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BACKGROUND: Unvaccinated or non-immune students training to become healthcare personnel (HCP) are at risk of acquiring or transmitting vaccine-preventable diseases when they undertake practical training components involving patient contact. This study aimed to characterize allied health schools by their immunization policies for acceptable forms of evidence of immunity, exemptions permitted, and immunization tracking methods.
METHODS: Data were collected between September 2011 and April 2012 using an internet-based survey emailed to a staff member deemed most appropriate at accredited schools of allied health. Surveyed schools were identified through accrediting associations for each type of program; for programs with ≥300 schools a simple random sample of schools was drawn for survey distribution. Analysis was limited to those schools requiring ≥1 vaccines recommended by the Advisory Committee on Immunization Practices (ACIP); vaccines examined were MMR, hepatitis B, varicella, pertussis, and influenza. For each vaccine, reported acceptable forms of evidence of immunity were evaluated to determine consistency with ACIP recommendations. Weighted bivariate frequencies were generated using SAS 9.3.
RESULTS: Of the 2775 schools surveyed, there was a 74.8% response rate; of responding schools, 93.3% (1947) required ≥1ACIP -recommended vaccinations. The proportion of schools accepting ≥1 non-ACIP recommended forms of evidence of immunity varied by vaccine: 9.2% for MMR, 18.2% for varicella, 21.8% for hepatitis B, 42.0% for pertussis, and 36.5% for influenza. The most common non-ACIP recommended forms of evidence accepted by schools varied for each vaccine: non-verified disease history for MMR (5.9%) and varicella (13.2%); provider-verified disease history for hepatitis B (18.6%); laboratory evidence for pertussis (35.1%) and influenza (29.1%). Among schools with ≥1 vaccination requirements, medical exemptions were permitted for ≥1 vaccine by 74.7% of schools, 54% permitted religious exemptions, 34.8% permitted personal belief exemptions, and 58.0% permitted any nonmedical exemption. Common methods for tracking vaccination compliance were by paper medical records (48.7%) and academic/personal files (42.3%).
CONCLUSIONS: Many schools accept non-ACIP-recommended forms of evidence of immunity which could lead some students to believe they are protected from vaccine preventable diseases when they may be susceptible. Additional efforts are needed to better educate school policy officials about current ACIP recommendations for acceptable forms of evidence of immunity so that school policies can be revised as needed.