title: An education in contrast: state-by-state assessment of school immunization records requirements.
abstract: OBJECTIVE
  We reviewed the complexities of school-related immunization policies, their relation to immunization information systems (IIS) and immunization registries, and the historical context to better understand this convoluted policy system.
  
  
  METHODS
  We used legal databases (Lexis-Nexis and Westlaw) to identify school immunization records policies for 50 states, 5 cities, and the District of Columbia (Centers for Disease Control and Prevention "grantees"). The original search took place from May to September 2010 (cross-referenced in July 2013 with the list on http://www.immunize.org/laws ). We describe the requirements, agreement with IIS policies, and penalties for policy violations.
  
  
  RESULTS
  We found a complex web of public health, medical, and education-directed policies, which complicates immunization data sharing. Most (79%) require records of immunizations for children to attend school or for a child-care institution licensure, but only a few (11%) require coordination between IIS and schools or child-care facilities.
  
  
  CONCLUSIONS
  To realize the full benefit of IIS investment, including improved immunization and school health program efficiencies, IIS and school immunization records policies must be better coordinated. States with well-integrated policies may serve as models for effective harmonization.
authors.affiliation: Erika M. Hedden and Amy B. Jessopare are with the Department of Health Policy and Public Health, University of the Sciences, Philadelphia, PA. Robert I. Field is with the School of Law and School of Public Health, Drexel University, Philadelphia, PA.
authors.forename: Erika M
authors.initials: EM
authors.lastname: Hedden
authors.forename: Amy B
authors.initials: AB
authors.lastname: Jessop
authors.forename: Robert I
authors.initials: RI
authors.lastname: Field
mesh_terms: D002648:Child; D002654:Child Care / Q000331:legislation & jurisprudence; D002675:Child, Preschool; D006291:Health Policy; D006801:Humans; D007223:Infant; D007256:Information Systems / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D012042:Registries; D012574:Schools / Q000331:legislation & jurisprudence*; D014481:United States; D014611:Vaccination / Q000331:legislation & jurisprudence*