▁cultural ▁factors ▁associated ▁with ▁v acc ine ▁hes it ancy . ▁Both ▁high ▁and ▁low ▁so cio e conom ic ▁status ▁as ▁well ▁as ▁high ▁and ▁low ▁education ▁levels ▁have ▁all ▁been ▁associated ▁with ▁v acc ine ▁hes it ancy ▁in ▁different ▁populations . ▁Other ▁studies ▁exam ining ▁various ▁populations ▁around ▁the ▁world ▁in ▁different ▁countries ▁found ▁that ▁both ▁high ▁and ▁low ▁so cio e conom ic ▁status ▁are ▁associated ▁with ▁v acc ine ▁hes it ancy . ▁Studies ▁have ▁demonstrated ▁that ▁children ▁of ▁parents ▁who ▁refused ▁the ▁pert uss is ▁v acc ine , ▁var ic ella ▁v acc ine , ▁and ▁p neum oc oc cal ▁v acc ine ▁are ▁ 2 3 ▁times ▁more ▁likely ▁to ▁contract ▁pert uss is ▁( who op ing ▁c ough ), ▁nine ▁times ▁more ▁likely ▁to ▁catch ▁var ic ella ▁( ch icken po x ), ▁and ▁six ▁times ▁more ▁likely ▁to ▁be ▁hospital ized ▁with ▁severe ▁p neum onia ▁from ▁Stre pt oc oc cus ▁p neum onia e ▁( p neum oc oc cus ). ▁ ▁Policy ▁imp lications ▁ ▁Multiple ▁major ▁medical ▁soci eties ▁including ▁the ▁In fect ious ▁D ise ases ▁Society ▁of ▁America , ▁the ▁American ▁Medical ▁Association , ▁and ▁the ▁American ▁Academy ▁of ▁Ped iat rics ▁support ▁the ▁elim ination ▁of ▁all ▁non med ical ▁exem ptions ▁for ▁child hood ▁v acc ines . ▁ ▁Ind ividual ▁liberty ▁Comp uls ory ▁v acc ination ▁policies ▁have ▁been ▁controvers ial ▁as ▁long ▁as ▁they ▁have ▁existed , ▁with ▁oppon