The Problem: Vaccine coverage for preventable disease is an essential public health goal. Healthy People 2020. Low vaccine coverage rates enable otherwise avoidable outbreaks of harmful diseases. CDC: Vaccines and Immunizations. A recent movement concerning the negative potential effects of immunization may lead to lower immunization rates and risks herd protection against vaccine-preventable diseases. Immunization Action Coalition (IAC); NIH, Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance.
The Law: State laws establish vaccination requirements for children attending primary public and private schools. All states provide medical exemptions and some states provide philosophical and religious exemptions CDC: Stat Vaccination Requirements. For examples of state immunization requirements for children attendance and program participation, see Mich. Admin. Code R 325.176 (Michigan), Neb. Admin. R. & Regs. Tit. 173, Ch. 4, § 002 (Nebraska), 77 Ill. Adm. Code 665.240 (Illinois), N.J.A.C. 8:57–4.16 (New Jersey)
The Evidence: An expert panel at The Community Guide systematically reviewed studies assessing the effect of vaccination requirements for child care, school and college attendance on increasing vaccination rates and decreasing rates of vaccine preventable diseases. The review identified 32 studies that implemented various study designs including before-after, retrospective-cohort, posttest only, and case control. Results showed an overall increase in vaccination rates by a median of 18%in states with implemented required vaccination laws. The incidence of measles and mumps was lower in U.S. states with vaccination requirements for school-aged children. Additionally, low incidence areas were more likely to enforce school entry laws and prevent participation by non-compliant children. The reviewers found sufficient evidence to conclude vaccination requirements for participation in childcare, school and college to be effective in increasing vaccination rates and decreasing rates of vaccine preventable diseases.
The Bottom Line: According to the reviewers of a Community Guide systematic review, there is sufficient evidence to conclude that vaccination compliance requirements for child care, school and college aged kids are effective in increasing vaccination rates and decreasing rates of vaccine preventable diseases.
Additional Information: A map providing k-12 and daycare immunization requirements, by state. Immunization Action Coalition. A Center for Disease Control (CDC) Report on State Vaccination Requirements.