Mohanty Salini, Delamater Paul, Feemster Kristen, Buttenheim Alison M
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Department of Geography and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Hum Vaccin Immunother. 2020 May 3;16(5):1166-1170. doi: 10.1080/21645515.2019.1673120. Epub 2019 Nov 5.
In March 2017, the Pennsylvania Department of Health reduced the time allowed to demonstrate compliance with school-entry vaccination requirements from eight months to five days. We describe changes in provisional enrollment, vaccine exemptions, and vaccine coverage rates before and after the new regulation. Across Pennsylvania, provisional enrollment decreased from 11.1% in 2016/17 to 2.5% in 2017/18 (77% relative decrease). Personal belief exemptions continued a modest upward trend, similar to previous years, and medical exemptions remained steady. Among kindergartners, coverage with ≥ 2 doses of MMR vaccine and 2 doses of Varicella vaccine increased; similar increases were seen for the MCV and Tdap vaccines among 7th graders. However, improvements in coverage and reductions in provisional enrollment were not consistent across counties. Provisional enrollment in Philadelphia County during the 2017/18 school year (10.4%) did not substantially decrease. The statewide reduction in provisional enrollment suggests that the new regulations accomplished the goal of increasing the proportion of students who are up-to-date on required vaccines at the beginning of the school year without a significant increase in vaccine exemptions. However, the persistence of high provisional enrollment in some counties points to additional barriers to this goal in some schools and regions.
2017年3月，宾夕法尼亚州卫生部将证明符合入学疫苗接种要求的允许时间从八个月缩短至五天。我们描述了新规定前后临时入学、疫苗豁免和疫苗接种覆盖率的变化。在宾夕法尼亚州，临时入学率从2016/17学年的11.1%降至2017/18学年的2.5%（相对下降77%）。个人信仰豁免继续呈适度上升趋势，与前几年类似，医疗豁免保持稳定。在幼儿园儿童中，≥2剂麻疹、腮腺炎和风疹（MMR）疫苗和2剂水痘疫苗的接种率有所提高；七年级学生中脑膜炎球菌结合疫苗（MCV）和破伤风、白喉、非细胞百日咳联合疫苗（Tdap）的接种率也有类似提高。然而，各县在接种率提高和临时入学率降低方面并不一致。2017/18学年费城的临时入学率（10.4%）没有大幅下降。全州临时入学率的下降表明，新规定实现了提高学年开始时已接种所需疫苗学生比例的目标，且疫苗豁免没有显著增加。然而，一些县的临时入学率持续居高不下，这表明在一些学校和地区实现这一目标还存在其他障碍。
