Vaccine Coverage Rates for Kindergartners: Some States Tightening Vaccination Exemptions

Vaccination coverage among children in kindergarten, in the 2012-13 school year is approaching the People 2020 goal of 95 percent, but rates among states vary significantly. For instance, MMR vaccine coverage among kindergartners ranged from 85.7 percent in Colorado to more than 99.9 percent in Mississippi. States with lower rates of vaccine coverage have begun to re-examine their laws on parental exemptions and tighten the requirements. California, Colorado, Oregon, Vermont, and Washington are highlighted. 

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Each year, the Centers for Disease Control and Prevention releases statistics on vaccination coverage among children in kindergarten. The numbers for the 2012-13 school year demonstrate that the national median rate is approaching the People 2020 goal of 95 percent vaccination coverage, but rates among states vary significantly. 

  • Forty-eight states and the District of Columbia reported vaccination coverage medians of 94.5 percent for the measles, mumps and rubella (MMR) vaccine, 95.1 percent for the diphtheria, tetanus and pertussis (DTaP) vaccine and 93.8 percent for the varicella (chickenpox) vaccine.
  • MMR vaccine coverage among kindergartners ranged from 85.7 percent in Colorado to more than 99.9 percent in Mississippi.
  • Four other states and five territories—Arkansas, Idaho, North Dakota, Pennsylvania, Guam, N. Mariana Islands, Palau, Puerto Rico and the Virgin Islandshave MMR vaccine coverage rates below 90 percent.
  • Twenty states have met the People 2020 goal of 95 percent coverage for MMR vaccine for kindergartners.
  • For the other two required vaccines, DTaP and varicella, the same five states post low rates.
  • Twenty-seven states meet the People 2020 goal of 95percent coverage for the DTaP vaccine and 20 states meet the goal for the varicella vaccine. 

A child may not be fully immunized for a host of reasons, one of which is exemptions, for which the CDC collects data.

  • All states allow exemptions from vaccine requirements for medical reasons.
  • Nonmedical exemptions are allowed for religious reasons in 46 states and for philosophic reasons in 18 states. Mississippi and West Virginia do not allow either nonmedical exemptions.
  • Parental concerns about immunizations, especially the MMR vaccine, were fueled by a now discredited 1998 British study by Dr. Andrew Wakefield that attempted to link the vaccine to autism.1

States with lower rates of vaccine coverage have begun to re-examine their laws on parental exemptions and tighten the requirements.

  • After Washington state enacted a 2011 law requiring a physician’s signature for children to be exempt from vaccination requirements, the state’s exemption rate fell by one-fourth.2 The law’s passage followed the worst outbreak of whooping cough in 50 years in any state. In the most recent CDC data, the overall exemption rate for the 2012-13 school year was 4.6 percent, down from 4.7 percent the year before.
  • California adopted legislation in 2012 to make the personal belief exemption more restrictive. Effective Jan. 1, 2014, parents, guardians or emancipated minors must obtain the signature of their health care practitioner to obtain the exemption. Gov. Jerry Brown also issued an executive order directing the health department to include a separate religious exemption on the new form.3
  • In Oregon, beginning June 26, 2014, parents will need to watch an educational video prepared by the state on the benefits and risks of immunization before a health care professional can sign the exemption form.4
  • Vermont in 2012 adopted Act 157, which requires parents who hold religious beliefs or philosophical convictions opposed to immunizations to review state prepared educational materials on adverse reactions, as well as the risks to other populations that cannot be immunized.5
  • Colorado in 2013 completed a report on immunization exemptions led by the Colorado Department of Public Health and Environment. The report outlined recommendations to make it harder to receive a personal belief exemption for a vaccination.6

References:

1 Editorial, “Wakefield’s article linking MMR vaccine and autism was fraudulent.” BMJ. Jan. 6, 2011.
2 Sabrina Tavernise. “Washington State Makes it Harder to Opt Out of Immunizations.” New York Times. Sept. 19, 2012. 
3 National Vaccine Information Center. “California State Vaccine Requirements.” Accessed Jan. 17, 2014.
4 Statesman Journal. “Oregon Rings in New ’14 Laws.” Dec. 29, 2013. 
5 Center for American Progress. “The Effect of Childhood Vaccine Exemption on Disease Outbreaks.” Nov. 14, 2013.
6 Summit Daily. “Colorado health organizations recommend making it harder to opt-out of vaccinations.” Jan. 12, 2014. 

 

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