1. 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

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

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

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

8. 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

9. 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

10. Percentage of Children Up to Date at Kindergarten School Entry, by Region, Colorado School Survey

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

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

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

14. 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

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

16. 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

17. 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

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

19. 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.

20. 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.

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

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

23. Colorado School Survey 2005/2006
Lane Wake