Top 5 Takeaways

1. Vaccination Coverage Decline: Coverage for all required vaccines was approximately 94%, about one percentage point lower than the previous school year.
2. Low Exemption Rates: The exemption rate remained low at 2.2% for the 2020–21 school year.
3. COVID-19 Impact: The pandemic caused disruptions that reduced reported enrollment, school response rates, and documentation.
4. State and Local Variations: Vaccination assessments varied by state due to differences in required vaccines, doses, and data collection methods.
5. Potential for Improvement: Increased follow-up with undervaccinated students can help mitigate the impact of COVID-19 disruptions and improve vaccination coverage.

Original Article Author and Citation

Corresponding Author

Ranee Seither, rseither@cdc.gov

Suggested Citation

Seither R, Laury J, Mugerwa-Kasujja A, Knighton CL, Black CL. Vaccination Coverage with Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2020–21 School Year. MMWR Morb Mortal Wkly Rep 2022;71:561–568. DOI: http://dx.doi.org/10.15585/mmwr.mm7116a1

Summary

This report summarizes vaccination coverage and exemption rates among kindergartners in the United States for the 2020–21 school year. Coverage for required vaccines was approximately 94%, a slight decrease from the previous year. The exemption rate remained low at 2.2%. The COVID-19 pandemic caused disruptions that affected enrollment, response rates, and documentation. Increased follow-up with undervaccinated students is recommended to improve vaccination coverage as schools return to in-person learning.

Methods

State immunization programs conducted annual assessments to monitor vaccination coverage among kindergartners. Data were collected from 47 states and the District of Columbia (DC) for vaccination coverage and from 48 states and DC for exemptions. The data were reported to the CDC via a web-based questionnaire. National estimates were produced using these data, and SAS software was used for analysis.

Discussion

Vaccination coverage among kindergartners was lower in the 2020–21 school year compared to the previous year, with coverage for MMR, DTaP, and varicella vaccines falling below the Healthy People 2030 target of 95%. The pandemic caused various barriers that limited the amount and quality of vaccination data collected. Despite these challenges, the exemption rate remained low. Increased outreach and follow-up with undervaccinated students are necessary to improve vaccination coverage.

Conclusion

The main takeaway is that vaccination coverage among kindergartners decreased slightly during the 2020–21 school year due to COVID-19 disruptions. However, the exemption rate remained low. Schools and immunization programs should focus on increasing follow-up with undervaccinated students to improve coverage as in-person learning resumes.

This has been your booster shot of MMWR Info! Please check back for more MMWR, Public Health, and Programming Tutorial content daily.