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December 13, 1995, Vol 274, No. 22 >
ARTICLE | December 13, 1995

Childhood Immunization Registries: Title and subTitle BreakA National Review of Public Health Information Systems and the Protection of Privacy FREE

Lawrence O. Gostin, JD; Zita Lazzarini, JD, MPH
[+] Author Affiliations

The views expressed herein are those of the authors and do not necessarily reflect the official policy of the Centers for Disease Control and Prevention, the Carter Presidential Center, or the Council of State and Territorial Epidemiologists.

Reprint requests to Georgetown University Law Center, 600 New Jersey Ave NW, Washington, DC 20001 (Mr Gostin).

Health Law and Ethics section editors: Lawrence O. Gostin, JD, the Georgetown/ Johns Hopkins University Program on Law and Public Health, Washington, DC, and Baltimore, Md; Helene M. Cole, MD, Contributing Editor, JAMA.


JAMA. 1995;274(22):1793-1799. doi:10.1001/jama.1995.03530220059034
Text Size: A A A
Published online
Article
References

COMMON childhood illnesses, such as measles, diphtheria, pertussis, tetanus, and polio, once accounted for a substantial proportion of infant and child morbidity and mortality in the United States.1 Complete and timely early immunization can now effectively prevent these and other childhood diseases.2-4 Despite the potential to protect the health of society's most vulnerable population, approximately one third of the 4 million infants born annually in the United States do not receive all of their recommended immunizations by age 2 years.5

The rate of complete immunization of school-aged children in the United States (>95%) is as high, or higher, than most other developed countries.6,7 Yet the rate of full immunization of preschoolers (<65%)8 is less than that of many developed (and even some developing) countries.9 While the most recent provisional data show significant improvement in specific immunizations, levels for all immunizations remain well below the

