Immunization requirements of the top 200 universities: Implications for vaccine-hesitant families |
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| Affiliation: | 1. Wayne State University School of Medicine, United States;2. Yale School of Medicine, United States;1. ACCORDS (Adult and Child Center for Outcomes Research and Delivery Science), University of Colorado Anschutz Medical Campus and Children''s Hospital Colorado, Denver, Colo;2. Department of Family Medicine, University of Colorado Anschutz Medical Campus, Denver, Colo;3. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Denver, Colo;1. Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden;2. Department of Infectious Diseases, Central Hospital Kristianstad, J A Hedlunds väg 5, SE-291 85 Kristianstad, Sweden;3. Department of Clinical Sciences Lund, Section of Infectious Diseases, Lund University, Skåne University Hospital, SE-221 85 Lund, Sweden;4. Department of Laboratory Medicine, Section of Microbiology, Immunology and Glycobiology, Lund University, Lund, and Clinical Immunology and Transfusion Medicine, Region Skåne, Sweden;1. National Immunization Programme, Chinese Center for Disease Control and Prevention, China;2. Department of Epidemiology, School of Health Sciences, FIN-33014 University of Tampere, Finland;3. National Institute for Health and Welfare THL, Helsinki, Finland;1. HealthPartners Institute, Minneapolis, United States;2. Obstetrics and Gynecology, Yale University, New Haven, United States;3. Kaiser Permanente Northern California, Oakland, United States;4. Kaiser Permanente Southern California, Pasadena, United States;5. Center for Health Research, Kaiser Permanente Northwest, Portland, United States;6. Institute for Health Research, Kaiser Permanente Colorado and Department of Ambulatory Care Services, Denver Health, Denver, United States;7. Harvard Pilgrim Health Care Institute & Lee Harvard Medical School, Boston, United States;8. Group Health Cooperative, Seattle, United States;9. Centers for Disease Control and Prevention, Atlanta, United States;1. Partnership for Research on Ebola Vaccines in Liberia (PREVAIL), Liberia–US Joint Clinical Research Partnership Program, Sinkor, Montserrado County, Monrovia, Liberia;2. Incident Management System, Emergency Operations Center, Ministry of Health, Congo Town, Montserrado County, Monrovia, Liberia;3. Liberian Institute for Biomedical Research, Charlesville, Margibi County, Liberia;4. Ministry of Health, Congo Town, Montserrado County, Monrovia, Liberia |
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| Abstract: | BackgroundThe majority of pediatricians encounter vaccine hesitancy in their practices. As part of a broad discussion about vaccination, school requirements arise as a topic yet providers may lack information about the effects of immunization on university matriculation.MethodsWe surveyed the top-ranked 200 universities regarding required immunizations, medical, religious, and philosophical exemptions, and noncompliance policies. We examined the legal requirements for involved jurisdictions.ResultsOf 129 responding universities (64%), 94% had ≥1 pre-matriculation immunization requirement (PIR), with a mean of 3.53 (95%CI 3.17–3.89) requirements. In unadjusted analyses, funding, region, jurisdictional requirements, undergraduate size, and tuition were significant predictors of the number of PIRs. In multivariate modeling, jurisdictional requirements outperformed all other university demographics, but excluding these, Northeast and South region and smaller undergraduate size persisted. The most common PIR was measles (93%). 67% of involved jurisdictions have laws mandating ≥1 university PIR, and 45% of universities surpassed their jurisdiction’s law. With respect to medical, religious, and philosophical exemptions, 24%, 40%, and 60% of universities with PIRs had the highest hardship category, and 2%, 2%, and 46% disallowed these outright. Frequent responses to student noncompliance were: hold on classes (89%), additional registration fees (13%), and hold on housing (11%).ConclusionsRequirements for pre-matriculation immunizations in top universities are common and exemptions are difficult to obtain. Conversations between providers and vaccine-hesitant families may be enriched by discussion of these future effects of their decision on immunization. |
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| Keywords: | Student immunization College immunization requirements Immunization law Immunization exemption |
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