1. Comparing School Immunization Exemptions to Registry Records
Joni Reynolds, RN/CNS, MSN Lane Wake, MS Immunization Program Colorado Department of Public Health and Environment Mary Beth Rensberger Health Services Coordinator Aurora Public Schools

2. School Survey History Self report Rates hovered around 90%
Immunization Record Audits

3. Percent of Colorado Kindergartners Meeting Colorado School Immunization Regulations at School Entry by Series*, Antigen and Year, Colorado School Survey
* Up to Date is 5 DTaP, 2 MMR, 4 Polio, 3 Hepatitis B, 1 Varicella or a History of Disease

4. Percent of Kindergartners Claiming an Exemption by School Year, Colorado School Survey

5. Type of Exemption Claimed by Kindergartners, Colorado School Survey, 2005/2006-2007/2008

6. Children Attending Aurora Public Schools who took an Exemption in the 2008/2009 School Year
Total enrollment for APS is 35,523 students.
Data query using Infinite Campus software to select any child in APS district with an exemption for DTaP (Tdap), MMR, Polio or Hepatitis B
1,734 shots exempted from for 673 children for the 2008/2009 school year
2% of children exempted from required school immunizations

7. Of Children Claiming an Exemption Percent by School Grade (n=673), Aurora Public Schools 2008/2009

8. Of Children Claiming an Exemption (n=673) Percent by Type of Vaccine, Aurora Public Schools 2008/2009

9. Percent of Children by Number of Vaccines Exempted from (n=673), Aurora Public Schools 2008/2009

10. Number of Vaccines Exempted from (n=1,734) by Vaccine Type, Aurora Public Schools 2008/2009

11. Exemption Type (n=673) Aurora Public Schools 2008/2009

12. Exemption Type by Vaccine Exempted From, n=1734, APS District 2008/2009

13. Of Children Claiming an Exemption Percent by School Grade and Vaccine (n=673), APS District 2008/2009

14. Linking APS Exemption data to Colorado Immunization Information System (CIIS)
62% (n=422) of children who exempted in the APS database had a record in the Colorado Immunization Information System (CIIS)

15. Shots in APS data Compared to Percent with Record in CIIS by Number of Shots Administered
Vaccine
# in APS data
# in CIIS
# of Shots
Percent
DTaP
538
324 (60.2%)
> 4
50.9%
MMR
432
257 (59.5%)
> 2
38.9%
Polio
380
220 (57.9%)
> 3
26.8%
Hep B
384
225 (58.6%)
43.0%

16. Number of Shots Greater than Required Recorded in CIIS by Vaccine Exempted From
Percent
DTaP
> 5
11.7%
MMR
> 2
2.7%
Polio
> 4
4.5%
Hep B
> 3
5.7%

17. Overimmunized Child, Aurora Public Schools, 2008/2009

18. Adjusting APS Exemption Rates by Number of Children Up to Date in CIIS
# of kids exempt
School Exemption Rate (n=35,523)
Number of kids UTD in CIIS
Adjusted School Exemption Rate (n=35,523)
Percent
Difference
DTaP
538
1.51
172
1.00
33.8%
MMR
432
1.22
226
0.58
52.5%
Polio
380
1.07
220
0.45
57.9%
Hep B
384
1.08
245
0.39
63.9%
Overall
673
1.89
116
1.57
16.9%

19. Caveats
Immunization data are entered into Infinite Campus from the child’s record
Exemptions seem to be entered randomly in Infinite Campus – no relation to actual dose
Did not download the child’s full immunization history just the shots with an exemption.

20. Conclusions
Exemption data obtained from school records in Colorado is unreliable
Electronic data collection by schools may be unreliable in tracking accurate exemption information
Access to CIIS can assist schools in accurately determining a child’s immunization status

21. Questions? Lane Wake lane.wake@state.co.us 303-692-2631 Joni Reynolds