The school entry requirement is the cornerstone of the U.S vaccination policies. The program decrees that all students without medical contraindications to be vaccinated against certain diseases before school admittance. Vaccine requirements vary from each state and apply only to schools receiving state or local funding – although most parochial and private schools have their vaccine requirements as well. The current public-private divide being experienced in California is an exception to this; the state passed a relatively recent school entry vaccination requirement applies to all private and public schools mandating those unvaccinated children without an acceptable exemption to be homeschooled (Feemster, 2017).
For schools with entry vaccination requirements, parents must provide immunization records that document the receipt of the required vaccine by a certain date at the beginning of school years or submit exemption notes. Failure to submit an exemption note, an unvaccinated child will not be permitted to continue schooling in the particular school (Allender, Rector, & Warner, 2013). However, enforcement of these requirements varies by schools; similar, whereas the immunization records must be reported to the state by stipulated dates, whatever happens to under-immunized children without exempt notes is solely at the discretion of these schools.
Importantly, school entry requirements are not in any way similar to fully compulsory vaccinations. It is only a condition of student attendance at a publicly funded school. Besides, it is not an absolute requirement as there are opportunities for opting out or choosing non-public schools without similar conditions.
The requirements on school entry immunization are meant to minimize the incidences of vaccine-preventable diseases among school-aged children whom by their proximities, are at a particular risk of exposure in the settings of a school. From the perspectives of public health policy programs, school entry immunization requirements are one of the effective ways of promoting high immunization levels among the community, termed herd immunity (Feemster, 2017). The requirements of immunization vaccines during school entry also prompts immunization programs to ensure the access of all required vaccines to all children, in turn promoting equity immunization rates. These policies positively shape the perspectives on vaccination: the required vaccinations are perceived as more important than the lesser required ones in turn potentially receiving stronger recommendations from providers. Additionally, as disease prevention is the norm, school entry immunization for children requirements make vaccination a default from which parents can opt out.
The United States, interestingly, is one of the only few countries that require vaccination for school entry. Other nations may prevent unvaccinated students from attending schools during times of an outbreak or deliver vaccinations in schools, but they do not have specific policies requiring vaccinations for school attendances. Thus, on Friday next week, a free sample school entry immunization for hepatitis B will be carried out School A from 8:00 am. During the event, major announcements on State policy changes on immunization requirements and progress made will also be made. All parents are invited to attend.
Funding and Partnerships
Ensuring that all school going children access the recommended vaccines regardless of their income level or health insurance status is a prerequisite for complex financing encompassing private and public funding mechanisms. In 2013, the public sector contributed 53% of the US children vaccination funding with the remaining 47% being funded by the private sector (Long, Prober, & Fischer, 2017). The 1994 enactment of the VFC (Vaccines for Children) program under the Social Security Act funds most of the public purchase of vaccines (58). Other sources of government funding include the discretionary purchase of vaccines through the discretionary Immunization Program as authorized under Section 317 of the Public Health Service Act of 1962 and funding from state and local governments (58). All these funding programs support state/local governments in the provisions of serial immunization to children non-qualifying for the VFC and those non-private insurance covered (Table 1). By using both federal and state funding, the program can easily purchase and distribute vaccinations and hire relevant personnel in public and private immunization provision centers.
The program will partner with various community organizations and relevant immunization agencies (including local immunization centers and other rural clinics) to increase its penetrance. High-level interventions such as peer incentives will be aimed at improving the return of vaccine consent forms. Community coalitions will also be formed. These coalitions will be aimed at the development of strategic alliances between key officials and higher ranking professional members with links to organizations and individuals in positions of power influence to help provide regular interactions with the state-run programs (Parvanta, 2017).
