BQ Journal Vol 48 - Q3 2022 - 13

Weekly / Vol. 71 / No. 16
Morbidity and Mortality Weekly Report
April 22, 2022
Vaccination Coverage with Selected Vaccines and Exemption Rates Among
Children in Kindergarten - United States, 2020-21 School Year
Ranee Seither, MPH1; Jessica Laury, MPH1,2; Agnes Mugerwa-Kasujja, MD1,3; Cynthia L. Knighton1; Carla L. Black, PhD1
State and local school vaccination requirements serve to
protect students against vaccine-preventable diseases (1). This
report summarizes data collected for the 2020-21 school year
by state and local immunization programs* on vaccination
coverage among children in kindergarten in 47 states and the
District of Columbia (DC), exemptions for kindergartners in
48 states and DC, and provisional enrollment or grace period
status for kindergartners in 28 states. Vaccination coverage†
nationally was 93.9% for 2 doses of measles, mumps, and
rubella vaccine (MMR); 93.6% for the state-required number
of doses of diphtheria, tetanus, and acellular pertussis vaccine
(DTaP); and 93.6% for the state-required doses of varicella
vaccine. Compared with the 2019-20 school year, vaccination
coverage decreased by approximately one percentage
point for all vaccines. Although 2.2% of kindergartners had
an exemption from at least one vaccine,§ an additional 3.9%
* Federally funded immunization programs are located in 50 states and DC, five
cities, and eight U.S territories and freely associated states (territories). Two
cities reported data to CDC, which were also included in data submitted by
their state. State-level data were used to calculate national estimates and medians.
Immunization programs in territories reported vaccination coverage and
exemptions; however, these data were not included in national calculations.
† National and median vaccination coverage was determined using estimates for
47 states and DC; Alaska, Illinois, and West Virginia did not report school
coverage data because of the impact of COVID-19 on data collection. Data
from cities were included with their state data. Data from territories were not
included in national and median calculations.
§ National and median exemption rates were determined using estimates for 48 states
and DC; Colorado, Minnesota, and Missouri did not collect information on the
number of kindergartners with an exemption but instead reported the number of
exemptions for each vaccine, which could count some children more than once. For
these states, the percentage of kindergartners exempt from the vaccine with the highest
number of exemptions (the lower bound of the potential range of exemptions) was
included in the national and median exemption rates. Washington was unable to
deduplicate students with both religious and philosophical exemptions, so the
nonmedical exemption type with the highest number of kindergartners (the lower
bound of the potential range of nonmedical exemptions) was included in the national
and median exemption rates for nonmedical exemptions. Illinois and West Virginia
did not report school vaccine exemption data because of the impact of COVID-19
on data collection. Data from cities were included with their state data. Data from
territories were not included in national estimates.
who did not have a vaccine exemption were not up to date for
MMR. The COVID-19 pandemic affected schools' vaccination
requirement and provisional enrollment policies, documentation,
and assessment activities. As schools continue to return
to in-person learning, enforcement of vaccination policies
and follow-up with undervaccinated students are important
to improve vaccination coverage.
To meet state and local school entry requirements, parents
submit children's vaccination or exemption documentation
to schools, or schools obtain records from state immunization
information systems. Federally funded immunization
programs work with departments of education, school nurses,
and other school personnel to assess vaccination and exemption
status of children enrolled in public and private kindergartens
and to report unweighted counts, aggregated by school type,
to CDC via a web-based questionnaire in the Secure Access
Management System, a federal, web-based system that gives
authorized personnel secure access to public health applications
operated by CDC. CDC uses these counts to produce
state-level and national-level estimates of vaccination coverage.
INSIDE
569 Poisoning Associated with Consumption of a
Homemade Medicinal Liquor - Chongqing,
China, 2018
574 Hospitalizations of Children Aged 5-11 Years with
Laboratory-Confirmed COVID-19 - COVID-NET,
14 States, March 2020-February 2022
582 QuickStats
Continuing Education examination available at
https://www.cdc.gov/mmwr/mmwr_continuingEducation.html
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Diagnostics I Pharmaceuticals I DxRx Solutions I Continuing Education I News
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A Henry Schein Publication

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BQ Journal Vol 48 - Q3 2022

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