REFERENCES

1 +
Cutts FT, Zell ER, Mason D, et al.  Monitoring progress toward US preschool immunization goals. JAMA . 1992;;267:1952-1955.
2 +
 Centers for Disease Control and Prevention. Update: childhood vaccine-preventable diseases—United States, 1994. MMWR Morb Mortal Wkly Rep . 1994;;43:718-720.
3 +
Peltola H, Heinonen OP, Valle M, et al.  The elimination of indigenous measles, mumps, and rubella from Finland by a 12-year, two-dose vaccination program. N Engl J Med . 1994;;331:1397-1402.
4 +
Centers for Disease Control and Prevention.  Progress toward elimination of Haemophilus influenzae type b disease among infants and children—United States, 1993-1994. MMWR Morb Mortal Wkly Rep . 1995;;44:545-550.
5 +
Centers for Disease Control and Prevention.  Vaccination coverage of 2-year-old children—United States, 1991-1992. JAMA . 1994;;271:260.
6 +
MMWR Morb Mortal Wkly Rep . 1994;;42-985-988.
7 +
UNICEF. Children and Development in the 1990s: A UNICEF Source-book . New York, NY: UNICEF; 1990;. (The United States is ranked 17th in immunization rates, below countries including Bulgaria, China, and Mexico.)
8 +
US General Accounting Office. Preventive Health Care for Children: Experience From Selected Foreign Countries . Washington, DC: US General Accounting Office; 1993;.
9 +
Centers for Disease Control and Prevention.  Vaccination coverage of 2-year-old children—United States, January-March 1994. MMWR Morb Mortal Wkly Rep . 1995;;44:142-143, 149-150.
10 +
Williams BC.  Immunization coverage among preschool children: the United States and selected European countries. Pediatrics . 1990;;115( (suppl) ):1052-1055.
11 +
US Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Public Health Service; 1991;.
12 +
US General Accounting Office. Vaccines for Children: Critical Issues in Design and Implementation . Washington, DC: US General Accounting Office; 1994;.
13 +
Children's Defense Fund. The State of America's Children . Washington, DC: Children's Defense Fund; 1992;.
14 +
Satcher D.  Keep up the progress on childhood immunization. Public Health Rep . 1994;:593.
15 +
Centers for Disease Control and Prevention.  Measles—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:378-381.
16 +
National Vaccine Advisory Committee.  The measles epidemic: the problems, barriers, and recommendations. JAMA . 1991;;266:1547-1552.
17 +
Atkinson WL, Orenstein WA, Krugman S.  The resurgence of measles in the United States, 1989-1994. Annu Rev Med . 1992;;43:451-463.
18 +
National Vaccine Advisory Committee, Subcommittee on Vaccination Registries. Developing a National Childhood Immunization System: Registries, Reminders, and Recall . Washington, DC: US Dept of Health and Human Services, National Vaccine Program Office; 1994;.
19 +
US General Accounting Office. Vaccines for Children: Reexamination of Program Goals and Implementation Needed to Ensure Vaccination . Washington, DC: US General Accounting Office; 1995;. Publication GAO/PEMD 95-22.
20 +
Hinman AR.  Immunizations in the United States. Pediatrics . 1990;;86: 1064-1066.
21 +
Institute of Medicine. Overcoming Barriers to Immunization: A Workshop Summary . Washington, DC: National Academy Press; 1994;.
22 +
Cutts FT, Orenstein WA, Bernier RH.  Causes of low preschool immunization coverage in the United States. Annu Rev Public Health . 1992;;13:385-398.
23 +
National Vaccine Advisory Committee. Access to Childhood Immunizations: Recommendations and Strategies for Action . Washington, DC: US Dept of Health and Human Services; 1992;.
24 +
Freed GL, Bordley WC, Defriese GH.  Childhood immunization programs: an analysis of policy issues. Milbank Q . 1993;;71:65-95.
25 +
Wood DL, Hayward RA, Corey CR, Freeman HE, Shapiro MF.  Access to medical care for children and adolescents in the United States. Pediatrics . 1990;;86:666-673.
26 +
National Center for Health Statistics. Health, United States, 1993 . Hyattsville, Md: US Public Health Service; 1994;:63.
27 +
Skolnick A.  Should insurance cover routine immunizations? JAMA . 1991;; 265:2453-2457.
28 +
Gostin LO, Widiss A.  What's wrong with the ERISA vacuum? employers' freedom to limit health care coverage provided by risk retention plans. JAMA . 1993;;269:2527-2532.
29 +
Freed GL, Bordley WC, Defriese GH.  Childhood immunization programs: an analysis of policy issues. Milbank Q . 1993;;71:65-95.
30 +
Flint SS.  Pediatrician participation in Medicaid: 1987 to 1989. Pediatrics . 1990;;85:567-577.
