The EPE Research Center conducted an analysis of state vaccination policy data from the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases for seven immunizations commonly required for entry into kindergarten. These vaccinations include: diphtheria, tetanus, pertussis—also known as whooping cough (DtaP); hepatitis A; hepatitis B; measles, mumps, rubella (MMR); measles (dose 2); polio; and varicella—also known as chickenpox. Most states (44) require five or six shots. Only three states—Nevada, Texas, and Utah—require all seven vaccinations for incoming kindergarteners.
The EPE analysis included vaccines for which states have requirements, even if states also permit individual exemptions to those requirements. For example, state law may allow students to claim exemption based on religious or philosophical beliefs, or to forgo immunizations with a simple waiver from a guardian. Students may be also be exempt if they provide documentation showing that immunizations would aggravate an existing disease or condition. The results of a study published in the Oct. 11, 2006, issue of Journal of the American Medical Association have led some experts to believe that lenient exemption policies pose a considerable threat to public health.
Regardless of the provisions of state law, the enforcement of these policies is largely the responsibility of local districts. Enforcement can be complicated by parental non-compliance and incomplete or dated vaccination records. (“Vaccination Policies Fall on Schools’ Shoulders,” Jan. 24, 2007.) Also, parents’ inability to procure vaccinations due to increased cost may pose further problems, according to a study published in the Aug. 8, 2007, issue of Journal of the American Medical Association.