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Most U.S. kindergartners in the 2017–18 school year had their required shots: median coverage was 95.1% for DTaP (diphtheria, tetanus and pertussis), 94.3% for two doses of MMR (measles, mumps and rubella) and 93.8% for two doses of varicella (chickenpox). But the share of children with an exemption from at least one vaccine rose for the third year in a row — and many children who weren't fully vaccinated had no exemption at all, meaning they could have been caught up.
Kindergartners up to date with MMR, exempt from one or more vaccines, or neither, in selected states, 2017–18. Credit: CDC, Morbidity and Mortality Weekly Report*.*
The numbers
| 2017–18 kindergartners | Median | Range across states |
|---|---|---|
| 2 doses of MMR | 94.3% | 81.3% (District of Columbia) to 99.4% or more (Mississippi) |
| DTaP, state-required doses | 95.1% | |
| 2 doses of varicella | 93.8% | |
| Exemption from 1 or more vaccines | 2.2% (2.0% in 2016–17) | 0.1% (Mississippi) to 7.6% (Oregon) |
| In a grace period or provisionally enrolled | 1.8% | 0.2% (Georgia, Hawaii) to 8.5% (Arkansas) |
Twenty-three states reported MMR coverage of 95% or higher; three states and the District of Columbia were below 90%. The number of states at or above 95% rose from 20 to 23 for MMR, 23 to 25 for DTaP and 15 to 17 for varicella compared with 2016–17.
Children who could catch up
Some children attend school while catching up — provisionally enrolled, or within a grace period before proof of vaccination is due. In 11 of the 28 states reporting such data, these children outnumbered those with exemptions. Of the 26 states and DC with MMR coverage below 95%, 20 could reach 95% if all their nonexempt, undervaccinated students were vaccinated.
The need is real: the share of children reaching age 2 with no vaccinations at all rose from 0.9% of those born in 2011 to 1.3% of those born in 2015, and state data suggest some children undervaccinated as toddlers still hadn't caught up by kindergarten — which is why school-entry requirements matter.
What worked
- Pennsylvania cut its provisional enrollment period from 240 days to 5, with a medical certificate showing missing doses were scheduled.
- Indiana issued school report cards on kindergarten coverage and linked its immunization information system both ways, increasing the data in it.
- Kentucky dropped the provider-signature requirement on printed immunization certificates, letting school nurses use the registry certificate.
- Virginia had more local health departments run back-to-school clinics, most following up with parents about missing shots beforehand.
Why exemptions are rising
The data can't say. Easier exemption procedures or parental vaccine hesitancy may play a part. Reported exemptions don't show whether a child skipped one vaccine or all, and earlier studies found most exempt children have had at least some vaccines.
How the data were gathered
State immunization programs work with education departments and school nurses to check vaccination records or exemption forms for kindergartners in public and private schools. In 2017–18, 49 states and DC reported coverage — about 3,988,127 kindergartners — using a census, a sample, voluntary school responses or a mix. Methods, requirements and definitions vary by state, documentation may be missing or wrong, and exemption and grace-period medians cover fewer states.
Sources
Based on Jenelle L. Mellerson, Choppell B. Maxwell, Cynthia L. Knighton, et al., "Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year," Morbidity and Mortality Weekly Report, volume 67, Centers for Disease Control and Prevention; a work of the United States government in the public domain. CDC later published an erratum to the report. State data are on CDC's SchoolVaxView.
Licencia: CC0 1.0 (dominio público) · Adaptado de www.cdc.gov
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