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AbstractSTAR METRICS is a data platform that is being voluntarily and collaboratively developed by U.S. federal science agencies and research institutions to describe investments in science and their results. It initially emerged as a result of reporting requirements associated with the 2009 American Recovery and Reinvestment Act; it has developed in response to a recognized need to begin to systematically document federal investments in science and their immediate and long‐term results. The eventual goal is to draw information from existing data on scientific and economic activities as well as from research institutions' and federal science agencies' systems to provide data that can be used for a more scientific analysis of science investments and their outcomes.

Michigan's introduction of mandatory counseling for nonmedical exemptions was associated with decreased nonmedical exemption rates. However, while each of Michigan's 45 local health departments made its own decisions about how to conduct immunization counseling, differences in the burdensomeness of counseling programs was not associated with greater or lesser changes in exemption rates. Data from a survey of Michigan local health departments (online, October 2015), epidemiological data from Michigan's Department of Health and Human Services (online, various dates), and social and economic data from the American Community Survey (online, various dates) were used in models explaining change in county-level nonmedical exemption rates. Counties that first required an education session after the December 2014 rule change had a 30% greater reduction in their nonmedical exemption rates for 2015 than did counties that already required education sessions. Michigan's experience with vaccination waiver education suggests that imposing burdens on nonmedical waiver applicants decreases nonmedical waiver rates. It also indicates there may be a burden threshold beyond which incremental increases in inconvenience do not further reduce exemption rates. Thus, in a context of hyper-politicization and austerity, health departments may be wise to avoid implementing additionally burdensome processes that are politically or economically expensive to administer.