Learning Objectives for this Presentation:
1. Describe a method of collecting immunization data from schools.
2. Understand the limitations of schools self-reporting data versus an audit of records.


Background:
CDC required school immunization data can be used by states to identify pockets of need. In Colorado, data were self-reported by schools and accuracy was a concern. A method that sampled schools and children and required auditing of the child's immunization record was implemented during the 2005/2006 school year.

Objectives:
Accurately determine the immunization status of Colorado kindergartners.

Methods:
Schools were sampled from 5 regions. Local health audited a sample of 20 kindergarten immunization records from each school. Data collected included demographics, shot dates, exemptions and type of school staff assigned to immunizations.


Results:
Based on available records, 76.3 percent of children entering kindergarten had received the required vaccines. 56.4 percent had their records recorded on the required immunization certificate. Most who were not up to date had no information in their record as to why. Being born outside the USA was associated with not being up to date in two of the regions. A nurse onsite was associated with having more kindergartners up to date. Self reported data collected in the same time frame indicated 89.4% of kindergartners were up to date.

Conclusions:
Conventional wisdom in Colorado was that most children are up to date by the time they enter school. Kindergartners in Colorado may not be as up to date as previously self reported data had indicated. For children not up to date with no reason noted in the record (as identified by the audit data) school personnel believed these children were up to date on their immunizations and reported it as such in the self reported data