Infectious Disease

The vaccine clearance fee continues to stagnate amongst US kindergarten academics

January 21, 2021

2 min read

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The national vaccine exemption rate in children who started kindergarten in the 2019-2020 school year was 2.5% from at least one vaccine, the same rate as last year, new data published in the MMWR showed.

Ranee Seither, MPH, epidemiologist in the Immunization Services division of the CDC, and colleagues reported on vaccine coverage for U.S. kindergarten teachers in 48 states, vaccination exemptions in 49 states, and the status of provisional registration and grace periods in 28 states.

The reported estimates for the 2019-2020 school year were based on 3,675,882 kindergarten teachers who were screened for vaccination protection, 3,914,961 for exemptions and 2,955,220 for grace period and provisional enrollment in a total of 4,025,574 children who were screened for vaccination programs in 49 States were enrolled in kindergarten. Since then, and colleagues noted that the 2019-2020 school year was more than halfway through before students switched to virtual learning due to the COVID-19 pandemic.

Nationally, the vaccination rate for both doses of MMR was 95.2% (range = at least 86.6% in Alabama to at least 99.1% in Mississippi). Twenty states reported coverage of at least 95%, while three reported coverage of less than 90%. The authors reported that 2.3% of kindergarten teachers were not up to date on MMR vaccinations and were not exempted.

The vaccination rate was 94.9% (range = 84% in Indiana to at least 99.1% in Mississippi) for the federally mandated number of DTaP doses. As with MMR, 20 states reported coverage of at least 95% and three states reported coverage of less than 90%.

In terms of the number of doses of varicella required by the state, coverage was 94.8% (range = at least 86.6% in Alabama to at least 99.1% in Mississippi), with 21 states having at least 95% coverage and four states having coverage of at least 95% reported less than 90%.

The unchanged 2.5% immunization clearance rate for one or more required vaccines ranged from 0.1% in New York and West Virginia to 7.6% in Idaho. Nationwide, 0.3% of children had a medical exemption and 2.2% had a non-medical exemption.

The percentage of kindergarten attendants with grace or provisional enrollment in 28 states where data was reported was 1.6% (range = less than 0.1% in Hawaii and Mississippi to 6.1% in Ohio).

The authors found that of the 28 states with less than 95% MMR coverage, 24 could potentially increase their coverage rate to at least 95% if all non-exempted kindergarten teachers were vaccinated.

The authors reported an increase in MMR coverage in 26 states during the 2019-2020 school year due to a decrease in the percentage of kindergarten teachers who were not up to date on MMR and had no exception this school year compared to 2018-2019 year .

MMR coverage in three states – Illinois, North Carolina, and South Carolina – rose to at least 95% between 2019 and 2020. During the 2018-2019 school year, all three states reported coverage of less than 95%.

“Schools and vaccination programs can work together to ensure that undervaccinated students are covered by vaccinations in preparation for return to face-to-face learning,” wrote Seither and colleagues. “This follow-up is especially important in the current school year, where under-vaccination is likely to be higher due to vaccination disorders during the ongoing COVID-19 pandemic.”

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