School-Based Vaccination Surveys of Kindergarten Children: The Importance of a Standardized Methodology

Background: Annually, school-based surveys are conducted to assess vaccination coverage rates among children entering school.  Currently, these surveys provide the most comprehensive assessment of vaccination coverage rates among kindergarten children because the assessment includes all states.  Using schools as the sampling frame has the advantage of providing coverage estimates in a cohort with close contact and therefore at an increased risk of disease transmission if left unvaccinated. Although all states conduct the kindergarten vaccination surveys, there is no standardized methodology across states.

Setting: U.S. 50 states and the District of Columbia (DC)

Population: Immunization programs in all 50 states and DC were surveyed about their methods for assessing vaccination coverage among kindergarteners.

Project Description: Annually, the Centers for Disease Control and Prevention (CDC) requires states and DC to review immunization records of children entering school in the fall, report the methodology used to collect the data and calculate vaccination coverage rates. These data are based on self-reports by the states and DC. The objectives of this poster are to present the current methodologies used by states to conduct their annual school-based vaccination survey and suggest ways to standardize this methodology in order to collect improved school vaccination data.  Standardization includes ensuring that the data source is a provider (physician, clinic, registry) and the methodology across states is comparable in other respects (sampling, timing, etc.). 

Results/Lessons Learned: Methodologies used to conduct school-based vaccination surveys need to be standardized across states and DC to obtain data that is comparable across states.  After reviewing the results, we have been able to identify areas for improvement in order to achieve comparability.  We have also been able to identify barriers for achieving standardized school vaccination assessment methodology across states (e.g., FERPA, resource constraints).