biostudies-literatureMorrison MDoD NDSEGNIAID NIH HHSNational Institutes of HealthNIGMS NIH HHSe1003049https://www.ebi.ac.uk/biostudies/studies/S-EPMC7064178biostudies-literatureUnknown17(3)<h4>Background</h4>As conscientious vaccination exemption (CVE) percentages rise across the United States, so does the risk and occurrence of outbreaks of vaccine-preventable diseases such as measles. In the state of Texas, the median CVE percentage across school systems more than doubled between 2012 and 2018. During this period, the proportion of schools surpassing a CVE percentage of 3% rose from 2% to 6% for public schools, 20% to 26% for private schools, and 17% to 22% for charter schools. The aim of this study was to investigate this phenomenon at a fine scale.<h4>Methods and findings</h4>Here, we use beta regression models to study the socioeconomic and geographic drivers of CVE trends in Texas. Using annual counts of CVEs at the school system level from the 2012-2013 to the 2017-20PLoS medicineConscientious vaccination exemptions in kindergarten to eighth-grade children across Texas schools from 2012 to 2018: A regression analysis.PMC7064178U01 GM087719R01 AI151176Ancel Meyers LCastro LAMorrison MfalseConscientious vaccination exemptions in kindergarten to eighth-grade children across Texas schools from 2012 to 2018: A regression analysis.<h4>Background</h4>As conscientious vaccination exemption (CVE) percentages rise across the United States, so does the risk and occurrence of outbreaks of vaccine-preventable diseases such as measles. In the state of Texas, the median CVE percentage across school systems more than doubled between 2012 and 2018. During this period, the proportion of schools surpassing a CVE percentage of 3% rose from 2% to 6% for public schools, 20% to 26% for private schools, and 17% to 22% for charter schools. The aim of this study was to investigate this phenomenon at a fine scale.<h4>Methods and findings</h4>Here, we use beta regression models to study the socioeconomic and geographic drivers of CVE trends in Texas. Using annual counts of CVEs at the school system level from the 2012-2013 to the 2017-202020-01-01T00:00:00Z2020 Mar2026-07-15T19:53:59.414Z2025-05-31T22:38:58.4ZS-EPMC70641783215514210.1371/journal.pmed.1003049