BQ Journal Vol 48 - Q3 2022 - 14

Morbidity and Mortality Weekly Report
During the 2020-21 school year, 47 states and DC reported
coverage for all state-required vaccines among public and
private school kindergartners;¶ 48 states and DC reported
exemption data on public school kindergartners and 47 states
and DC on private school kindergartners. Overall national and
median vaccination coverage for the state-required number
of doses of DTaP, MMR, and varicella vaccine are reported.
Hepatitis B and poliovirus vaccination coverage, not included
in this report, are available at SchoolVaxView (2). Twenty-eight
states reported the number of kindergartners who were attending
school under a grace period (attendance without proof of
complete vaccination or exemption during a set interval) or
provisional enrollment (school attendance while completing a
catch-up vaccination schedule). Thirty states and DC reported
the number of kindergartners who had no documentation of
¶ Nine states reported coverage and exemption data for at least some homeschooled
kindergartners. Alaska and North Dakota reported some homeschool data
separately. California included data for students who attend virtual, partial, or
full charter schools with some or all online instruction and students receiving
individualized education program services who are medically unable to attend
school in public school data. California also included data for homeschools
with six or more students in private school data. Montana reported
homeschooled students in public school data if the students also attend classes
or extracurricular activities at a public school. New Mexico and Pennsylvania
included all homeschooled students in public school data. Oregon reported
data for students enrolled in exclusively online homeschool programs separately;
online students of otherwise traditional public schools were included in public
school data. South Carolina and Wisconsin include homeschooled students in
their public and private school data if the students also attend classes,
extracurricular activities, or have other contact with a school.
any vaccinations or exemptions. Seventeen states reported the
number of kindergartners who were out of compliance; these
kindergartners did not have complete documentation of having
received all required vaccinations but were not eligible for
provisional enrollment and did not have documented exemptions
for the missing vaccinations. This measure includes those
with no documentation at all. All counts were current as of
the time of the assessment.** National estimates, medians,
and summary measures include only U.S. states and DC. This
activity was reviewed by CDC and was conducted consistent
with applicable federal law and CDC policy.††
Vaccination coverage and exemption estimates were adjusted
according to survey type and response rate.§§ National estimates
measure coverage and exemptions among all kindergartners,
whereas medians measure the midpoint of state-level
** Assessment date varied by state and area. Four states were assessed on the first
day of school; 13 states were assessed by December 31; 17 states and DC were
assessed by some other date, ranging from 30 days after admission to June 23,
2021; and 16 states were assessed on a rolling basis. Maryland ended data
collection early because of COVID-19 response activities.
†† 45 C.F.R. part 46.102(l)(2), 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d);
5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.
§§ A majority of immunization programs that used census or voluntary response
provided CDC with data aggregated at the state or local (city or territory)
level. Coverage and exemption data based on a census or voluntary response
were adjusted for nonresponse using the inverse of the response rate, stratified
by school type (public, private, and homeschool, where available). Programs
that used complex sample surveys provided CDC with deidentified data
aggregated at the school or county level for weighted analysis. Weights were
calculated to account for sample design and adjusted for nonresponse for data
collected through complex sample design wherever possible.
The MMWR series of publications is published by the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA 30329-4027.
Suggested citation: [Author names; first three, then et al., if more than six.] [Report title]. MMWR Morb Mortal Wkly Rep 2022;71:[inclusive page numbers].
Centers for Disease Control and Prevention
Rochelle P. Walensky, MD, MPH, Director
Debra Houry, MD, MPH, Acting Principal Deputy Director
Daniel B. Jernigan, MD, MPH, Deputy Director for Public Health Science and Surveillance
Rebecca Bunnell, PhD, MEd, Director, Office of Science
Jennifer Layden, MD, PhD, Deputy Director, Office of Science
Leslie Dauphin, PhD, Director, Center for Surveillance, Epidemiology, and Laboratory Services
MMWR Editorial and Production Staff (Weekly)
Charlotte K. Kent, PhD, MPH, Editor in Chief
Brian A. King, PhD, MPH, Executive Editor
Jacqueline Gindler, MD, Editor
Paul Z. Siegel, MD, MPH, Associate Editor
Mary Dott, MD, MPH, Online Editor
Terisa F. Rutledge, Managing Editor
Teresa M. Hood, MS, Lead Technical Writer-Editor
Leigh Berdon, Glenn Damon, Soumya Dunworth, PhD,
Tiana Garrett-Cherry, PhD, MPH, Srila Sen, MA,
Stacy Simon, MA, Jesse Sokolow, Morgan Thompson,
Technical Writer-Editors
MMWR Editorial Board
Timothy F. Jones, MD, Chairman
Matthew L. Boulton, MD, MPH
Carolyn Brooks, ScD, MA
Jay C. Butler, MD
Virginia A. Caine, MD
Jonathan E. Fielding, MD, MPH, MBA
David W. Fleming, MD
William E. Halperin, MD, DrPH, MPH
Jewel Mullen, MD, MPH, MPA
Jeff Niederdeppe, PhD
Celeste Philip, MD, MPH
Patricia Quinlisk, MD, MPH
Patrick L. Remington, MD, MPH
Carlos Roig, MS, MA
William Schaffner, MD
Morgan Bobb Swanson, BS
Abbigail Tumpey, MPH
Martha F. Boyd, Lead Visual Information Specialist
Alexander J. Gottardy, Maureen A. Leahy,
Julia C. Martinroe, Stephen R. Spriggs, Tong Yang,
Visual Information Specialists
Quang M. Doan, MBA, Phyllis H. King,
Terraye M. Starr, Moua Yang,
Information Technology Specialists
Ian Branam, MA,
Acting Lead Health Communication Specialist
Shelton Bartley, MPH, Leslie Hamlin,
Lowery Johnson, Amanda Ray,
Health Communication Specialists
Will Yang, MA,
Visual Information Specialist
562
MMWR / April 22, 2022 / Vol. 71 / No. 16
US 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
BQ Journal Vol 48 - Q3 2022

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