School vaccination assessments are used to provide information for the state and local institutions about who in their community has vaccine coverage or vaccine exemption. This assessment can provide explanations when looking at where there is a clustering of vaccine preventable diseases. It allows state/local institutions to develop campaigning strategies on where and how to target a particular group where we see a clustering of vaccine preventable infections.
An assessment like this was done on kindergartners entering the public school system year 2012-2013 in all 50 states by the CDC. The data was reported in the Morbidity and Mortality Weekly Report August 2, 2013.
While reviewing the data I came upon some very interesting facts. Over all as a nation we did very well with vaccination coverage this academic year, it was reported that vaccine coverage was about 95%, which is the national target coverage rate recommended by HEALTHY PEOPLE 20/20. The HEALTHY PEOPLE 20/20 recommend that the nation keep a 95% coverage level for "2 doses of MMR vaccine, 4 doses of DTaP† vaccine, and 2 doses of varicella vaccine"( MMWR 62(30);607-612). Nevertheless, the rest of the 5% of people that were not covered could pose a problem. We see that high vaccine exemption rates and low vaccination could cluster in communities and that could lead to the introduction of a vaccine preventable disease that could cause an outbreak and potentially harm a lot of people.
The data reported that among all 50 states and D.C vaccine exemption were allowed. Specifically 46/50 of the states allowed religious exemptions, 18/50 allowed philosophic exemptions and 2/50 (Mississippi and West Virginia) did not allow either religious or philosophic exemptions but they did allow other exemptions. Regardless of all of these exemptions, 48 states and D.C reported a 94.5% median coverage of the mandatory 2 dose MMR vaccine. This percentage ranged from (85.7% coverage in Colorado to 99.9% coverage in Mississippi). The median percentage for DTap vaccine was 95.1% ranging from (82.9% in Colorado to 99.9% in Mississippi). And lastly the median percentage for the 2 dose varicella was 93.8% ranging from (84.6% in Colorado to 99.9% in Mississippi). It is important to note that 91,453 out of 4,242,558 kindergarteners surveyed reported exemptions. This is valuable information when trying develop "health communication strategies to help parents understand the risks for vaccine-preventable diseases and the benefits of vaccinations to the health of their children and other
kindergarteners"(MMWR 62(30);607-612).
What this survey provided state/local programs with, was information on where a VPD outbreak could happen. The data reported in this article did have some data collecting set backs. For example, there were three different methods used to collect information. Those were a public census, a IIs immunization information systems, voluntary resopnse or combination of the three. There were no data for home schooled children. There was also another discrepancy with the data collection only 12/50 states were concordant with the CDC requirements for data collection and that at the time of collection some children were in the process of filling out their vaccine schedules and once they were compliant with the vaccine schedule this information was not updated in the data.
If you would like to take a look at the report and analyze the data for carefully click here. You will find the full report and data. This picture below is just a representation of the states that had more than one vaccine exemption for kindergartner in the academic year 2012-2013.
First Image: http://www.ubm1.org/vaccines.jpg
Article reference : "Vaccination Coverage Among Children in Kindergarten — United States, 2012–13 School Year." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 02 Aug. 2013. Web. 30 Oct. 2013. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm>.
This blog is full of great statistical facts! I actually didn't consider the percentage of people not vaccinated to be exempt from vaccination because of religious reasons. There was even philosophical exemption!. Although I wonder, because such a high percentage of people are already vaccinated could a small percentage of people no vaccinated pose a real threat? Do people think because everyone else is vaccinated they'll be safe and do no need to be vaccinated?
ReplyDeleteKaren, this is useful information not only on the institutional level but also on the guardian level, since it provides parents with their state’s vaccination track record. The table found in the report was really useful as well, because it provides the method of assessment. I’m sure there are some examples out there, but I am curious to see statistical data from this MMWR translated into a more attractive and simplified version, so as to target and inform a broader range of people in our society. Thanks again for sharing this, Karen.
ReplyDeleteI was surprise when I found out that West Virginia and Mississippi did not allow religious exemption. I assumed because America is such a "free country" that they would have religious exemption everywhere. I wonder why is that. Thanks for sharing!
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