KEYWORDS:
Vaccine coverage, school surveys, immunization law

BACKGROUND:
School-based vaccination assessment surveys are conducted among children enrolled in licensed day care facilities and the Head Start program, and among children entering kindergarten or first grade annually by State Immunization Programs (IPs). These annual surveys comprise a surveillance system which monitors vaccination coverage among pre-school and school age children. Sixty-four immunization programs submit results from these surveys to the National Immunization Program (NIP). Results from these surveys are used to: identify under vaccinated children entering school; facilitate the implementation of newly recommended vaccines; document the proportion of children who are exempt from vaccinations; determine national levels of coverage; and monitor progress towards Healthy People 2010 objectives.

OBJECTIVE(S):
The overall goal of this project was to evaluate the surveillance system with regard to assessment of vaccination coverage among children entering kindergarten and first grade.

METHOD(S):
This evaluation used CDC’s Guidelines for Evaluating Surveillance Systems to collect and examined credible evidence about the system, including system stability, acceptability, usefulness, attributes, resources, and processes.

RESULT(S):
Results from school surveys have been reported to CDC since 1978, indicating a very stable surveillance system. Acceptability was indicated by a 6.8% increase in the proportion of states submitting annual reports from the 1998-99 to the 1999-2000 school year. Issues pertaining to data collection methodologies and timeliness of reporting were identified as problematic.

CONCLUSIONS(S):
As school based vaccination assessment surveys are used to ensure compliance with state laws, IPs (grantees) are encouraged to continue to conduct annual assessment surveys. Recommendations and strategies for improving this surveillance system at both state and national levels will be discussed.

LEARNING OBJECTIVES:
1) Describe the school based surveillance system,
2) List the uses of the surveillance system,
3) List and explain the major limitations of the system, and
4) Describe NIP’s approaches to improving the system.