Kindergarten enrollment reported by the 48 states and DC was approximately 10% lower than that reported for the 2019–20 school year by 48 states. ¶¶ Reported estimates are based on 3,187,569 of these kindergartners who were surveyed for vaccination coverage 3,337,916 for exemptions 2,467,326 for grace period and provisional enrollment 1,799,190 for documentation and 1,049,075 for compliance. During the 2020–21 school year, 3,520,205 children in 48 states and DC were reported by immunization programs as enrolled in kindergarten. §§ National estimates measure coverage and exemptions among all kindergartners, whereas medians measure the midpoint of state-level coverage regardless of population size. Vaccination coverage and exemption estimates were adjusted according to survey type and response rate. This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy. All counts were current as of the time of the assessment.** National estimates, medians, and summary measures include only U.S. This measure includes those with no documentation at all. Seventeen states reported the number of kindergartners who were out of compliance these kindergartners did not have complete documentation of having received all required vaccinations but were not eligible for provisional enrollment and did not have documented exemptions for the missing vaccinations. Thirty states and DC reported the number of kindergartners who had no documentation of any vaccinations or exemptions. Twenty-eight states reported the number of kindergartners who were attending school under a grace period (attendance without proof of complete vaccination or exemption during a set interval) or provisional enrollment (school attendance while completing a catch-up vaccination schedule). Hepatitis B and poliovirus vaccination coverage, not included in this report, are available at SchoolVaxView ( 2). Overall national and median vaccination coverage for the state-required number of doses of DTaP, MMR, and varicella vaccine are reported. During the 2020–21 school year, 47 states and DC reported coverage for all state-required vaccines among public and private school kindergartners ¶ 48 states and DC reported exemption data on public school kindergartners and 47 states and DC on private school kindergartners. CDC uses these counts to produce state-level and national-level estimates of vaccination coverage. Federally funded immunization programs work with departments of education, school nurses, and other school personnel to assess vaccination and exemption status of children enrolled in public and private kindergartens and to report unweighted counts, aggregated by school type, to CDC via a web-based questionnaire in the Secure Access Management System, a federal, web-based system that gives authorized personnel secure access to public health applications operated by CDC. To meet state and local school entry requirements, parents submit children’s vaccination or exemption documentation to schools, or schools obtain records from state immunization information systems. As schools continue to return to in-person learning, enforcement of vaccination policies and follow-up with undervaccinated students are important to improve vaccination coverage. The COVID-19 pandemic affected schools’ vaccination requirement and provisional enrollment policies, documentation, and assessment activities. Although 2.2% of kindergartners had an exemption from at least one vaccine, § an additional 3.9% who did not have a vaccine exemption were not up to date for MMR. Compared with the 2019–20 school year, vaccination coverage decreased by approximately one percentage point for all vaccines. Vaccination coverage † nationally was 93.9% for 2 doses of measles, mumps, and rubella vaccine (MMR) 93.6% for the state-required number of doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP) and 93.6% for the state-required doses of varicella vaccine. This report summarizes data collected for the 2020–21 school year by state and local immunization programs* on vaccination coverage among children in kindergarten in 47 states and the District of Columbia (DC), exemptions for kindergartners in 48 states and DC, and provisional enrollment or grace period status for kindergartners in 28 states. State and local school vaccination requirements serve to protect students against vaccine-preventable diseases ( 1).
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