School Reports  |  Immunization Index  |  Data and Statistics

School Immunization Validation Survey

Results of the 2001-2002

School Validation

Indiana State Department of Health

Gregory A. Wilson, M.D., State Health CommissionerMichael Hurst, J.D., Deputy State Health Commissioner

Public Health Services Commission

Immunization Program

Primary Author

Sandra Beck, M.P.H., Epidemiologist

Immunization Program

Indiana State Department of Health

2 North Meridian

Indianapolis, IN  46204

Published: 08/2002
2001-2002 School Immunization Report Validation Survey

Preface

Each year, according to Indiana Code 20-8.1-7-11, all schools in Indiana are required to self-report immunization coverage levels of their kindergarten, first grade, second grade, sixth grade, and newly enrolled students to the immunization program at the Indiana State Department of Health (ISDH).  In order to verify the accuracy of the reports sent to ISDH, the immunization program annually conducts a validation survey on a random sample of schools. The results of the school validation survey for the 2001-2002 school year are found in this report.

Methods

A random sample of schools was selected from the 2,596 schools listed in the 2001-2002 school immunization assessment. This sampling was conducted according to procedures developed by the Assessment Branch of the National Immunization Program at CDC. Factors involved in this sampling include: total number of students, approximate immunization coverage levels, and acceptable level of error in sampling. Using this methodology, a total of 96 schools were selected for validation. Of these, 34 were selected for a validation of their kindergarten immunization report and 40 for a validation of their sixth grade immunization report (two schools were selected to receive both).  Validations for the first grade were completed at 24 schools using the standardized random selection.

ISDH immunization field representatives reviewed records for the up-to-date or exemption status of students in the selected grade levels at each of the 96 schools chosen to receive a validation. Complete immunization levels for each grade level were then calculated and compared with the school’s reported immunization coverage levels for the 2001-2002 school assessment. In order to determine overall coverage levels for each school, grade-level validation findings were combined at those schools where more than one grade was validated.

Results

The Indiana State Department of Health validated 96 schools from the 2001-2002 annual school immunization assessment. Table 1 shows a summary of kindergarten, first grade, and sixth grade immunization completion levels from the 1995-1996 through 2001-2002 school years. First grade information was not collected until the 1999-2000 school year due to new school immunization requirements.

Table 1. Percent of kindergarten, first grade, and sixth grade students with complete immunizations, 1995-96 to 2001-2002 school years, annual school immunization assessments, Indiana.

*For the 1999-2000 school year, Indiana implemented new school requirements, which affected kindergarten and first grade students.  First grade immunization rated began to be collected with the new requirements.

Figure 1: Percent change in overall completion levels at time of validation compared with school assessment reports, 2001-2002 Indiana school immunization validation survey. (N = 96 schools)

Table 2: Summary results of the 2001-2002  school immunization report validation survey, Indiana (N = 96 schools)*

*Standardized sampling techniques were followed for reviewing records at schools with >100 enrolled students.

Figure 2: Mean immunization completion levels, by grade level, 2001-2002 school assessment reports and validation surveys, Indiana. (N= 96 schools)

Recommendations and Conclusions

• Validation of self-reported immunization coverage levels among a statistically significant sample of schools is an important role of the ISDH immunization program. Schools have consistently reported high immunization coverage levels in recent years, and validating these reports is an essential means of ensuring that the quality of reporting is maintained.

• Overall, the difference between the school report and validation survey was minute.  More than half of the schools validated showed a difference between the school immunization assessment and school validation of less than (±)2 percent.

• The results of the report found 36.5% (35 out of 96) of the schools randomly selected showed a decrease in their coverage levels between the time of the self-report and the validation survey.  This percentage is significantly lower than the previous year.  However, this highlights the fact that not all schools are strictly adhering to state school immunization policies.

• Schools must track students’ immunization status early in the school year in order to limit the potential spread of vaccine-preventable disease among susceptible students.

• Schools and parents need to ensure that students missing immunizations receive the proper vaccinations to bring them up-to-date on their immunization requirements.

• All schools must implement and strictly enforce immunization policies to prevent the outbreak of vaccine-preventable diseases among their student populations. Failure to do so not only violates state law, but also unnecessarily places susceptible students at risk for contracting an otherwise preventable disease.

Data in this report was collected from validation surveys conducted by ISDH immunization field representatives at a sample of 96 schools throughout Indiana