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Friday August 10 5:28 PM ET
State Law Improves Teen Immunization Rate
ATLANTA (Reuters Health) - A law requiring California
middle school students to have documented receipt of immunizations has
increased vaccination rates, especially the hepatitis B vaccination rate,
according to a report from the Centers for Disease Control and Prevention
(CDC).
In the US, 43 states have developed middle school entrance
requirements or laws requiring that students have one or more of up to four
recommended vaccines. These include hepatitis B, measles-containing vaccine
(MCV), varicella, and tetanus-diphtheria.
In 1997, the CDC began collaborating with the Pre-Teen
Health Project in San Diego, California, to evaluate the impact of the law,
which required that students entering 7th grade on or after July 1,
1999 have documented receipt of a series of three hepatitis B shots and two
doses of MCV.
CDC researchers used three different analyses to assess
the impact of the law, which affected nearly 500,000 California students during
the 1999-2000 school year.
They estimated baseline immunization in 5th and
6th graders in San Diego County by telephone survey, collected
reports of student immunizations required from the schools by the State of
California, and reviewed vaccination records in randomly selected schools
statewide.
The baseline telephone survey of 741 households, conducted
in 1998, found that 70% had received MCV, 16% had received hepatitis B, and 13%
had received both vaccines.
During October 1999, after documentation of vaccination
was required, data collected from all 315 San Diego County Schools with 7th
graders indicated that 93% of students had received MCV, and 68% had received
hepatitis B vaccine.
“When school entrance requirements are enforced, high
vaccination can be achieved,” the CDC researchers write in the August 10th
issue of the Morbidity and Mortality Weekly Report.
“There was a very large increase in hepatitis B coverage
as a result of this law,” Dr. Fishbein, with the CDC’s National Immunization
Program, told Reuters Health. “This is probably one of the largest increases we’ve
seen in such a short period of time anywhere in the US,” he said. “We were very
happily surprised by that large of an increase.”
Fishbein pointed out that perhaps the hardest part of
enforcing this law is that, at some point, you need to be willing to exclude
children who are not up to date on their vaccination schedule. But he said that
“the parents were given a tremendous amount of warning and we feel it does a
tremendous amount of good.”
He added, “Without the law, it just couldn’t have been done.”
Currently, CDC does not have a formal position on laws
requiring vaccinations. “We believe they are effective, but it’s really up to
the states to decide between the difficulty of enforcing the law and the benefits
in improving health,” Fishbein stated.
SOURCE: Morbidity and Mortality Weekly Report
2001;50:660-662.
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