Vaccination coverage among children in kindergarten — United States, 2014–15 School Year

State and local jurisdictions require children to be vaccinated before starting school to maintain high vaccination coverage and protect schoolchildren from vaccine-preventable diseases (1). State vaccination requirements, which include school vaccination and exemption laws and health department regulations, permit medical exemptions for students with a medical contraindication to receiving a vaccine or vaccine component and may allow nonmedical exemptions for religious reasons or philosophic beliefs. To monitor state and national vaccination coverage and exemption levels among children attending kindergarten, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage estimates in 49 states and the District of Columbia (DC) and vaccination exemption estimates in 46 states and DC that reported the number of children with at least one exemption among kindergartners during the 2014–15 school year. Median vaccination coverage* was 94.0% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 94.2% for the local requirements for diphtheria, tetanus, and acellular pertussis vaccine (DTaP); and 93.6% for 2 doses of varicella vaccine among the 39 states and DC with a 2-dose requirement. The median percentage of any exemptions† was 1.7%. Although statewide vaccination coverage among kindergartners was high during the 2014–15 school year, geographic pockets of low vaccination coverage and high exemption levels can place children at risk for vaccine-preventable diseases (2). Appropriate school vaccination coverage assessments can help immunization programs identify clusters of low coverage and develop partnerships with schools and communities to ensure that children are protected from vaccine-preventable diseases. Federally funded immunization programs work with health departments, education departments, school nurses, or other school personnel to assess the vaccination and exemption status (as defined by state and local school vaccination requirements) of children enrolled in public and private kindergartens. Among the 50 states and DC, 44 programs used an immunization information system as a source of data for their assessment.§ For the 2014–15 school year, the type of vaccination assessment varied: 29 programs used a census, including all kindergartners in all schools; two used a voluntary response¶ of schools; 10 used a sample**; and 10 used a mix of methods.†† Three states (Alaska, Kansas, and New Mexico) used a sample to collect vaccination coverage data and a census for exemption data. Two local areas (Houston, Texas; New York, New York) reported separately. Because these areas are represented in their respective state reports, the area-specific data are not included in the calculation of median MMR, DTaP, and varicella vaccine coverage and medical, nonmedical, and any exemption levels.§§