Immunization Grantees' Collection and Reporting of Kindergarten Vaccination and Exemption Data: Results From the 2010 Grantees Survey

Background: Among the responsibilities of the 317 Immunization Grant Program is the reporting of immunization and exemption data for children entering kindergarten.  Standards for collecting and reporting these data include measuring coverage according to state requirements and ACIP recommendations, using appropriate sampling methodologies, validating non-provider verified vaccination information, and determining kindergarten vaccination status by the end of the first semester in the school year.  Annual reports from grantees show that these standards are not followed consistently, making it difficult to conduct state-to-state comparisons of vaccination and exemption estimates.

Objectives: To develop an understanding of how kindergarten immunization and exemption data are currently collected and identify barriers and facilitators to the use of consistent methods to collect and report these data.

Methods: We conducted hour-long semi-structured telephone interviews with each of the 50 state grantees and four urban grantees (including Washington, D.C.). Questions included closed and open-ended questions related to a variety of topics. Emphasis was placed on the data collection process and data use.

Results: The process by which kindergarten immunization and exemption data are collected varies by state. Most grantees submit data compiled from multiple sources including immunization information systems; provider records; parent-held records signed by provider, and/or parent-held records without a provider’s signature. Only ten grantees submit data from one source. Thirty-three grantees receive data directly from schools; the remainder receives data from an intermediary (e.g., local health department or school district). The type of data (i.e., aggregate vs. student-level) transferred between the schools, intermediaries, and grantees also varies.

Conclusions: There is considerable variation among grantees in terms of the ways in which kindergarten immunization and exemption data are collected. Variations reflect a myriad of factors such as state politics, economics, the level of collaboration between health and education agencies, and states’ interpretation of the Family Educational Rights and Privacy Act (FERPA).