Abstract
State and local school vaccination requirements exist to ensure that students are protected against vaccine-preventable diseases (1). This report summarizes data collected by state and local immunization programs* on vaccination coverage among children in kindergarten in 49 states, exemptions for kindergartners in 50 states, and provisional enrollment and grace period status for kindergartners in 30 states. Nationally, vaccination coverage† was 94.9% for the state-required number of doses of diphtheria and tetanus toxoids, and acellular pertussis vaccine (DTaP); 94.7% for 2 doses of measles, mumps, and rubella vaccine (MMR); and 94.8% for the state-required doses of varicella vaccine. Whereas 2.5% of kindergartners had an exemption from at least one vaccine,§ 2.8% of kindergartners were not up to date for MMR and did not have a vaccine exemption. Nearly all states could achieve the recommended ≥95% MMR coverage if all nonexempt kindergartners were vaccinated in accordance with local and state vaccination policies.
Highlights
MMR and without a vaccine exemption. † The exemptions used to calculate the potential increase in MMR coverage for Arizona, Arkansas, Colorado, Idaho, Illinois, Maine, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, Texas, Utah, Vermont, and Wyoming are the number of children with exemptions for MMR vaccine
The exemption rate slightly increased to 2.5%, most states could achieve the recommended ≥95% MMR coverage if undervaccinated children without an exemption were completely vaccinated
All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest
Summary
The percentage of kindergartners with an exemption from one or more required vaccines (not limited to MMR, DTaP, and varicella vaccines) was 2.5% in 2018–19 (range = 0.1% [Mississippi] to 7.7% [Idaho and Oregon]). This is slightly higher than the 2.3% during the 2017–18 school year and 2.1% in 2016–17. The percentage of kindergartners attending school within a grace period or provisionally enrolled among the 30 states reporting these data was 2.0% (range = 0.2% [Georgia] to 6.7% [Ohio]) (Table). Forty-four states could potentially achieve ≥95% MMR coverage if all nonexempt kindergartners, many of whom are within a grace period or provisionally enrolled, were vaccinated (Figure 2). Follow-up could assure all missing vaccinations are completed and all missing documentation of vaccination is provided to schools
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