31 +
Moore P, Hepworth JT.  Use of perinatal and infant health services by Mexican-American Medicaid enrollees. JAMA . 1994;;272:297-304.
32 +
Centers for Disease Control and Prevention.  Reported vaccine-preventable diseases—United States, 1993, and the Childhood Immunization Initiative. MMWR Morb Mortal Wkly Rep . 1994;;43:57-60.
33 +
Hemenway D.  Economics of childhood immunization. Econ Inq . 1994;;32: 519.
34 +
Freed GL, Katz SL.  The Comprehensive Childhood Immunization Act of 1993. N Engl J Med . 1993;;329:1957-1960.
35 +
Hinman AR.  What will it take to fully protect all children with vaccines? AJDC . 1991;;145:559-562.
36 +
Orenstein WA, Atkinson W, Mason D, Bernier RH.  Barriers to vaccinating preschool children. J Health Care Poor Underserved . 1990;;1:315-329.
37 +
Centers for Disease Control and Prevention. Standards for Pediatric Immunization Practices . Atlanta, Ga: National Vaccine Advisory Committee; 1992;.
38 +
Institute of Medicine. Stratton KR, Johnston, Jr, RB, eds. Adverse Events Associated With Childhood Vaccines: Evidence Bearing on Causality . Washington, DC: National Academy Press; 1994;.
39 +
Gale JL, Thapa PB, Wassilak SGF, Bobo JK, Mendelman PM, Foy HM.  Risk of serious acute neurological illness after immunization with diphtheria-tetanuspertussis vaccine: a population-based case-control study. JAMA . 1994;;271:37-41.
40 +
Salsberry PJ, Nickel JT, Mitch R.  Why aren't preschoolers immunized? a comparison of parents' and providers' perceptions of the barriers to immunizations. J Community Health Nurs . 1993;;10:213-224.
41 +
Clayton EW, Hickson GB, Miller CS.  Parents' responses to vaccine information pamphlets. Pediatrics . 1994;;93:369-372.
42 +
National Childhood Vaccine Injury Act of 1986, at §2125 of the Public Health Service Act as codified at 42 USC §300aa (suppl 1987).
43 +
Centers for Disease Control and Prevention.  Impact of missed opportunities to vaccinate preschool-aged children on vaccination coverage levels— selected US sites, 1991-1992. MMWR Morb Mortal Wkly Rep . 1994;;43:709-710, 716-717.
44 +
Centers for Disease Control and Prevention.  Measles prevention: recommendations of the Immunization Practices Advisory Committee. MMWR Morb Mortal Wkly Rep . 1989;;38:4.
45 +
Szilagyi PG, Rodewald LE, Humiston SG, et al.  Missed opportunities for childhood vaccinations in office practices and the effect on vaccination status. Pediatrics . 1993;;91:1-7.
46 +
Goldstein KP, Kuiz FJ, Drum RS.  Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department. JAMA . 1993;;270:2190-2194.
47 +
Herold AH, Roetzheim RG, Woodard LJ, et al.  Validity of immunization documentation presented to a student health program. J Fam Pract . 1993;; 36:158-160.
48 +
Orenstein WA, Bernier RH.  Toward immunizing every child on time. Pediatrics . 1994;;94:545-546.
49 +
Linkins RW, Dini EF, Watson G, et al.  A randomized trial of the effectiveness of computer-generated telephone messages in increasing immunization visits among preschool children. Arch Pediatr Adolesc Med . 1994;;148: 908-914.
50 +
Tollestrup K, Hubbard BB.  Evaluation of a follow-up system in a county health department's immunization clinic. Am J Prev Med . 1991;;7:24-28.
51 +
Byrne EB, Schaffer W, Dini EF, Case GE.  Infant immunization surveillance: cost vs effect: a prospective controlled evaluation of a large-scale program in Rhode Island. JAMA . 1970;;212:770-773.
52 +
Young SA, Halpin TJ, Hohnson DA, et al.  Effectiveness of a mailed reminder on the immunization levels of infants at high risk of failure to complete immunizations. Am J Public Health . 1980;;70:422-424.
53 +
Loeser H, Zvagulis I, Hercz L, Pless IB.  The organization and evaluation of a computer-assisted, centralized immunization registry. Am J Public Health . 1983;;73:1298-1301.
54 +
Klachko DM, Wright DL, Gardner DW.  Effect of a microcomputer-based registry on adult immunizations. J Fam Pract . 1989;;29:169-172.
55 +
Szilagyi PG, Rodewald LE, Savageau J, et al.  Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics . 1992;; 90:871-875.
56 +
Litt JCB, Lake PB.  Improving influenza vaccine coverage in at-risk groups: good intentions are not enough. Med J Aust . 1993;;159:542-545.
57 +
Centers for Disease Control and Prevention. ACIP Recommended Immunization Schedule . Atlanta, Ga: Centers for Disease Control and Prevention; 1995;.
58 +
