State and local vaccination requirements for school entry seek to protect schoolchildren from vaccine-preventable diseases.  But not all parents agree medicine is a good thing and the newest CDC results show what states are leading and what states are lagging in protection for kids.

Each year, to assess state and national vaccination coverage and exemption levels as children enter kindergarten, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. Their new report analyzed vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013–14 school year.  See the CDC report for details on how they normalized reporting from various states.

Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine, 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine, and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement.  The median total exemption rate was 1.8%.

Obviously, high exemption levels and suboptimal vaccination coverage leave children vulnerable to vaccine-preventable diseases. The target is 95% nationally under the Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine.

As has been noted in discussions about why some states have such poor vaccination levels, Mississippi leads the country in basic measles, mumps, and rubella (MMR) vaccination levels, while Colorado is at a low 81.7% level. But exemptions are the real problem, since they tell us whether or not people are poor and cannot afford health care or if they just deny their children medicine.

When it comes to exempting kids from vaccines, Oregon leads the nation with 7.1%.

In raw numbers, California had 17,253 non-medical exemptions, almost 3X the number two state, Michigan. Despite being the most populous state, they only had 1,017 medical exemptions. Mississippi had 17 of those, while Texas had 2,266.

Citation: Ranee Seither, MPH, Svetlana Masalovich, MS, Cynthia L Knighton, Jenelle Mellerson, MPH, James A. Singleton, PhD, Stacie M. Greby, DVM, Vaccination Coverage Among Children in Kindergarten — United States, 2013–14 School Year - Centers for Disease Control, October 17, 2014