School-Entry Vaccine Policies: States' Responses To Federal Recommendations Varied From Swift To Substantially...

Area of Science:

• Public Health
• Epidemiology
• Health Policy

Background:

• School-entry immunization requirements are critical for controlling vaccine-preventable diseases.
• Adolescent vaccinations, including tetanus, diphtheria, and acellular pertussis (Tdap) and meningococcal ACWY (MenACWY), are recommended by the Advisory Committee on Immunization Practices (ACIP).

Purpose of the Study:

• To examine the time lag between ACIP recommendations and state adoption of school-entry requirements for Tdap and MenACWY vaccines.
• To identify temporal patterns and variations in state-level immunization policies.

Main Methods:

• A legal epidemiological review of statutes, regulations, and state agency guidance was conducted for all 50 states and Washington, D.C.
• The time interval between ACIP recommendations and the effective dates of state school-entry policies was calculated through the 2023-24 school year.

Main Results:

• All 51 jurisdictions have Tdap school-entry requirements, while 36 have MenACWY requirements.
• Average delays between ACIP recommendations and state policy adoption were 4.94 years for Tdap, 9.61 years for MenACWY first dose, and 8.24 years for MenACWY booster.

Conclusions:

• Significant and varied delays exist in state adoption of school-entry requirements for Tdap and MenACWY vaccines.
• The heterogeneous nature of state policies suggests a need for ACIP to reassess the impact of these requirements on disease prevention across the U.S.