Improving school immunization rates may be as basic as record reconciliation and policy enforcement: a report from a rural Colorado public health/school district initiative.

The aim of this report was to assess the coverage rate of required immunizations for kindergarten-12 students in the Eagle County School District and to create a process for annual, district-wide immunization assessments to inform immunization campaigns. All kindergarten-12 student records were reviewed, and immunization rates during the 2012-2014 years were compiled. At baseline, only 2096 (34%) were in compliance with the Colorado School Immunization Law. After reconciliation of records and instituting a recall system in year 1 and enforcement of the Colorado School Immunization Law suspension rule in year 2, a total of 5862 (98.8%; P < .001) students were in compliance. Immunization rates for Eagle County School District students were unknown due to the lack of a process to assess a compliance rate and the lack of reconciliation of records. Although initially time-intensive, the project has impacted the community through the creation of a sustainable process of collecting and reporting student immunization records through a centralized state immunization registry.