title: Vaccination policies among health professional schools: evidence of immunity and allowance of vaccination exemptions.
abstract: OBJECTIVE To characterize health professional schools by their vaccination policies for acceptable forms of evidence of immunity and exemptions permitted. METHODS Data were collected between September 2011 and April 2012 using an Internet-based survey e-mailed to selected types of accredited health professional programs. Schools were identified through accrediting associations for each type of health professional program. Analysis was limited to schools requiring ≥1 vaccine recommended by the Advisory Committee on Immunization Practices (ACIP): measles, mumps, rubella, hepatitis B, varicella, pertussis, and influenza. Weighted bivariate frequencies were generated using SAS 9.3. RESULTS Of 2,775 schools surveyed, 75% (n=2,077) responded; of responding schools, 93% (1947) required ≥1 ACIP-recommended vaccination. The proportion of schools accepting ≥1 non-ACIP-recommended form of evidence of immunity varied by vaccine: 42% for pertussis, 37% for influenza, 30% for rubella, 22% for hepatitis B, 18% for varicella, and 9% for measles and mumps. Among schools with ≥1 vaccination requirement, medical exemptions were permitted for ≥1 vaccine by 75% of schools; 54% permitted religious exemptions; 35% permitted personal belief exemptions; 58% permitted any nonmedical exemption. CONCLUSIONS Many schools accept non-ACIP-recommended forms of evidence of immunity which could lead some students to believe they are protected from vaccine preventable diseases when they may be susceptible. Additional efforts are needed to better educate school officials about current ACIP recommendations for acceptable forms of evidence of immunity so school policies can be revised as needed.
authors: 1Centers for Disease Control and Prevention (CDC),National Center for Immunization and Respiratory Diseases (NCIRD),Immunization Services Division (ISD),Atlanta,GA,USA.
authors: Samantha B
authors: SB
authors: Dolan
authors: 2California Emerging Infections Program,Oakland,CA,USA.
authors: Tanya E
authors: TE
authors: Libby
authors: 1Centers for Disease Control and Prevention (CDC),National Center for Immunization and Respiratory Diseases (NCIRD),Immunization Services Division (ISD),Atlanta,GA,USA.
authors: Megan C
authors: MC
authors: Lindley
authors: 1Centers for Disease Control and Prevention (CDC),National Center for Immunization and Respiratory Diseases (NCIRD),Immunization Services Division (ISD),Atlanta,GA,USA.
authors: Faruque
authors: F
authors: Ahmed
authors: 1Centers for Disease Control and Prevention (CDC),National Center for Immunization and Respiratory Diseases (NCIRD),Immunization Services Division (ISD),Atlanta,GA,USA.
authors: John
authors: J
authors: Stevenson
authors: 1Centers for Disease Control and Prevention (CDC),National Center for Immunization and Respiratory Diseases (NCIRD),Immunization Services Division (ISD),Atlanta,GA,USA.
authors: Raymond A
authors: RA
authors: Strikas
mesh_terms: D002644:Chickenpox / Q000276:immunology / Q000517:prevention & control; D003625:Data Collection; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006509:Hepatitis B / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007109:Immunity; D007251:Influenza, Human / Q000276:immunology / Q000517:prevention & control; D008457:Measles / Q000276:immunology / Q000517:prevention & control; D009107:Mumps / Q000276:immunology / Q000517:prevention & control; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D012409:Rubella / Q000276:immunology / Q000517:prevention & control; D012576:Schools, Health Occupations / Q000458:organization & administration / Q000706:statistics & numerical data*; D013334:Students; D014611:Vaccination / Q000592:standards*; D014917:Whooping Cough / Q000276:immunology / Q000517:prevention & control
references: Vaccine. 2013 Jun 24;31(29):3009-13
references: 23664998
references: J Contin Educ Nurs. 2008 Sep;39(9):419-26
references: 18792608
references: MMWR Morb Mortal Wkly Rep. 2012 Jan 20;61(2):30-2
references: 22258416
references: Ann Intern Med. 1990 Oct 15;113(8):628-31
references: 2400169
references: MMWR Morb Mortal Wkly Rep. 2013 Sep 27;62(38):781-6
references: 24067582
references: JAMA. 1999 Mar 10;281(10):908-13
references: 10078487
references: J Infect Dis. 2011 Jun 1;203(11):1517-25
references: 21531693
references: J Allied Health. 2014 Spring;43(1):12-21
references: 24598895
references: MMWR Morb Mortal Wkly Rep. 2008 Jun 6;57(22):600-3
references: 18528316
references: J Pediatr. 1991 Aug;119(2):322-6
references: 1861223
references: N Engl J Med. 2006 Aug 3;355(5):447-55
references: 16885548
references: Emerg Infect Dis. 2010 Mar;16(3):426-32
references: 20202417
references: Infect Control. 1985 Apr;6(4):150-6
references: 3845926
references: J Am Geriatr Soc. 2009 Sep;57(9):1580-6
references: 19682118
references: MMWR Suppl. 2013 Feb 1;62(1):1
references: 23364301
references: MMWR Morb Mortal Wkly Rep. 2013 Aug 2;62(30):607-12
references: 23903595
references: MMWR Morb Mortal Wkly Rep. 2014 Feb 7;63(5):95-102
references: 24500288
references: Infect Control Hosp Epidemiol. 2004 Nov;25(11):967-73
references: 15566032
references: PLoS One. 2011;6(10):e26239
references: 22028840
references: Am J Infect Control. 2013 Jul;41(7):661-3
references: 23352075
references: MMWR Recomm Rep. 2011 Nov 25;60(RR-7):1-45
references: 22108587
references: Clin Infect Dis. 2014 Jan;58(1):50-7
references: 24046301
references: Ann Intern Med. 2011 Mar 15;154(6):391-400
references: 21403075
references: Arch Intern Med. 1990 Jan;150(1):44-6
references: 2297297
references: MMWR Morb Mortal Wkly Rep. 2013 Sep 13;62(36):741-3
references: 24025755