Arkansas, California, Colorado, Connecticut, Mississippi, New York, North Carolina, Oregon, Rhode Island.
59 +
Delaware, Nevada, North Dakota, South Carolina.
60 +
Arizona, Georgia, Louisiana, Maryland, Michigan, Minnesota, Montana, Ohio, Washington.
61 +
Jacobson v Massachusetts, 197 US 11 (1905).
62 +
Maricopa County Health Dept v Harmon, 750 P2d 1364 (Ariz Ct App 1987).
63 +
Brown v Stone, 378 So 2d 218 (Miss 1979), cert denied, 449 US 887 (1980).
64 +
Mason v General Brown Central School District, 851 F2d 47 (2d Cir 1988).
65 +
Berg v Glen Cove City School District, 853 F Supp. 651 (EDNY 1994).
66 +
Sherr v Northport-East Northport Union Free School District, 672 F Supp 81, 91, 97 (EDNY 1987).
67 +
Wright v DeWitt School District, 385 SW2d 644, 648 (Ark 1965) (parents 'freedom to act according to their religious beliefs is subject to a reasonable regulation for the benefit of society as a whole').
68 +
District of Columbia, Maine, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Wisconsin, Wyoming, Puerto Rico.
69 +
Alabama, Hawaii, Maine, Oklahoma, Tennessee, Texas, West Virginia, Wisconsin.
70 +
Alabama, Maine, Massachusetts, Missouri, New Jersey, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia.
71 +
Tennessee.
72 +
Arkansas, Connecticut, Idaho, Maine, Massachusetts, New Hampshire, North Carolina, Rhode Island, South Dakota, Vermont, Washington, Wyoming.
73 +
Alabama, California, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, New York, North Dakota, Rhode Island, South Carolina, Utah, Virginia, West Virginia, Wyoming.
74 +
Gostin LO.  Health information privacy. Cornell Law Rev . 1995;;80:101-184.
75 +
Gostin LO, Turek-Brezina J, Powers M, Kozloff R, Faden R, Steinhauer DD.  Privacy and security of personal information in a new health care system. JAMA . 1993;;270:2487-2493.
76 +
In re Christine M, 595 NYS2d 606 (Fam Ct 1992).
77 +
US Dept of Health, Education, and Welfare, Secretary's Advisory Committee on Automated Personal Data Systems. Records, Computers, and the Rights of Citizens . Washington, DC: US Dept of Health, Education, and Welfare; 1973;.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Cutts FT, Zell ER, Mason D, et al.  Monitoring progress toward US preschool immunization goals. JAMA . 1992;;267:1952-1955.
2 +
 Centers for Disease Control and Prevention. Update: childhood vaccine-preventable diseases—United States, 1994. MMWR Morb Mortal Wkly Rep . 1994;;43:718-720.
3 +
Peltola H, Heinonen OP, Valle M, et al.  The elimination of indigenous measles, mumps, and rubella from Finland by a 12-year, two-dose vaccination program. N Engl J Med . 1994;;331:1397-1402.
4 +
Centers for Disease Control and Prevention.  Progress toward elimination of Haemophilus influenzae type b disease among infants and children—United States, 1993-1994. MMWR Morb Mortal Wkly Rep . 1995;;44:545-550.
5 +
Centers for Disease Control and Prevention.  Vaccination coverage of 2-year-old children—United States, 1991-1992. JAMA . 1994;;271:260.
6 +
MMWR Morb Mortal Wkly Rep . 1994;;42-985-988.
7 +
UNICEF. Children and Development in the 1990s: A UNICEF Source-book . New York, NY: UNICEF; 1990;. (The United States is ranked 17th in immunization rates, below countries including Bulgaria, China, and Mexico.)
8 +
US General Accounting Office. Preventive Health Care for Children: Experience From Selected Foreign Countries . Washington, DC: US General Accounting Office; 1993;.
9 +
Centers for Disease Control and Prevention.  Vaccination coverage of 2-year-old children—United States, January-March 1994. MMWR Morb Mortal Wkly Rep . 1995;;44:142-143, 149-150.
10 +
Williams BC.  Immunization coverage among preschool children: the United States and selected European countries. Pediatrics . 1990;;115( (suppl) ):1052-1055.
11 +
US Public Health Service. Healthy People 2000: National Health Promotion and Disease Prevention Objectives . Washington, DC: US Public Health Service; 1991;.
12 +
US General Accounting Office. Vaccines for Children: Critical Issues in Design and Implementation . Washington, DC: US General Accounting Office; 1994;.
13 +
Children's Defense Fund. The State of America's Children . Washington, DC: Children's Defense Fund; 1992;.
14 +
Satcher D.  Keep up the progress on childhood immunization. Public Health Rep . 1994;:593.
15 +
Centers for Disease Control and Prevention.  Measles—United States, 1992. MMWR Morb Mortal Wkly Rep . 1993;;42:378-381.
16 +
