Comparing School Immunization Exemptions to Registry Records

Background: It is relatively easy in Colorado to exempt from required school immunizations. There is suspicion that parents may take an immunization exemption rather than produce an immunization record at school registration.  This raises concern over the validity of  using school immunization records to characterize children’s immunization status.

Objectives: To determine if immunization exemptions identified in school records are consistent with immunization records in the Colorado Immunization Information System (CIIS).

Methods: Any child with and immunization exemption attending school in the Aurora Public School system was identified.  All immunization record data for that child were abstracted electronically.  Each of these children was compared to CIIS records to verify the exemption.

Results: For the 2008/2009 school year 679 children exempted from one or more vaccines.  Of those, 58% had an immunization record in CIIS.  . The number of children exempting varied by dose in the DTaP series; 101 from the first dose, 60 from the second dose, 7 from the third dose, 11 from the fourth dose, 76 from the fifth dose and 81 from the 6^th dose. Overall, Of the children with an exemption for DTaP, and a record in CIIS (n=305), 48% had a shot date recorded in CIIS when there was an exemption noted in the school record.  Similar analyses will be presented for each vaccine required by the Colorado School Law.

Conclusions: Exemptions noted in school records in Colorado may not accurately represent children who have truly exempted.  Parents may be claiming an exemptions rather than produce a written immunization record.