Daily Dose: US Childhood Vaccination Exemption Rate Unprecedented in 2022-23

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On December 13, 2023, we reported on findings from a recent report from the US Centers for Disease Control and Prevention (CDC) on vaccination coverage and exemptions to vaccination among kindergartners in the US.

The analysis

Researchers conducted a retrospective study to evaluate coverage and exemptions of school-required vaccines among kindergartners in the US for the 2022-23 school year. They aimed to determine the impact of the COVID-19 pandemic on vaccine administration. Data for this analysis were sourced from state and local immunization programs and reported to the CDC. Investigators assessed national- and state-level estimates of exemptions and coverage for several vaccines, including measles, mumps, and rubella (MMR); diphtheria, tetanus, and acellular pertussis (DTaP); poliovirus (polio); and varicella virus (VAR), according to the study.

A total of 3 832 381 children were enrolled in kindergarten in 2022-23. Overall, 3 559 366 children were assessed for vaccine coverage, 3 711 948 were assessed for vaccine exemptions, and 2 683 880 were assessed for grace period and provisional enrollment status, noted researchers.

The findings

During the 2022–23 school year, coverage remained near 93% for all reported vaccines, ranging from 92.7% for DTaP to 93.1% for MMR and polio. The exemption rate increased 0.4 percentage points to 3.0%. Exemptions increased in 41 states, exceeding 5% in 10 states.

Clinical implications

"Exemptions >5% limit the level of achievable vaccination coverage, which increases the risk for outbreaks of vaccine preventable diseases. Vaccination before school entry or during provisional enrollment periods could reduce exemptions resulting from barriers to vaccination during the COVID-19 pandemic."

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