National Vaccine Advisory Committee.  The measles epidemic: the problems, barriers, and recommendations. JAMA . 1991;;266:1547-1552.
17 +
Atkinson WL, Orenstein WA, Krugman S.  The resurgence of measles in the United States, 1989-1994. Annu Rev Med . 1992;;43:451-463.
18 +
National Vaccine Advisory Committee, Subcommittee on Vaccination Registries. Developing a National Childhood Immunization System: Registries, Reminders, and Recall . Washington, DC: US Dept of Health and Human Services, National Vaccine Program Office; 1994;.
19 +
US General Accounting Office. Vaccines for Children: Reexamination of Program Goals and Implementation Needed to Ensure Vaccination . Washington, DC: US General Accounting Office; 1995;. Publication GAO/PEMD 95-22.
20 +
Hinman AR.  Immunizations in the United States. Pediatrics . 1990;;86: 1064-1066.
21 +
Institute of Medicine. Overcoming Barriers to Immunization: A Workshop Summary . Washington, DC: National Academy Press; 1994;.
22 +
Cutts FT, Orenstein WA, Bernier RH.  Causes of low preschool immunization coverage in the United States. Annu Rev Public Health . 1992;;13:385-398.
23 +
National Vaccine Advisory Committee. Access to Childhood Immunizations: Recommendations and Strategies for Action . Washington, DC: US Dept of Health and Human Services; 1992;.
24 +
Freed GL, Bordley WC, Defriese GH.  Childhood immunization programs: an analysis of policy issues. Milbank Q . 1993;;71:65-95.
25 +
Wood DL, Hayward RA, Corey CR, Freeman HE, Shapiro MF.  Access to medical care for children and adolescents in the United States. Pediatrics . 1990;;86:666-673.
26 +
National Center for Health Statistics. Health, United States, 1993 . Hyattsville, Md: US Public Health Service; 1994;:63.
27 +
Skolnick A.  Should insurance cover routine immunizations? JAMA . 1991;; 265:2453-2457.
28 +
Gostin LO, Widiss A.  What's wrong with the ERISA vacuum? employers' freedom to limit health care coverage provided by risk retention plans. JAMA . 1993;;269:2527-2532.
29 +
Freed GL, Bordley WC, Defriese GH.  Childhood immunization programs: an analysis of policy issues. Milbank Q . 1993;;71:65-95.
30 +
Flint SS.  Pediatrician participation in Medicaid: 1987 to 1989. Pediatrics . 1990;;85:567-577.
31 +
Moore P, Hepworth JT.  Use of perinatal and infant health services by Mexican-American Medicaid enrollees. JAMA . 1994;;272:297-304.
32 +
Centers for Disease Control and Prevention.  Reported vaccine-preventable diseases—United States, 1993, and the Childhood Immunization Initiative. MMWR Morb Mortal Wkly Rep . 1994;;43:57-60.
33 +
Hemenway D.  Economics of childhood immunization. Econ Inq . 1994;;32: 519.
34 +
Freed GL, Katz SL.  The Comprehensive Childhood Immunization Act of 1993. N Engl J Med . 1993;;329:1957-1960.
35 +
Hinman AR.  What will it take to fully protect all children with vaccines? AJDC . 1991;;145:559-562.
36 +
Orenstein WA, Atkinson W, Mason D, Bernier RH.  Barriers to vaccinating preschool children. J Health Care Poor Underserved . 1990;;1:315-329.
37 +
Centers for Disease Control and Prevention. Standards for Pediatric Immunization Practices . Atlanta, Ga: National Vaccine Advisory Committee; 1992;.
38 +
Institute of Medicine. Stratton KR, Johnston, Jr, RB, eds. Adverse Events Associated With Childhood Vaccines: Evidence Bearing on Causality . Washington, DC: National Academy Press; 1994;.
39 +
Gale JL, Thapa PB, Wassilak SGF, Bobo JK, Mendelman PM, Foy HM.  Risk of serious acute neurological illness after immunization with diphtheria-tetanuspertussis vaccine: a population-based case-control study. JAMA . 1994;;271:37-41.
40 +
Salsberry PJ, Nickel JT, Mitch R.  Why aren't preschoolers immunized? a comparison of parents' and providers' perceptions of the barriers to immunizations. J Community Health Nurs . 1993;;10:213-224.
41 +
Clayton EW, Hickson GB, Miller CS.  Parents' responses to vaccine information pamphlets. Pediatrics . 1994;;93:369-372.
42 +
National Childhood Vaccine Injury Act of 1986, at §2125 of the Public Health Service Act as codified at 42 USC §300aa (suppl 1987).
43 +
Centers for Disease Control and Prevention.  Impact of missed opportunities to vaccinate preschool-aged children on vaccination coverage levels— selected US sites, 1991-1992. MMWR Morb Mortal Wkly Rep . 1994;;43:709-710, 716-717.
44 +
Centers for Disease Control and Prevention.  Measles prevention: recommendations of the Immunization Practices Advisory Committee. MMWR Morb Mortal Wkly Rep . 1989;;38:4.
