Since evidence and well-argument facts fail to convince parents to vaccinate their children, Michigan state authorities have taken up a more convincing approach — by requiring extra effort to get a vaccine waiver.

So most people agree (with the science, that is) that we should vaccinate our kids. But the perks of wiping out horrible diseases isn’t enough to convince everybody, for some reason. Granted, some kids need to steer clear of vaccines because they’re allergic to them, or due to a host of immunodeficiency conditions. I don’t think anybody wants to force them to take the shots. But the vast majority of parents opt out of vaccinations based on religious or philosophical reasons, and I guess we’ll have to get used to that until facts aren’t a make your own adventure type of thing any longer.

Or… do we? Michigan says ‘haha, no.’ The state set a pretty nifty system in place to gently, passively, stealthily persuade parents that maybe, just maybe, they should get their kids vaccinated. And it’s surprisingly simple: they just added more red tape to the process of getting a waiver.

So to get your child off those hidden-agenda vaccines and just go on faith (sorry kid), you need a little slip of paper known as a vaccine waiver. Between 2013-2014 Michigan had the fourth highest rate of children entering kindergarten with a vaccination waiver in the US, around 22%. This came down to how easy it was to get the waiver — over the Internet, the phone, or simply by mailing a form. But following outbreaks of whooping cough and measles in the state, legislators added the ‘inconvenience factor’ in December 2014, requiring parents to consult with a health educator before they would be granted a waiver. With this extra bureaucratic step, which parents have to do in person, the state has managed to bring this rate down by 35% in one year’s time.

Vaccination rates also rose accordingly. The percentage of children who took the state-required fourth round of immunizations for diphtheria, tetanus, and pertussis in the state rose from about 78 to 85% during this time. Rates of unvaccinated children dropped from 22 to 15% — bringing Michigan to about the national average for this vaccination metric.

“The idea was to make the process more burdensome,” Michigan State University health policy specialist Mark Largent, who has written extensively about vaccines, told KHN.

“Research has shown that if you make it more inconvenient to apply for a waiver, fewer people get them.”

This approach removed messy debates over vaccines with opponents, Largent added, because “by heightening the burden, you change some of the [parents’] incentives” in the first place.

“Moral claims and ideology don’t matter as much when it’s inconvenient,” he explains.

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