2002 to present
Mode of Collection
Abstraction of school records to assess adherence to State vaccination requirements and the Advisory Committee on Immunization Practices (ACIP) recommended vaccinations among kindergarten children.
The Annual School Assessment Program is the only currently available source of vaccination coverage data among students attending kindergarten in the United States. These data are used to monitor compliance with school vaccination laws and to identify areas vulnerable to outbreaks of vaccine-preventable diseases due to increasing exemptions or other reasons for non-vaccination. Federally funded immunization programs partner with departments of education, school nurses, and other school personnel to assess vaccination coverage and exemption status of children enrolled in public and private kindergartens. In accordance with state and local school entry requirements, parents and guardians submit their children's vaccination records or exemption forms to schools, or schools obtain kindergarteners' records from their states' immunization information systems. Schools report vaccination coverage and exemption data to local or state health departments; state immunization programs report aggregated vaccination coverage and exemption data to the Centers for Disease Control and Prevention (CDC). CDC and the states use the data for national, state, and local assessment and follow-up.
Vaccination status (recommended doses) for measles, mumps, and rubella vaccine (MMR); diphtheria, tetanus, and acellular pertussis vaccine (DTaP); varicella vaccine; polio vaccine; and hepatitis B vaccine (Hep B). Vaccination exemptions by type (e.g., medical, religious, etc.).
Children enrolled in kindergarten.
School nurses or other designated individuals at the state or local level review school records or the state's Immunization Information System (IIS) and abstract vaccination information on all state-required vaccines and vaccines recommended by ACIP. In state and local areas, vaccination status and exemption information are collected from all schools or a random sample of schools, and from all children or a random sample of children within each school. Every year, state and local immunization grantees report an aggregate of these data to CDC via a web-based questionnaire.
Response Rates and Sample Size
During the 2017-2018 school year, 49 states reported data on coverage for all state-required vaccines among public school kindergarteners, while 48 states reported the same information among private school kindergarteners; 49 states also reported exemption data on public school kindergarteners and 48 on private school kindergarteners.
Data may not be directly comparable across state and local levels. States may not collect data from both public and private schools. Data collection may vary across states; states may review all school records, a sample of school records, or may use a combination of methods that include both school records and state and local registries. In addition, response rates for participating schools may vary across states.
Mellerson JL, Maxwell CB, Knighton CL, Kriss JL, Seither R, Black CL. Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year. MMWR Morb Mortal Wkly Rep 2018;67:1115–1122.