key findings from this research include:
• There was a correlation between the number of measles cases and whether a state was able to remove an exemption.
• Bipartisanship has decreased in the last 10 years, and exemption removal bills that had bipartisan support had a higher passage rate than bills that were solely sponsored by a single party.
• How local media framed the problem and the solution varied between states that removed exemptions and those that did not remove/add an exemption. States that removed exemptions the problem most identified was local cases and the solution most identified urged people to get vaccinated.
• States that were identified as the problem by other states’ local media were more likely to remove exemptions.
• States that had a Democrat governor and Democrat controlled legislative bodies, had a higher passage rate over states that were controlled by both parties or were controlled by Republicans
• There are signs the vaccination debate will move to new venues.
To examine why some states were successful/unsuccessful when proposing to add or remove vaccine exemption policy, it was important to bring in multiple public policy components to understand this multi-faceted issue. This research begins to establish a framework that the researcher will apply to COVID and other disease outbreaks.
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Details
- Title
- Understanding policy changes in the US states
- Creators
- Steffanie Sinclair Chritz
- Contributors
- Mark Stephan (Chair)Steven Stehr (Committee Member)William Kabasenche (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- Politics, Philosophy and Public Affairs, School of
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Publisher
- Washington State University
- Number of pages
- 176
- Identifiers
- 99901169140601842
- Language
- English
- Resource Type
- Dissertation