Vanderbilt University Medical Center has announced a phase 3 vaccine trial. WPLN News (File)

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Nashville’s Board of Health is responding to a sharp uptick of vaccine refusal in Davidson County.

An annual survey that tracks vaccines in 2-year-olds suggests more families are turning them down.

The survey is meant to give a rough idea of vaccination rates ahead of the more concrete numbers that come when children enroll in kindergarten. It found that Nashville was an outlier in Tennessee, with far more people refusing vaccinations.

None of those interviewed said they avoided vaccines for medical reasons. Instead, they cited religious objections.

“Frequently, that religious exemption is really used for people who object philosophically to vaccinations. So that’s really what we want to crack down on,” Metro health director Wendy Long says.

The Metro Board of Health* passed a resolution last week asking the state to consider eliminating non-medical exemptions, or at least restricting them. New York, Maine and Washington State have all restricted allowable exemptions this year because of the ongoing measles outbreak.

Tennessee has avoided a large outbreak of measles, with just five cases centered in East Tennessee. But each case requires a monumental response to contain the disease once considered eradicated from the U.S.

More: Why Every Case Of Measles In Tennessee Spawns A Costly Emergency Response

Long says prevention is key, so she doesn’t want Tennessee to make refusal too easy.

“In other states, if you claim a religious exemption, you have to really demonstrate that you are a member of a religion that has an objection to vaccination,” she says. “In reality, there are very few religious out there that have an absolute objection to vaccination.”

* Correction: A previous version misstated which government entity passed a resolution. We regret the error.