45 +
Szilagyi PG, Rodewald LE, Humiston SG, et al.  Missed opportunities for childhood vaccinations in office practices and the effect on vaccination status. Pediatrics . 1993;;91:1-7.
46 +
Goldstein KP, Kuiz FJ, Drum RS.  Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department. JAMA . 1993;;270:2190-2194.
47 +
Herold AH, Roetzheim RG, Woodard LJ, et al.  Validity of immunization documentation presented to a student health program. J Fam Pract . 1993;; 36:158-160.
48 +
Orenstein WA, Bernier RH.  Toward immunizing every child on time. Pediatrics . 1994;;94:545-546.
49 +
Linkins RW, Dini EF, Watson G, et al.  A randomized trial of the effectiveness of computer-generated telephone messages in increasing immunization visits among preschool children. Arch Pediatr Adolesc Med . 1994;;148: 908-914.
50 +
Tollestrup K, Hubbard BB.  Evaluation of a follow-up system in a county health department's immunization clinic. Am J Prev Med . 1991;;7:24-28.
51 +
Byrne EB, Schaffer W, Dini EF, Case GE.  Infant immunization surveillance: cost vs effect: a prospective controlled evaluation of a large-scale program in Rhode Island. JAMA . 1970;;212:770-773.
52 +
Young SA, Halpin TJ, Hohnson DA, et al.  Effectiveness of a mailed reminder on the immunization levels of infants at high risk of failure to complete immunizations. Am J Public Health . 1980;;70:422-424.
53 +
Loeser H, Zvagulis I, Hercz L, Pless IB.  The organization and evaluation of a computer-assisted, centralized immunization registry. Am J Public Health . 1983;;73:1298-1301.
54 +
Klachko DM, Wright DL, Gardner DW.  Effect of a microcomputer-based registry on adult immunizations. J Fam Pract . 1989;;29:169-172.
55 +
Szilagyi PG, Rodewald LE, Savageau J, et al.  Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics . 1992;; 90:871-875.
56 +
Litt JCB, Lake PB.  Improving influenza vaccine coverage in at-risk groups: good intentions are not enough. Med J Aust . 1993;;159:542-545.
57 +
Centers for Disease Control and Prevention. ACIP Recommended Immunization Schedule . Atlanta, Ga: Centers for Disease Control and Prevention; 1995;.
58 +
Arkansas, California, Colorado, Connecticut, Mississippi, New York, North Carolina, Oregon, Rhode Island.
59 +
Delaware, Nevada, North Dakota, South Carolina.
60 +
Arizona, Georgia, Louisiana, Maryland, Michigan, Minnesota, Montana, Ohio, Washington.
61 +
Jacobson v Massachusetts, 197 US 11 (1905).
62 +
Maricopa County Health Dept v Harmon, 750 P2d 1364 (Ariz Ct App 1987).
63 +
Brown v Stone, 378 So 2d 218 (Miss 1979), cert denied, 449 US 887 (1980).
64 +
Mason v General Brown Central School District, 851 F2d 47 (2d Cir 1988).
65 +
Berg v Glen Cove City School District, 853 F Supp. 651 (EDNY 1994).
66 +
Sherr v Northport-East Northport Union Free School District, 672 F Supp 81, 91, 97 (EDNY 1987).
67 +
Wright v DeWitt School District, 385 SW2d 644, 648 (Ark 1965) (parents 'freedom to act according to their religious beliefs is subject to a reasonable regulation for the benefit of society as a whole').
68 +
District of Columbia, Maine, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, Oklahoma, Pennsylvania, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Wisconsin, Wyoming, Puerto Rico.
69 +
Alabama, Hawaii, Maine, Oklahoma, Tennessee, Texas, West Virginia, Wisconsin.
70 +
Alabama, Maine, Massachusetts, Missouri, New Jersey, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia.
71 +
Tennessee.
72 +
Arkansas, Connecticut, Idaho, Maine, Massachusetts, New Hampshire, North Carolina, Rhode Island, South Dakota, Vermont, Washington, Wyoming.
73 +
Alabama, California, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Mexico, New York, North Dakota, Rhode Island, South Carolina, Utah, Virginia, West Virginia, Wyoming.
74 +
Gostin LO.  Health information privacy. Cornell Law Rev . 1995;;80:101-184.
75 +
Gostin LO, Turek-Brezina J, Powers M, Kozloff R, Faden R, Steinhauer DD.  Privacy and security of personal information in a new health care system. JAMA . 1993;;270:2487-2493.
76 +
In re Christine M, 595 NYS2d 606 (Fam Ct 1992).
77 +
US Dept of Health, Education, and Welfare, Secretary's Advisory Committee on Automated Personal Data Systems. Records, Computers, and the Rights of Citizens . Washington, DC: US Dept of Health, Education, and Welfare; 1973;.

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