Immunization Status of Colorado Kindergartners Lane Wake, MS Marianne Koshak, MS Joni Reynolds, RN, CNS, MSN Colorado Department of Public Health and Environment Carol Stanwyck National Immunization Program The Centers for Disease Control and Prevention

Colorado School Survey Pockets of Need Grant Requirement Self report in past surveys New protocol

Colorado School Survey Sample of schools CO Dept of Education Contract with local health 124 schools in 34 health jurisdictions

Colorado School Survey Letter to all schools Authority to collect information Audit Records Access database Data Analyses

Northeast Western Slope Western Slope East Central Southeast Denver Metro Western Slope n = 450 Western Slope n = 450 East Central n = 456 Southeast n = 518

Up to Date at Entry into Kindergarten, Colorado School Survey, 2004-2005 5 diphtheria/tetanus/pertussis (DTaP) shots 4 polio shots 2 measles/mumps/rubella shots (MMR) 3 hepatitis B shots 1 varicella shot or history of having had varicella Each county returned their data to us Cleaned it up Analyzed it

Percentage of Children Up to Date at Kindergarten School Entry, by Region, Colorado School Survey 2004-2005

Immunization Record Type in School File, Colorado School Survey, 2004-2005

Percentage of Children Up to Date and with Exemptions, Colorado School Survey, 2004-2005

For Kindergartners NOT Up to Date, Percentage of Exemptions Taken, Colorado School Survey, 2004-2005

Percentage of Kindergartners Not Up to Date by Vaccine, Colorado School Survey 2004-2005 Of those not utd over 60% had not received MMR, about 58% nUTD on DTaP, about 50% not utd on polio – etc. For Hep B and Varicella if a child wasn’t up to date had not received 3 Hep B or 1 Varicella

Reasons Why MMR is Not Up to Date, School Survey 2004-2005

Reasons why DTaP is Not Up to Date, Colorado School Survey 2004-2005 *If 4th shot received after the 4th birthday the child is counted as up to date

Reasons Why Polio is Not Up to Date, Colorado School Survey 2004-2005 *If 3rd shot received after the 4th birthday the child is counted as up to date

Colorado School Survey – Variables Analyzed Age Gender Race Ethnicity Immunization Staff and time on site County of Birth

Percent of Children Up to Date by Staff and Time on Site, Colorado School Survey 2004-2005 We collected a lot of additional information to see if being utd was associated with some other factors such as gender, race, ethnicity, type of immunization staff at the school and the amt of time the staff spent at school and the country of birth. The only factor associated with being utd consistently across all the regions was having a school nurse on site and this was true whether the nurse was there daily or weekly. Kindergarteners were more likely to be utd if there was a school nurse on site daily, weekly or monthly as compared to having a clerk, secretary, clinic aide or health para assigned as the immunization staff person.

Comparison of Results from Self Reported and Audited School Survey Data, 2004-2005 Self reported indicated a higher percentage of kindergarteners utd The 11.7% of kids in audit data who were not utd when the shot data was analyzed and had no indication in their school record that they had taken an exemption makes up almost all the difference between the audit and self reported data. The probable conclusion here is that staff self reports these kids as utd, but when the shot record is audited and really examined it turns out the child was really not utd.

Colorado School Survey 2005/2006 Statewide Sample County Oversample Provider Check

Colorado School Survey 2005/2006 School Software Infinite Campus SASI Powerschool NIH grant

Colorado School Survey 2005/2006 Lane Wake 303-692-2631 lane.wake@state.co.us http://www.cdphe.state.co.us/dc/Immunization