School-Entry Vaccine Policies: States' Responses To Federal Recommendations Varied From Swift To Substantially Delayed.

School-entry immunization requirements are a valuable strategy to reduce the spread of vaccine-preventable diseases. This research examined the temporal relationship between recommendations issued by the federal Advisory Committee on Immunization Practices (ACIP) and corresponding school-entry requirements adopted by states for adolescent meningococcal ACWY (MenACWY) and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines. A legal epidemiological review of statutes, regulations, and state agency guidance identified school-entry policies across fifty states and Washington, D.C. Researchers measured the number of months between the date of an ACIP recommendation and the effective dates for state policies that were in place through the 2023-24 school year. All fifty-one jurisdictions had school-entry requirement policies for Tdap vaccination, and thirty-six had school-entry requirements for MenACWY vaccination. The average period between ACIP's recommendations and state policy adoption was 4.94, 9.61, and 8.24 years for Tdap and for MenACWY first and booster doses, respectively. This analysis found diverse timelines and notable delays for both Tdap and MenACWY school-entry requirement policies. This heterogeneity and patchwork of state requirements underscores the need for ACIP to evaluate the role of these policies in reducing vaccine-preventable diseases across the United States.