Department of Geography and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Center for Health Policy and Media Engagement, School of Nursing, George Washington University, Washington, DC, USA.
Public Health Rep. 2024 Jan-Feb;139(1):66-71. doi: 10.1177/00333549231156569. Epub 2023 Mar 16.
Before the 2017-2018 school year, Pennsylvania shortened the grace period for provisional entrants-kindergarteners who are not up-to-date on vaccination and do not have medical or nonmedical exemption-from 8 months to 5 days. We analyzed the impact of this change on school-entry vaccination status.
Using data from the Pennsylvania Department of Health for school years 2015-2016 through 2018-2019, we examined state-level trends in Pennsylvania kindergarteners' vaccination status, including the percentage who were up-to-date on each required vaccine, provisionally enrolled, medically exempted from vaccination, and nonmedically exempted from vaccination. Using the Spearman correlation coefficient, we assessed associations at the school level among changes in kindergarteners' vaccination status after the grace period was shortened.
From 2016-2017 to 2017-2018, the provisional entrance rate of kindergarteners in Pennsylvania decreased substantially after the change in the grace period (from 8.1% to 2.2%), the medical exemption rate remained stable, and the nonmedical exemption rate increased slightly (from 1.8% to 2.5%). The percentage of kindergarteners up-to-date on required vaccines increased or remained stable across the study period except for polio, which decreased from 97.9% in 2015-2016 to 96.2% in 2018-2019. The change in provisional entrance rate was negatively associated with change in kindergarteners up-to-date on required vaccines (ρ range, -0.30 to -0.70) but not with change in medical or nonmedical exemptions (ρ range, -0.01 to -0.08).
Efforts to reduce provisional entrants may increase the percentage of kindergarteners up-to-date on vaccinations at school entry without a corresponding increase in exemptions.
在 2017-2018 学年之前，宾夕法尼亚州将临时入学（即未及时接种疫苗且无医学或非医学豁免的幼儿园新生）的宽限期从 8 个月缩短至 5 天。我们分析了这一变化对入学接种疫苗状况的影响。
利用宾夕法尼亚州卫生部门 2015-2016 学年至 2018-2019 学年的数据，我们考察了宾夕法尼亚州幼儿园儿童疫苗接种状况的州级趋势，包括及时接种每种规定疫苗、临时注册、因医学原因免接种疫苗和因非医学原因免接种疫苗的儿童比例。我们采用斯皮尔曼相关系数评估了宽限期缩短后幼儿园儿童疫苗接种状况变化在学校层面的关联。
自 2016-2017 学年至 2017-2018 学年，宽限期改变后，宾夕法尼亚州临时入学率大幅下降（从 8.1%降至 2.2%），医学豁免率保持稳定，非医学豁免率略有增加（从 1.8%增至 2.5%）。除脊髓灰质炎疫苗外，各研究期间，要求接种疫苗的幼儿园儿童及时接种率均增加或保持稳定，脊髓灰质炎疫苗接种率从 2015-2016 学年的 97.9%降至 2018-2019 学年的 96.2%。临时入学率的变化与要求接种疫苗的幼儿园儿童及时接种率的变化呈负相关（ρ 值范围为-0.30 至-0.70），但与医学或非医学豁免的变化无关（ρ 值范围为-0.01 至-0.08）。
减少临时入学人数的努力可能会增加入学时及时接种疫苗的幼儿园儿童比例，而不会相应增加豁免人数。
