Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T10:05:48.309Z Has data issue: false hasContentIssue false

Vaccination Policies Among Health Professional Schools: Evidence of Immunity and Allowance of Vaccination Exemptions

Published online by Cambridge University Press:  29 December 2014

Samantha B. Dolan*
Affiliation:
Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), Atlanta, GA, USA
Tanya E. Libby
Affiliation:
California Emerging Infections Program, Oakland, CA, USA
Megan C. Lindley
Affiliation:
Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), Atlanta, GA, USA
Faruque Ahmed
Affiliation:
Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), Atlanta, GA, USA
John Stevenson
Affiliation:
Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), Atlanta, GA, USA
Raymond A. Strikas
Affiliation:
Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD), Immunization Services Division (ISD), Atlanta, GA, USA
*
Address correspondence to Samantha Dolan, MPH, Immunization Services Division, Centers for Disease Control and Prevention, 1600 Clifton Road, MS A 19, Atlanta, GA 30333 ([email protected]).

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.

Infect Control Hosp Epidemiol 2014;00(0): 1–6

Type
Original Articles
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bonebrake, AL, Silkaitis, C, Monga, G, et al. Effects of mumps outbreak in hospital, Chicago, Illinois, USA, 2006. Emerg Infect Dis 2010;16:426432.CrossRefGoogle ScholarPubMed
2. Centers for Disease Control and Prevention. Hospital-acquired pertussis among newborns—Texas, 2004. MMWR Morb Mortal Wkly Rep 2008;57:600603.Google Scholar
3. Kuster, SP, Shah, PS, Coleman, BL, et al. Incidence of influenza in healthy adults and healthcare workers: a systematic review and meta-analysis. PLoS One 2011;6:e26239.CrossRefGoogle ScholarPubMed
4. Lemaitre, M, Meret, T, Rothan-Tondeur, M, et al. Effect of influenza vaccination of nursing home staff on mortality of residents: a cluster-randomized trial. J Am Geriatr Soc 2009;57:15801586.CrossRefGoogle ScholarPubMed
5. Wilde, JA, McMillan, JA, Serwint, J, Butta, J, O’Riordan, MA, Steinhoff, MC. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA 1999;281:908913.CrossRefGoogle ScholarPubMed
6. Weber, DJ, Rutala, WA, Orenstein, WA. Prevention of mumps, measles, and rubella among hospital personnel. J Pediatr 1991;119:322326.CrossRefGoogle ScholarPubMed
7. Maltezou, HC, Wicker, S. Measles in healthcare settings. Am J Infect Control 2013;41:661663.CrossRefGoogle Scholar
8. Ahmed, F, Lindley, MC, Allred, N, Weinbaum, CM, Grohskopf, L. Effect of influenza vaccination of health care personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clin Infect Dis 2013;58:5057.CrossRefGoogle ScholarPubMed
9. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention. Immunization of healthcare personnel: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011;60:145.Google Scholar
10. Immunization and infectious diseases objectives. U.S. Department of Health and Human Services website. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=23. Published 2012. Accessed January 22, 2013.Google Scholar
11. Williams, WW, Lu, PJ, O’Halloran, A, et al. Noninfluenza vaccination coverage among adults—United States, 2012. MMWR Morb Mortal Wkly Rep 2014;63:95102.Google ScholarPubMed
12. Centers for Disease Control and Prevention. Influenza vaccination coverage among healthcare personnel—United States, 2012–2013 influenza season. MMWR Morb Mortal Wkly Rep 2013;62:781786.Google Scholar
13. Matthews, E, Armstrong, G, Spencer, T. Pertussis infection in a baccalaureate nursing program: clinical implications, emerging issues, and recommendations. J Contin Educ Nurs 2008;39:419426.CrossRefGoogle Scholar
14. Poland, GA, Nichol, KL. Medical students as sources of rubella and measles outbreaks. Arch Intern Med 1990;150:4446.CrossRefGoogle ScholarPubMed
15. Storch, GA, Gruber, C, Benz, B, Beaudoin, J, Hayes, J. A rubella outbreak among dental students: description of the outbreak and analysis of control measures. Infect Control 1985;6:150156.CrossRefGoogle ScholarPubMed
16. Friedman, DS, Curtis, CR, Schauer, SL, et al. Surveillance for transmission and antibiotic adverse events among neonates and adults exposed to a healthcare worker with pertussis. Infect Control Hosp Epidemiol 2004;25:967973.CrossRefGoogle ScholarPubMed
17. Lindley, MC, Lorick, SA, Spinner, JR, et al. Student vaccination requirements of US health professional schools: a survey. Ann Intern Med 2011;154:391400.CrossRefGoogle ScholarPubMed
18. Libby, T. Student vaccination requirements of US health professional schools: a national survey. J Allied Health 2014;43:1221.Google ScholarPubMed
19. Centers for Disease Control and Prevention. Vaccination coverage among children in kindergarten—United States, 2012–2013 school year. MMWR Morb Mortal Wkly Rep 2013;62:607612.Google Scholar
20. Richards, JL, Wagenaar, BH, Van Otterloo, J, et al. Nonmedical exemptions to immunization requirements in California: a 16-year longitudinal analysis of trends and associated community factors. Vaccine 2013;31:30093013.CrossRefGoogle ScholarPubMed
21. Centers for Disease Control and Prevention. Measles—United States, January 1–August 24, 2013. MMWR Morb Mortal Wkly Rep 2013;62:741743.Google Scholar
22. ACHA guidelines: recommendations for institutional premarticulation immunizations. American College Health Association website. http://www.acha.org/publications/docs/ACHA_RIPI_April_2014.pdf. Published 2014. Accessed August 14, 2014.Google Scholar
23. Parker, AA, Staggs, W, Dayan, GH, et al. Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States. N Engl J Med 2006;355:447455.CrossRefGoogle ScholarPubMed
24. Centers for Disease Control and Prevention. Hospital-associated measles outbreak—Pennsylvania, March–April 2009. MMWR Morb Mortal Wkly Rep 2012;61:3032.Google Scholar
25. Chen, SY, Anderson, S, Kutty, PK, et al. Health care-associated measles outbreak in the United States after an importation: challenges and economic impact. J Infect Dis 2011;203:15171525.CrossRefGoogle ScholarPubMed
26. Centers for Disease Control and Prevention. Advisory Committee on Immunization Practices (ACIP) recommended immunization schedules for persons aged 0 through 18 years and adults aged 19 years and older—United States, 2013. MMWR Surveill Summ 2013;62(Supplement 1).Google Scholar
27. Poland, GA, Nichol, KL. Medical schools and immunization policies: missed opportunities for disease prevention. Ann Intern Med 1990;113:628631.CrossRefGoogle ScholarPubMed